Sexual Assault Survivors, SANEs, and the Nonreport Option

By Sylvia Foley, AJN senior editor

Until recently, survivors of sexual assault had to make quick decisions about whether to report the assault to law enforcement. Those who chose not to report it weren’t entitled to a free medical forensic examination, and many felt further traumatized by this situation.

The Violence Against Women and Department of Justice Reauthorization Act of 2005 changed this. It added a “nonreport” option, which mandates that survivors be given medical forensic examinations even if they choose not to cooperate with law enforcement or the criminal justice system; states must pay for these medical examinations, regardless. In order to receive certain federal funds, states had to comply by 2009. States have responded in various ways. (Click the image above for an enlarged view of the steps followed in Texas.) But there has been little investigation into the impact of the new provision.

An important question. How has the nonreport option affected survivors, sexual assault nurse examiners (SANEs), and victim advocates? To learn more, Laurie Cook Heffron and colleagues conducted a study in Texas. They report on their findings in this month’s original research CE, “Giving Sexual Assault Survivors Time to Decide: An Exploration of the Use and Effects of the Nonreport Option.” The following abstract offers a quick overview.

Objectives: This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process.
Methods: A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data.
Results: The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified.
Conclusions: Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research is warranted. The authors also present recommendations to improve health care delivery.

Some findings:

• The nonreport option does appear to make it more likely that a survivor receives timely health care. As one respondent stated, the survivor can “go and do that first step and get the exam” without having to make a decision about reporting the crime.
• The nonreport option was helpful when survivors were worried about legal, familial, or social repercussions of reporting an assault, giving them more time.
• SANEs reported feeling that the nonreport option helped them better understand their role in sexual assault cases.

Various challenges were also identified. In closing, the authors stated that “