Coordinated sexual assault response teams or programs are generally designed to ensure that victims are provided with a broad range of necessary care and services (legal, medical, social services) and to increase the likelihood that the assault can be successfully prosecuted. Often, such programs or teams include a forensic examiner, a sexual assault advocate, a prosecutor, and a law enforcement officer. All responding actors follow specific protocols that set out their responsibilities in treating and providing services to victims of sexual assault.
Different countries have approached multi-disciplinary coordination efforts in different ways. As the then Special Rapporteur noted in her 2003 report, some jurisdictions have created "one-stop" crisis centers that "provide 24-hour services, including legal, medical and psychological counselling services." These centers might be attached to a hospital or police station, or may be independent. The former Special Rapporteur explains that such centers often "support the victim through every step of the criminal justice process. These groups, working in partnership with the police, ensure that the rape trial is not the terrible, isolating ordeal that it once was. In addition, because of this support more women are willing to come forward, give evidence and work with the police and the prosecutors in their search for a rape conviction." From 2003 Report of the Special Rapporteur on Violence Against Women, Developments in the area of violence against women (1994-2002) (E/CN.4/2003/75 and Corr.1) 45 (6 January 2003).
In the United States, such teams are called Sexual Assault Response Teams (SARTs). The response of a SART is activated Response by the SART is activated wherever a sexual assault victim comes into contact with the system:
Wherever the survivor enters the system — a police station, an emergency department or by calling a sexual assault program's crisis line — the SART can be activated. A SART has the potential to provide a greater continuum of care for sexual assault survivors, increased quality of care for survivors, and a reduction of the secondary trauma survivors often experience as they move through the medical and judicial/law enforcement systems.
From The Response to Sexual Assault: Removing Barriers to Services and Justice: The Report of the Michigan Sexual Assault Systems Response Task Force 27 (2001).
In Malaysia, for example, a "One-Stop Crisis Centre" for battered women has been established in the emergency room of the Kuala Lumpur Hospital. It provided victims with a way to address their medical, legal, psychological and social problems at a single location. Since its establishment, it has expanded its services from domestic violence to also cover rape. Its creation has not only helped individual victims, but has also allowed advocates to identify areas in which improvement is needed, including sensitivity training for hospital staff and a lack of shelters for victims. In 1996, the government expanded the program all public hospitals in the country. From World Health Organization, First World Report on Violence and Health168 (2002). The procedures of the "One-Stop Crisis Centre" are described on pages 248-251 and 257 of the Compendium: Model Strategies and Practical Measures on the Elimination of Violence Against Women in the Field of Crime Prevention and Criminal Justice, International Centre for Criminal Law Reform and Criminal Justice Policy (March 1999).
Centralized sexual assault crisis centers have also been established in South Africa. The purpose of a center in Johannesburg was "to ensure that reporting of rape was less traumatic while offering social and psychological support." The center could take a victim's statement and provide an immediate medical examination, medical care and treatment, and counseling support. "The centre was staffed by trained female police officers twenty-four hours a day. Doctors who examine rape survivors are issued a protocol book produced by the centre which outlines the steps which doctors should take in conducting the examination." The center has since collapsed, however, in large part because "[i]nternal disagreements within the police resulted in insufficient personnel being available to staff the centre on a full-time basis." From Compendium: Model Strategies and Practical Measures on the Elimination of Violence Against Women in the Field of Crime Prevention and Criminal Justice, International Centre for Criminal Law Reform and Criminal Justice Policy 262-63 (March 1999). As the former Special Rapporteur has noted in discussing the creation of specialized women's police desks, when such specialized bodies are housed within state structures, they may be "marginalized . . . , underfunded, understaffed and suffer from low status within the criminal justice establishment." From 1997 Report of the Special Rapporteur on Violence Against Women, Alternative Approaches and Ways and Means Within the United Nations System for Improving the Effective Enjoyment of Human Rights and Fundamental Freedoms (E/CN.4/1997/47) (12 February 1997).
The Rape Treatment Center in San Francisco, a non-profit organization, for example, is another a comprehensive rape crisis unit. The Center provides twenty-four hour emergency medical care, evidence collection, crisis intervention, advocacy, court accompaniment, legal assistance, and psychotherapy services. The Center also conducts outreach and public education campaigns, trains police, media, mental health professionals and prosecutors, and consults with the government. From 1997 Report of the Special Rapporteur on Violence Against Women, Alternative Approaches and Ways and Means Within the United Nations System for Improving the Effective Enjoyment of Human Rights and Fundamental Freedoms (E/CN.4/1997/47) (12 February 1997).
As explained in the Alaska Statewide Protocols for Sexual Assault Response Teams, the goals of SART teams generally include the following:
From Alaska Statewide Protocols for Sexual Assault Response Teams.
