1. Ynys Saff: Providing a safe island for children and young people who have experienced sexual victimisation Amanda Robinson School of Social Sciences Roxanne Hammonds Manager, Ynys Saff Nel Richards ISVA, Ynys Saff Sexual Objectification, Sexual Exploitation and Sexual Abuse: Engaging with Research, Policy and Practice 30th April 2012

2. Overview Part 1 (Amanda Robinson) Policy context and development of services for victims of sexual violence in the UK –Child-focussed developments? –Characteristics of young Ynys Saff clients Part 2 (Ynys Saff) Practitioner perspectives on service delivery –Aims of the SARC –Supporting young clients Part 3 (all) Roundtable discussion –Case examples of young clients –Sexualisation and service provision

3. The Guardian (30/01/2012) "What staggers me is when I remind myself that it was only in 1991 that the law was changed to make rape within marriage an offence. When you look at that then the developments in rape are all relatively recent. Alison Saunders, head of the Crown Prosecution Service in London Discussion / attention to sexual violence = ADULT victims

4. Developments in service provision Historic neglect of sexual violence services –First Rape Crisis Centres (RCCs) in London and Glasgow (1976) Action Plan for Tackling Violence, 2008-11 –one SARC in each police force area by 2011 –ISVA support for all victims of sexual violence Stern Review (2010) –Further highlighted importance of ISVAs, SARCs HM Government (2011) Call to End Violence Against Women and Girls: Action Plan –Commitment to funding ISVAs, SARCs and RCCs What is a SARC? Sexual Assault Referral Centre What is an ISVA? Independent Sexual Violence Advisor

5. What is a SARC?

6. What is an ISVA?

7. CYPSVA?

8. Research on services for (young) victims of sexual violence NSPCC funded research Few services available: –less than one service per 10,000 children and young people –a shortfall of 88,544 spaces per year (assuming only 5% want to access service in any one year). Only a small proportion of these services are specialist post-sexual abuse services. Allnock et al. (2009) Sexual abuse and therapeutic services for children and young people

9. Research on services for victims of sexual violence Home Office funded research –35 sexual violence projects, including SARCs and Rape Crisis Centres –N=5989 cases from 2005-2007 30 cases involved infants <3 years old (<1%) 34 cases involved children aged 3-10 (<1%) 1406 cases involved young people 11-17 (24%) 4519 cases of adults aged >18 (75%) –Neither type of project supported very many children –SARCs more likely than RCCs to provide services to young people Robinson, A. (2009). INDEPENDENT SEXUAL VIOLENCE ADVISORS: A process evaluation.

10. Research on services: SARCs Kelly et al (2005), drawing on data from one SARC, reported a notable increase in the proportion of service users aged under 20. Figures from the Manchester SARC showed that the average age of service users was 23.5 years, while the most common age was 16 years (St Marys SARC, 2005). Figures from the 8 SARCs in the Robinson (2009) study found almost identical results (average age 24.5, most common age 17 years). 56% of referrals to SARCs less than 21 years old. London Safeguarding Children Board (2007) identified 4 centres specifically dealing with child sexual abuse, three of which were SARCs Are SARCs responding to the needs of young people who would be unlikely to contact services for children affected by sexual abuse?

11. Perspectives of practitioners N=76 interviews When asked about gaps in service provision, the vast majority of respondents immediately mentioned services for children and young people experiencing sexual violence. Robinson, A. (2009). INDEPENDENT SEXUAL VIOLENCE ADVISORS: A process evaluation.

12. Ynys Saff Sharing a broader view of the victim Contemplating their response to children and young people from the outset

13. Ynys Saff: supporting adults, young people, and children

17. Age distribution by gender Under 18s represent a greater proportion of cases for males vs females

18. Age distribution by gender Three years of complete data show that: 33% of male clients were children 25% of male clients were young people Under 18s represent a greater proportion of cases for males vs females

19. Age distribution by gender

20. Three years of complete data show that: 9% of female clients were children 28% of female clients were young people But both have similar proportions of young people

21. U18s only (n=602)

22. Male victims more likely to be children Female victims more likely to be young people

23. Other gender differences? Ethnicity –Similar for males and females (majority are white), except more diversity of female infants (10% black) Sexuality –LGBT clients more likely to be male (only 30 cases/ missing data) Disability –Children w/physical disabilities and more than one type of disability more likely to be female –Young people with psych/LD more likely to be male

24. Victim-offender relationship

25. U18s are more likely to be assaulted by people known to them (acquaintances, professionals, relatives)

26. Gender differences: Victim-offender relationship

27. Male children mostly assaulted by acquaintances or relatives

28. Gender differences: Victim-offender relationship Male young people mostly assaulted by acquaintances or strangers

29. Gender differences: Victim-offender relationship

30. Like males, female children mostly assaulted by acquaintances or relatives (but they are twice as likely to be assaulted by strangers)

31. Gender differences: Victim-offender relationship Like males, female young people mostly assaulted by acquaintances or strangers

32. Gender differences: Victim-offender relationship ….but they are twice as likely to be assaulted by relatives …. and they also are assaulted by ex/intimate partners

