Delaney-Rose Hunsdale
Guest writer from step above stigma
All too often the conversations surrounding sexual assault and mental health focus on the individual. What did the individual do to provoke the crime? What can individuals do to protect themselves from sexual assault? Why do some survivors face greater mental health challenges than others after an assault? While it is important to understand individual factors, the conversation should not stop there. As a fourth-year Health Studies student with a minor in Psychology at Queen’s University and an executive member of Step Above Stigma, I have come to learn the importance of looking beyond the individual when it comes to any health-related problem, including the mental health of sexual assault survivors. The socio-ecological approach is a theory in health promotion that offers a framework to think about the individual and their social connections, in addition to the context in which they live (organizations, communities, government, culture) to gain a deeper understanding of how to effectively create a lasting positive change [1]. Keeping this theory in mind, I argue that to truly support the mental health of a sexual assault survivor, one must look at all levels of influence on sexual assault survivors and subsequent mental health effects.
Am I saying it is bad or wrong to help an individual with their mental health following a sexual assault? No. What I am saying is that to create a lasting positive change, we also have to look at the role sexual assault survivors’ social networks, formal supports, interconnections amongst these formal supports, and policies can play in supporting or adversely affecting their mental health. Additionally, health promotion efforts that tend to only focus on the individual level can be associated with victim-blaming [2], a negative social response that can severely impact a sexual assault survivor’s mental health [3,4].
After a survivor discloses their sexual assault, negative social responses from friends, spouses and/or family are described as the second injury to sexual assault survivors [4]. Negative social responses from family and friends, such as victim-blaming, stigmatization, or brushing off the seriousness of the crime can be detrimental to the mental health of a sexual assault survivor [3,4], creating a greater likelihood of developing mental illnesses such as depression and PTSD [3]. This holds especially true when survivors believe before their disclosure that their social network would have shown a more positive or helpful response [4]. Knowing that friends and family are the most likely to receive a disclosure of sexual-violence from a sexual assault survivor, it is important to look beyond an individual to also support and educate their social networks on the impact their responses have on the mental health of sexual assault survivors [3,4]. This issue is especially pressing when trying to support the mental health of sexual assault survivors, considering this community reports receiving more negative responses than positive from their social networks after disclosing sexual assaults [3].
Nearly 25 years ago, literature reviews focused on supporting sexual assault survivors showed that survivors most often felt negative about their experience with formal supports. This includes police, physicians, crisis centre workers, counsellors, and so on [4]. Reports today show that now informal supports (social networks) are more likely than formal supports to be sources of negative experience for sexual assault survivors [3], yet I found it very difficult to find any concrete examples of specific activities, programs, or cultural shifts that created this change. I think this scarcity of information speaks to the uncomfortability people have with crimes of a sexual nature, or sexuality in general. It’s important to look at the formal supports a sexual assault survivor may access because a positive reaction from formal supports leads to less negative outcomes on a sexual assault survivor’s mental health [3]. Positive reactions can include believing and supporting the survivor in their choice whether or not to report the assault, and avoiding asking if the survivor did anything to provoke the crime [3,4]. To offer a hypothetical activity, a health promoter could design a program for formal supports to educate on positive reactions, and providing effective support. If such educational resources already exist, a health promoter could talk to the employer of formal supports and discuss the importance of this training [1]. Sometimes people need support beyond what their family and friends can provide, but ensuring sexual assault survivors are supported by quality care is critical to improving their mental health.
The community aspect of the socio-ecological model is all about creating connections between organizations, institutions, and the local community [1]. In relation to supporting the mental health of sexual assault survivors, working at the community level could mean working on improving interprofessional communication between counsellors, doctors, criminal justice networks, victim advocation services, and so on. When accessing multiple services concurrently, sexual assault survivors often are forced with reliving their assaults to inform formal supports on their situation. This is considered a negative response from formal supports, which as previously mentioned are detrimental to sexual assault survivors’ mental health [3]. Therefore, at this community level, working on initiatives to improve interprofessional communication could reduce the incidence of negative responses sexual assault survivors experience, and thus improve mental health [3].
The last level of the socio-ecological model focuses on policy [1]. Not just about government, this level maintains a broad focus, housing advocacy efforts for certain legislature, policy change, and funding and infrastructure requests [1]. Some examples of policy-level initiatives are international movements such as #MeToo and Time’s Up, which are advocacy groups that provide a space for voices to sexual assault survivors from various communities [3]. If there is a specific policy or law that may be viewed as adverse to or even harmful to sexual assault survivors’ mental health, advocating for change through letter writing, petition signing, peaceful protests, PSA or media campaigns, and so on, are all forms of supporting the mental health of sexual assault survivors at the policy level [1].
Through my writing, I hope I was able to highlight the importance of a multifaceted approach to supporting the mental health of sexual assault victims. Of course, I believe in the positive change that working with individuals can achieve, but that is not where the work should stop. Oftentimes, there are many barriers an individual faces that can only be seen when looking at the full picture. To begin the process of change much needed at the informal/interpersonal level [3], I would like to end this post by offering positive informal support to survivors of sexual assault, I believe you.
Sources
1. Lévesque L. Ecological Approach Ingredients. Kingston: Queen’s University; 2020.
2. Massd R. Ethical Dilemmas in Health Promotion Practice. In: Health Promotion in Canada. 3rd ed. Toronto: Canadian Scholars’ Press; 2012. p. 241–53.
3. Lonsway KA, Archambault J, Russo L. Improving Responses to Sexual Assault Disclosures : Both Informal and Formal Support Providers [Internet]. 2019. Available from: http://evaw.threegate.com/Library/DocumentLibraryHandler.ashx?id=1336
4. Ullman SE. Social support and recovery from sexual assault: A review. Aggress Violent Behav. 1999;4(3):343–58.
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