Transcript Meeting the Clinical Service Needs of NYC’s Sexual

Meeting the Clinical Service Needs of NYC’s
Sexual Violence Survivors
The Critical Importance of a
Resource Guide
Debi Fry, MA MPH, Research Director
Tamara Pollak, RN MPH, Training and Ed Director
NYC Alliance Against Sexual Assault
The Alliance:
Who We Are & What We Do
The Alliance was founded in 1999 as a
coordinating agency to facilitate a network
of support and share knowledge on behalf
of the professionals who care for victims of
sexual assault throughout New York City.
The Alliance:
Who We Are & What We Do
The Alliance was founded in 1998 as a
coordinating agency to facilitate a network
of support and share knowledge on behalf
of the professionals who care for victims of
sexual assault throughout New York City.
• RESEARCH
• TRAINING & ED
• ADVOCACY
•DETECTION
•INTERVENTION
&
•PREVENTION
throughout lifespan
The Alliance Resource Guide
 Published in Fall, 2000
 At that time goal was to provide a complete
and comprehensive listing of specialized
programs within the city.
 Criteria for inclusion
 Specialized funding to provide direct service
to New Yorkers affected by sexual violence OR
 Ongoing agency commitment to training &
supervision in sexual violence issues.
Successes & Shortcomings
of Resource Guide
 Successes
 Widely distributed to and utilized by hotlines
and allied multi-sector service providers
 Accessed frequently by web audience
 Shortcomings
 Criteria for inclusion vs. definition of services
 Are you really a rape crisis program?
 Ignores services at community based mental
health centers
 Important access point?
Successes & Shortcomings
of Resource Guide
 Shortcomings
You’ll hear more
About this in the
next presentation
 Criteria for inclusion vs. definition of services
 Are you really a rape crisis program?
 Ignores services at community based mental
health centers
We suspect it is…
& that we should
 Important access point?
consider this when
updating guide…
More on this now.
What is the role of Community Based
Mental Health Services?
 Consider the capacity of rape crisis
centers
 Consider the perceived function of rape
crisis centers by the public
 Consider the mental health outcomes
that accompany a history of sexual
violence or partner violence
 Consider the capacity of CBMHS both in
terms of numbers & in terms of where
survivors access services & why …
Capacity of Rape Crisis Services
 Number of active cases seen by NYSDOHfunded Rape Crisis Programs in NYC on a given
day
 1,918 active cases
 (on 6-30-05 snapshot data;
NYSDOH Bureau of Women’s Health
)
 Number of people thought to experience sexual
violence in NYC in a given year
22,000 women and nearly 7,000 men will
experience attempted or completed rape
 Tjaden, P. & Thoennes, N. (2006). Extent, nature, and consequences of
rape victimization: Findings from the National Violence Against Women
Survey. National Institute of Justice.
Perceived function of rape crisis
centers by the public
 Not well studied
 Few studies ask survivors what services they need or
where they want to get services.
 Misperceptions of RCP services?
 “Urban participants indicated that even if women are
aware of specific services, they often have
misperceptions about what these services offer. For
example, one participant suggested that organizations
with names that include the words trauma or crisis
conveyed the message that only women with an urgent
need immediately following a rape should use those
services.”
Logan TK et. al. Barriers to Services for Rural and Urban Survivors of Rape JOURNAL OF
INTERPERSONAL VIOLENCE, Vol. 20 No. 5, May 2005591-616
Consider mental health outcomes
of sexual violence / IPV
MENTAL HEALTH OUTCOMES
Peri-traumatic stress response
Post-traumatic stress
Depression
Anxiety
Phobias/panic disorder
Eating disorder
Sexual dysfunction
Low self-esteem
Substance abuse
Assumption:
Many
access
CBMHS,
butanot
explicitly
And if these pts
aresurvivors
never asked
explicitly
about
history
of
for services
related
to the
violence they have experienced …
violence,
it may
never
be addressed.
Fact Sheet of the Program on Women, Health & Development, Pan American Health
Organization, accessed September, 2004 from
http://www.paho.org/English/DPM/GPP/GH/VAW2003.pdf
Consider mental health comorbities
HEIGHTENED RISK OF SEXUAL / IPV AMONGST MENTALLY ILL
•“Goodman et al. published a
review of studies of victimization
of women with “serious mental
illness.:
• “A large proportion of women
with a serious mental disorder
are victimized repeatedly in the
course of their lives.” ..
•Hiday et. Al: 331 individuals with
severe psychiatric disorders were
questioned about victimization in the
4-month period immediately preceding
their psychiatric hospitalization.
• 8.2 % experienced assault,
rape, or mugging a rate 2.7 times
higher than the annual rate of
violent criminal victimization in
the United States.
Goodman LA, Rosenberg SD, Mueser KT, Drake RE. Physical and sexual assault history in women
with serious mental illness: prevalence, correlates, treatment, and future research directions.
Schizophrenia Bulletin 23:685–696, 1997.
Hiday VA, Swartz MS, Swanson JW, Borum R, Wagner HR. Criminal victimization of persons with
severe mental illness. Psychiatric Services 50:62–68, 1999.
And capacity of community
based mental health centers …
•NYS Office of Mental Health Licensed
Outpatient programs, (removing child-only
services)
• About 400 adult / adolescent serving
programs in NYC
• ? ? Capacity to address sexual violence /
intimate partner violence??
• Training needs?
Which brings us back to our
resource guide …
 Goals for updated resource guide:
To comprehensively map the mental health
resources available in NYC for survivors of
sexual violence / IPV
 Update what we know about specialized programs
 Determine what services exist at community based
programs
 Determine gaps in services
 Determine training needs of professionals at
community based programs
Tonight’s presentations
1) Mapping the mental health resources available
in NYC for survivors of sexual violence / IPV
 New School piloted survey tool that Alliance hopes to
use to achieve this goal
2) Universal Screening … resources and beyond
o Panel Discussion: NYC is in a unique position to
initiate groundbreaking services and create and evidence
base for the efficacy of universal screening for SV/IPV
which is critically important because …
Remember these numbers?
 Number of active cases seen by NYSDOH-funded Rape
Crisis Programs in NYC on a given day
 1,918 active cases
 (on 6-30-05 snapshot data; NYSDOH Bureau of Women’s Health)
 Number of people thought to experience sexual
violence in NYC in a given year
22,000 women and nearly 7,000 men will
experience attempted or completed rape &
many will interface with health services
 (Tjaden, P. & Thoennes, N. (2006). Extent, nature, and consequences of rape victimization:
Findings from the National Violence Against Women Survey. National Institute of Justice.)
Impetus behind universal screening
 If we screen and treat effectively, we can help
mitigate negative health outcomes for thousands of
undetected survivors
 Benefits:
 save lives
 save money
 contribute to prevention (ultimate public health
goal)
 Tonight’s panel will consider questions about
how NYC can build a screening initiative on a
citywide level in the context of our discussion of
resource mapping and beyond.