33. Vulnerability factors Yes/no items indicated whether clients were experiencing the following: –alcohol use –drug use –domestic violence –immigration status –history of sexual abuse –mental health issues –looked after/in the care system Additional details possible for the last two items

34. Vulnerability factors Alcohol use –15% of adults –4% of young people … higher rates for female young people Drug use –11% of adults –2% of young people … higher rates for female young people

35. Vulnerability factors History of sexual violence –7% of adults –12% of infants, 2% of children, 3% of young people … higher rates for females Mental health –35% of adults –14% of young people … higher rates for male young people –5% of children … higher rates for female children

36. Vulnerability factors Looked after –5% of adults –24% of infants, 16% of children … higher rates for males –13% of young people … higher rates for females

37. Conclusions Few services for children and young people experiencing sexual violence –SARCs going some way towards filling this gap Intersection of age and gender important for understanding client experiences and needs –Young female clients more vulnerable in terms of alcohol, drugs, history of SV, IPV –Young male clients vulnerable in terms of psychological disabilities/ mental health problems

38. Part 2: Practitioner Perspectives

39. Cardiff Sexual Assault Referral Centre For men, women and children who have experienced sexual violence

40. Background In 2006 strategic group formed to develop SARC in Cardiff Multi-agency approach –police, health, voluntary services Pooled funding streams –Home office, police, CSP, health Opened 2 nd October 2008 Overseen by Multi agency Executive Board

41. Aims To ensure the best possible care to minimise the risk of further harm and to promote recovery Facilitate the collection of high quality forensic evidence and interviews Address the issue of variable co-ordination between agencies that can be detrimental to the client and/or criminal proceedings Collect intelligence which may be of benefit in the prevention of further sexual assaults

42. Guiding Principles of Ynys Saff The physical and emotional welfare of the client/victim is paramount All client/victims will be treated with respect and dignity Each client/victim will be viewed and assessed as an individual and treated in a holistic manner The collection of trace or corroborative evidence will not take precedence over the client/victims wishes and need for medical treatment

43. Ynys Saff Team SARC Manager Clinical Lead (Adults) Clinical Lead (Paeds) Crisis Workers ISVA CYPSVA Police CPS Voluntary Sector FMEs Paediatric Team Counselling Team

44. Services offered at Ynys Saff 24/7 Police referral with forensic examination Police referral without forensic examination Mon – Fri, 9am – 5pm Self referral with forensic examination Sharing intelligence Support and advocacy

45. On arrival at Ynys Saff Dedicated parking Crisis worker will meet you Crisis worker will focus on supporting client/victim Police can concentrate on co-ordinating investigation/briefing FME Team approach to addressing immediate needs of victim/client

46. The waiting room Forensically sealed Comfortable space for discussion/consent prior to exam Space for friends/relative to wait

47. The Role of the Crisis Worker To provide support at the point of crisis (during examination and interview) To inform the client of the process and ensure they are making an informed choice To liaise with the police and FME on behalf of the client if they so wish To gain consent for follow up support/contact To forensically clean the SARC after use

48. The staff room Tea/coffee/snacks Shower Space for brief/debrief

49. The medical examination room Forensically sealed Fully equipped Colposcope EHC Antibiotics

50. Following the examination Shower and clothes Consent to follow up support from ISVA Arrange interview Ensure client is taken to a safe place

51. The interview room 3 interview rooms Fully equipped with rotating cameras, full room camera and built in microphones provides high quality DVD interviews

52. The monitoring room Fully equipped monitoring room Easy to use equipment Possible to do more than 1 interview at a time

53. Counselling Service Counselling / play therapy services for adults, Children and Young people. Specialist counselling using evidence based therapeutic interventions service for clients of the SARC Short term focused work with referral in to long term counselling services if required i.e. NSPCC, PTSD clinic

54. Paediatric Service Forensic examination for children and young people who have been raped or sexually assaulted 24/7 if within forensic window Joint examination for all children under 13 Young people aged 13-15 are discussed with a paediatrician

55. Paediatric Clinic Historical cases of sexual abuse Sexual health screening for children Referral to GUM for STI screening for adolescents General assessment of health needs

56. Referrals Police, Third party, self Referral by phone: 02920 335795 For non urgent queries or further information Contact: Roxanne.hammonds@wales.nhs.uk

57. ISVA service (adults) CYPSVA service (children/yp) Emotional and practical support for the client and family Criminal justice Accompaniment to court Facilitating and supporting pre-trial meetings Liaising with police Liaising with CPS Facilitating and supporting self referrals reporting to the police Multi-agency coordination Referring to and liaising with statutory health services i.e. community mental health teams, primary care, sexual health. Liaising, attending and referring to MARAC Liaising and referring to child protection teams Liaising and referring to POVA

58. Part 3: Roundtable discussion

59. Discussion Questions Case studies –Child victim –Teenage victim Questions to consider –What issues are present? –What would you do? –What challenges would you face in trying to help this child/young person?

60. Further Resources http://www.rapecrisis.org.uk/index.php http://www.homeoffice.gov.uk/crime/violence-against-women-girls/sexual-violence/ Dr Amanda Robinson RobinsonA@cardiff.ac.uk