Why I don’t encourage my patients to report sexual assault

Ed. note: This post was originally published on the Community site. It is by Lily Divino.

Campus sexual assault rightly gets a lot of press. It’s an important topic: a horrific amount of women are victimized while in school (the most recent study puts the number at one in four).

But sexual violence is not confined to ivy-covered walls. Young women and men are victimized every day, throughout the country—in high schools and apartments, parks and parties, and in every neighborhood in every borough of my city of New York.

I am a social worker and rape crisis coordinator at the Mount Sinai Adolescent Health Center, which means that I work with teen and adolescent survivors of sexual assault. In the immediate aftermath, I’ll accompany my patients to the emergency room, where they are given treatment for common STIs, HIV prophylactics, and emergency contraception as part of a forensic rape exam. I coordinate follow-up medical care, crisis counselling, and legal advocacy for our patients, as well as longer-term counselling, if they want it.

I also help my patients decide whether to report their assault to the police—and more often than not, reporting is not my main objective.

I know this sounds counter-intuitive. If I care about reducing sexual violence, don’t I want to see rapists prosecuted and punished? I do. But the well-being of my adolescent patients is my number one priority—and in many cases, reporting their assault to the police risks damaging their mental health.

It is extremely emotionally difficult to press charges in a rape case.  The victim will have to recount the details of her assault over and over again. She’ll be questioned on the veracity of her memory, and she risks opening herself up to public criticisms of her clothing, alcohol consumption, drug use, and prior sexual behavior. This can be traumatizing in and of itself. If the victim was raped by her boyfriend or intimate partner, she risks isolation and even danger from reporting.

Reporting is particularly difficult for teens. If the assailant is a fellow student, reporting the assault can have vicious and damaging social consequences. The survivor may fear physical, social, or emotional retaliation. Sometimes, the circumstances surrounding the assault involve underage drinking, or staying out past curfew. Since the victim has disobeyed her or his parents’ rules, my patients might blame themselves for their victimization, or they might be scared of punishment if they report. In addition, many of my patients lack a network of supportive adults who can help them through the process of healing from, much less reporting a rape.

If a patient makes the deeply personal decision to report her assault, she can’t expect their rapist to be convicted. Only one-fifth of rapes reported to the police lead to an arrest, and the rapist is convicted just six percent of the time. For many of my patients, the ordeal and trauma of reporting their rape is not worth the very small chance that they will find justice.

The most important thing is to help my patients heal. Sexual violence is associated with depression, anxiety, substance abuse, and academic problems. Some of my patients are suffering from PTSD. It is my job to provide support, as well as individual, group, and family therapy, to help teens who have been victims of assault become healthy, confident, and whole.

I would love to see rapists prosecuted for their crimes, but what’s more important to me is supporting teen survivors. When reporting will only increase the stress, isolation, and trauma of many patients, instead of focusing on punishing the perpetrator, I work on healing the victim.

Lily Divino, LCSW, MPH, is a Licensed Clinical Social Worker and the Rape Crisis Coordinator at the Center. She specializes in sexual violence, domestic violence, teen relationship abuse, adolescent health and mental health, Asian Pacific Islander health and mental health, and cultural competency.

New York, NY

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year.

The Mt Sinai Adolescent Health Center is a free, confidential, comprehensive adolescent healthcare program in NYC, ages 10-22.

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