The Alaska Protocols summarize the roles of three members of a SART team—the advocate, law enforcement officer and health care professional (often a SANE)—as follows:
1. Advocate: Advocates provide support to the victim, answer any questions the victim may have, and inform the victim of the process for the interview and examination. The advocate does not participate in the gathering of evidence, fact-finding, or the investigation of the assault. Rather, their focus is placed on insuring that the victim is supported throughout the process. As advocates often provide individual and group support for months and sometimes years to come, the initial bond that develops between advocate and victim is critical. Advocates do not provide an opinion on the merits of the case or participate in conducting the interview, and generally will not testify in court. 2. Law Enforcement: Law enforcement's role is to investigate and report the facts of the case. Law enforcement will be responsible for the immediate safety needs of the victim; interviewing the victim; investigation of the crime; identifying, arresting, and/or referring charges on the suspect; arranging for forensic examination of the suspect when necessary, writing a report, participating in court proceedings, and all other duties normally associated with investigative and law enforcement functions. 3. Health Care Professional: The health care professional's role is to provide the health care component of the SART. They perform the physical assessment of the sexual assault victim; collect, document, and preserve forensic evidence; provide information and referral to the victim on health care matters; document the examination in the medical record; and present expert testimony in court.
Although a law enforcement officer may become involved in case through the SART, the decision about whether an assault is "reported" to the police and whether, once the assault is reported, a complaint is made that would lead to a prosecution, should ideally remain with the victim. Victims should always be encouraged to see a doctor to address any health concerns; in addition, the victim might be informed about the option of having a forensic examination that would aid in a prosecution, should she decide to proceed with a complaint. This would leave the options open for the victim—she would not be required to decide immediately what course of action is best for her to pursue. Minnesota Coalition for Sexual Assault's (MCASA) Training Manual describes the legal system in Minnesota that allows victims a range of choices in deciding whether to report an assault. The Manual emphasizes that a victim should never be pressured to report the assault. It is the advocate's role to provide information about options. Only the victim herself can make the decision about whether to report. MCASA's Training Manual also provides additional information about the role of the advocate during medical examinations.
The SART model has taken different forms in different communities. As Ledray explains, some SARTs are composed of a team of individuals "who respond together to jointly interview the victim at the time of the sexual assault exam." Other SARTs are composed of individuals who "work independently on a day-to-day basis but communicate with each other regularly (possibly daily, and meet weekly or monthly) to discuss mutual cases and solve mutual problems thus making the system function more smoothly." From Linda E. Ledray, Sexual Assault Nurse Examiner (SANE), Office for Victims of Crime (July 1999), available in PDF and HTML formats.
In 2008 the United Nations Division for the Advancement of Women released recommendations on protection, support, and assitance to suvivors of sexual assault in its expert group report entitled "Good practices in legislation on violence against women" in Section 6. For the Russian version of the report recommendations, click here.
Whatever model is chosen, all actors within the community should ensure that they are working from the same theory of sexual assault. Prior to implementing a coordinated response, "[s]exual assault programs and the systems and individuals in their community should work together to define the roles, duties, and responsibilities of the criminal justice system, the medical system, victim advocates, and other professionals in responding to sexual assault." It can be helpful to put the agreements reached about each actor's role, duties and responsibilities in writing. From The Response to Sexual Assault: Removing Barriers to Services and Justice: The Report of the Michigan Sexual Assault Systems Response Task Force 30 (2001).
A coordinated and victim-centered response not only results in more effective service provision and evidence collection, but also help increase the likelihood that survivors will proceed with a complaint. "If survivors of sexual assault experience a more compassionate and collaborative response, they may be more likely to want to make a police report and participate in prosecution." From The Response to Sexual Assault: Removing Barriers to Services and Justice: The Report of the Michigan Sexual Assault Systems Response Task Force 27 (2001).
While there are many benefits that accompany the coordinated response of a SART, there are also disadvantages, particularly in terms of the protocols regarding interviewing and reporting. For example, a victim who is uncertain about whether to report an assault to the police
may feel pressured to report when protocol requires law enforcement personnel to interview the victim before the SANE becomes involves. The advocate will support the victim in whatever decision she makes, even if the decision is not to prosecute. If the victim decides not to report, this also may result in a victim who cannot access health care for STD and pregnancy risk evaluation and prevention. . . . . In addition, while repetition of the account of the sexual assault is certainly an unpleasant experience that most victims want to avoid, the assumption that they will be better off if they do not have to do so is only a presumption. Research of treatment efficacy has in fact shown that repetition of the account of the assault in detail has a beneficial, desensitizing, healing effect.
From Linda E. Ledray, Sexual Assault Nurse Examiner (SANE), Office for Victims of Crime (July 1999), available in PDF and HTML formats.
A number of protocols for SARTs are included in the Sexual Assault: Law and Policy section of this website. More information about assessing the feasibility of starting a SANE program (including identifying and overcoming obstacles that have been encountered by other programs), how to start a SANE program, funding issues, certification procedures for SANEs, operating models, and a host of other issues can be found it the Office for Victims of Crime publication, Sexual Assault Nurse Examiner (SANE), available in PDF and HTML formats.
For a collection of research and reports on Sexual Assault Response Teams, click here.