Multi-disciplinary evaluation of sexual assault referral centres for better health (MESARCH)

FUNDER

The National Institute for Health Research

TEAM MEMBERS

Dr. Lorna O’Doherty (chief investigator), Prof Sarah Brown, Dr Emma Sleath, Prof Katherine Brown, Coventry University; Dr Louise Jackson, University of Birmingham; Prof Gene Feder, Prof Richard Morris, University of Bristol; Millicent Gant, Juniper Lodge SARC; Dianne Whitfield, Coventry Rape and Sexual Abuse Centre; Dr Rachel Caswell, University Hospitals Birmingham NHS Foundation Trust.

For further information or if you would like to check if your SARC might be eligible for participation, please contact Lorna O’Doherty by e-mail at: lorna.odoherty@coventry.ac.uk or mesarch@coventry.ac.uk or telephone at: +44 (0)24 7765 7470

PROJECT OVERVIEW

This research project will evaluate Sexual Assault Referral Centres (SARCs) across England in terms of benefits and costs to service users and survivors of sexual assault and rape. The project seeks to understand the work that SARCs do, and where their services sit within the broader context of supporting survivors of sexual violence. This study commenced in September 2018 and will run for just under 4 years. It is funded by the National Institute for Health Research (NIHR; 16/117/04) and was commissioned by the NIHR’s Health Services and Research Delivery Programme. Our work is being led by Coventry University in partnership with University of Bristol, University of Birmingham, University Hospitals Birmingham NHS Trust, Juniper Lodge SARC and several charity partners.

1 in 5 women and 1 in 25 men have experienced sexual assault since the age of 16, with 47,000 sexual offences against children annually.

Sexual violence has short- and long-term consequences for the wellbeing of survivors, both physical and mental. The negative effects can be seen across families and communities, affecting an individual’s capacity to work and participate in family and social life. Estimates suggest that child sexual abuse alone costs £182m in health spending annually, meaning that it is very costly to society in terms of lost work, health, police and legal costs.

A victim of a sexual crime may seek support from a SARC, by making contact themselves or being offered a referral by another person or organisation like a doctor, nurse or member of the police. However, the true impact of SARCs on users is largely unknown. The way things are done can vary from one centre to another, and it is not known what works best for different groups of people like men, LGBT service users, and people with particular vulnerabilities (e.g. those with disability, migrants, refugees and those seeking asylum, people affected by sexual exploitation, children and young people).

PROJECT OBJECTIVES

This project will take an in-depth look at the work of SARCs and how they affect people. Over four years, we will work with survivors, patients and members of the public, charities, SARC staff, and those who make decisions about services in different areas. Firstly, we will look at research already conducted to see what it says about supporting survivors, and use this in conjunction with our own findings to examine the benefits (and possible harms) for different user groups who access SARCs as part of putting forward recommendations and good practice guidelines for SARCs.

PROJECT IMPACT

We will build on currently available information about SARCs by developing a rich national ‘map’ of SARC services by interviewing SARC managers across England in conjunction with another research team led by Elizabeth Hughes from Leeds University. From this work, we will produce an infographic on key facts and figures, but we will also be able to provide mapping summaries that are confidential and tailored to individual SARCs. We will select 10 SARCs that give good representation of services across the country and undertake case studies. These will involve interviews with commissioning and SARC staff, service users and third sector providers to gain insights into how SARCs care for service users, as well as how they work with NHS services and charities that specialise in supporting survivors. This will add to our understanding of the content and mechanisms of SARCs, models and referral pathways.

In the next phase, following our pilot work, we will focus on outcomes and impacts from SARCs in a cohort study. With their permission, we will follow a large group of adults ≥18 years who attend SARCs collecting information over 2 years to understand the impact of different interventions and services on mental and sexual health, life quality and costs. As part of our embedded children and young people’s study – MESARCH-CYP, we will invite two pediatric SARCs and a small group of children and young people (aged 13-17 years) to be involved. Across the project, SARC staff and ISVAs will be asked (and funded) to play a key role in sharing with service users about the project. Following the index visit at the SARC, a SARC support worker/ISVA known to the service user will explain the project and request permission to pass their name and number to the team. We will get in touch and request consent from the person. Follow-up will be done on three occasions - at 6 months, 1 and 2 years. Each time, participants will be offered vouchers for their time. Methods will be tailored to suit diverse user groups.

Our approach is co-created with survivors of abuse and charities that support them to ensure our project will be conducted respectfully and ethically and will lead to relevant changes in practice and policy. The final phase of the project will focus on bringing every element together and involving collaboration across the research team, study steering committee, patient and public involvement group and our partners to co-produce ‘messages’ for maximum impact – that is, to reach those who commission SARCs, deliver day-to-day SARC services, those who work with SARCs, and those who use SARCs or could benefit from attending SARCs but experience social and other barriers.