Rape Survivors’ Experiences of Forensic Medical Examinations Sandy Brindley National Coordinator August 2016

Justice statistics for 2014-15 1,901 rapes and attempted rapes reported to the police 270 prosecutions 125 convictions (46.3%) conviction rate of cases which reach court

Key issues in the current response to sexual violence survivors Very patchy provision across Scotland in relation to meeting the immediate and short term needs of survivors Lack of joined up services, e.g. between forensics, support and sexual health Lack of access to female doctors for forensic examination

A Woman’s Story

For whoever is reading this for whatever reason, please set aside the notion that you know how you would respond in a situation like this. You might think you know, but you don’t! I honestly thought that if something like this should happen to me, I’d fight back. I tried. I said, “no, please don’t do this to me.” He verbally and physically abused me. He must have known that I stood no chance against a powerful man. My body took over, slowed down and froze. My body gave up and I was aware of wondering if he’d kill me when he’d finished raping me. He didn’t rape ‘only’ my body that night. Physical injuries heal. He raped my mind and spirit – it’ll never go away. My life now, and in the future, is different to the life I would have had if I hadn’t been raped. With hindsight, heaven forbid that if anything like this should happen again, I would not put myself through it. I would close the door on the police and legal process whilst accessing support to enable me to survive and move on with my life. Even with support I have felt suicidal and come close to ending my life.

Experiences of forensic examinations

From a woman's story CID Officers explained that there would need to be a forensic examination when the on-call forensic examiner (FE) arrived. I was not given any idea around how long that would be. I felt that I had to wait a long time for this. I do not recall being asked if I would prefer a female FE. When the FEs arrived, they were two men. The nature of the testing was explained to me. I was never asked if I felt ok with a second person attending. I did not feel in the frame of mind to object. I was asked to get on to the examination table. I was wearing a medical gown and no other clothing. I was feeling very apprehensive and vulnerable. I felt like a piece of meat, not a live human being who has just been through extreme trauma. I did not want any man anywhere near me and certainly not touching me. Because I wanted all this to be over, I didn’t feel able to voice this. I just wanted to scream at them.

From a woman's story (cont.) Clinical information was given to me but I felt no compassion, care or consideration for my feelings. I know all this has to be done, but everything is heightened when a person goes through such trauma. I experienced no evidence of the FEs having had training to understand the impacts of trauma and how to deal with people in a severe traumatic state. In order for someone to understand and empathise, there needs to be a level of expertise and training and also natural human compassion. I felt no evidence of this.

Another survivor's views “I got a shock when I turned up at the examination and it was a male doctor. I didn’t want the examination. At the start when I seen the man I just thought, ‘no, I can’t, I don’t want him anywhere near me. I just felt vulnerable… She (the police officer) told me that I didn’t have to go ahead with it.. but I may have to wait for a few hours for a female to be there, and so I decided that I was going to go ahead - I wanted it over and done with as quickly as possible… so I went ahead with it, and the man couldn’t have been nicer, he was an absolute gentleman and advised me all through what he was doing…But, I do think just for anybody going along to one of these things I think there should definitely be a same sex physician.”

Direct Referral & Feedback Protocol RCS / Police Scotland Direct Referral & Feedback Protocol

Did you have a forensic examination Did you have a forensic examination? If yes, was there anything that could have been done differently?

The caller would have preferred a female doctor and commented that if it had to be a male, one with some compassion and understanding would have helped. The caller did not feel anything could have been done differently; she said it was unpleasant but fine. The caller did not feel anything could have been done differently and said that the doctor was amazing.

Lack of joined up services

“So, I had been calling them and couldn’t get through and by the time I actually got through to them so many weeks had passed and I wasn’t able to get certain vaccinations that I should have got. But I was just told to come down to the clinic in St Johns - which I did - and that was a bit of a nightmare, sitting waiting in the waiting room. I don’t Mean that I’m any different from anybody else - we’re all there for the same kind of reasons, but I remember walking into the waiting room - the waiting room was full, and it was all just what I would class as wee boys. They were all very young males all just sitting laughing and joking and I just remember one of their mobile phones ringing, and the boy just saying down the phone to the caller that he was “at the clinic waiting to get checked oot”… and, I just felt absolutely awful. I just thought it was a horrible situation for anybody to be in. You’re already feeling pretty vulnerable after what you’ve been through….”

Archway – an (urban?) model for meeting survivors’ needs Scotland’s only Sexual Assault Referral Centre (SARC) ‘One stop shop’ – services all in one place and offered proactively (Previously) guaranteed access to female doctors Self- referral -provide access to medical examinations even where undecided about reporting to police Specialist training for all staff – gender sensitive services Established in 2007 as a ‘pilot’ for Scotland but has never been replicated

Produced in May 2013 by a short term National guidelines for the provision of forensic examinations following a sexual offence Produced in May 2013 by a short term working group comprising representatives from the Police, Scottish Government, NHS, Crown Office, Rape Crisis Scotland, Victim Support and SPA Forensic Services. The standards were approved by both the Cabinet Secretaries for Justice and Health. If implemented, they have the potential to make a huge difference.

Key aspects of the standards Provision of a coordinated service - access to support, advocacy, trauma care, clinical needs assessment and health care follow up, including sexual health Access to a forensic examiner of the gender of their choosing. Access to forensic examinations on a self referral basis Police stations should not be used for examinations FME’s and nurses must have undertaken specialised training – in trauma informed responses, as well as forensic procedures

Progress? Limited implementation of the standards to date Govt unable to implement provision in Victim & Witnesses (Scotland) Act relating to right to ask for a specific gender of examiner Some developments e.g funding for advocacy worker within every rape crisis centre in Scotland, discussions on establishing a self referral protocol for access to forensic examinations, in some areas of Scotland New Scottish Govt funded post within health to work with Boards to improve arrangements for forensic examinations Need for leadership nationally and locally to commit to implementing the standards

Make yourself aware of campaigns which highlight the myths surrounding rape, e.g. www.thisisnotaninvitationtorapeme.co.uk "In whatever contact you have with a ‘victim’, see that person first and foremost as a human being. Maintain professional standards but always treat her/him with the compassion, dignity and respect with which you would expect to be treated if you or a loved one was subjected to a deeply traumatic violation“ (A Woman’s Story, http://tinyurl.com/z5f34mx)