Clinicians’ role in sexual harassment and sexual assault prevention

The following story includes discussions of sensitive topics like sexual harassment and sexual assault. VA acknowledges it may be difficult to engage with this content. It is our priority to make our stories educational where we can engage empathetically and thoughtfully.

Sexual Assault Awareness and Prevention Month (SAAPM) is dedicated to raising awareness about sexual violence while emphasizing that it takes a community effort to prevent it. Clinicians across the VA community play a unique role in supporting their patients affected by sexual violence while also actively contributing to prevention efforts.

Denise Boehm, chief nursing officer for Veterans Integrated Service Network (VISN) 4 has nearly 30 years of experience working with Veterans and understands how critical prevention work is to sustain a safe and inclusive community. She knows the key roles clinicians play in sexual assault and sexual harassment prevention and response.

Providing prevention education and awareness

Clinicians are in a unique position to educate their patients about healthy relationships, boundaries and consent. During appointments with a VA clinician, Veterans will receive an assessment for military sexual trauma (MST) and an assessment for intimate partner violence (IPV). This is an opportunity for clinicians to screen for indicators as well as educate their patients on these types of abuse.

Boehm says that recently some VA facilities, including several in her own VISN, have started incorporating an additional assessment into patient visits. This assessment helps clinicians determine if Veterans may be exposed to social risks. This social risk screening and referral program known as the Assessing Circumstances and Offering Resources for Needs (ACORN) aims to identify and address unmet social needs among all Veterans to improve health outcomes and advance health equity.

While the ACORN screening may not specifically identify the risk for sexual harassment or sexual assault, it can shed light on circumstances that may increase vulnerability or indicate a need for additional support.

Creating a safe environment for disclosure

Clinicians, like nurses, doctors and therapists, could be the first people that Veterans affected by sexual violence disclose to. These clinicians understand the importance of creating safe and non-judgmental spaces for those affected by sexual violence to share their experiences. Regardless of how a Veteran receives care, clinicians across every area of VA, from a nurse triaging a patient in the emergency department to a psychologist conducting a routine telehealth appointment, know how to create safe spaces.

“Our role in sexual violence prevention is rooted in everyday actions and genuine connections with the Veterans we serve,” says Boehm. “It’s about creating a safe space where open conversations happen.”

Recognizing signs and symptoms

VA clinicians are trained to identify signs and symptoms of trauma. Boehm notes that sometimes a sign that a Veteran is dealing with the aftermath of sexual assault or sexual harassment is small and emphasizes that VA clinicians are trained to spot the smaller signs, by “listening with all their senses.”

Maj. Bridget Flannery, South Dakota National Guard Sexual Harassment/Assault Response and Prevention master trainer, gives a few examples of how to identify if someone may have been sexually assaulted. Flannery states if you see one indicator that something is not the norm for a person, then stay vigilant and look for a second sign. Once a second indicator is observed, then ask the person if they have experienced sexual harassment or sexual assault and if they need help.

Some signs to look out for can include:

• Hypervigilance
• Isolation
• Relationship difficulties
• Exercising excessively

This is not an exhaustive list. There may be other signs which will vary for each individual depending on the situation.

Boehm says it is important to recognize when someone may be willing to share what happened but maybe not to you. “Everyone discloses in their own way and at their own pace. Being able to pick up on cues that a Veteran may be more comfortable speaking to someone else and finding a different clinician or survivor advocate can go a long way. It builds trust and can aid in their healing process.”

Empowering those affected

Veterans can confidentially report incidents of sexual assault or harassment that occur at VA facilities by calling 1-800-MyVA411 (1-800-698-2411) and selecting option 9. The call center is staffed to answer reports of this nature all day every day.

For more information about how you can reduce instances of harassment or sexual assault at the VA and create a more respectful, welcoming environment for all, visit the VHA Assault and Harassment Prevention Office.