You are listening to Relationships Shouldn't Hurt, a podcast brought to you by Central Bedfordshire Council. During this series you'll be able to hear us talk all things domestic abuse and raise awareness of the support available to those affected. This episode could contain content which some listeners may find upsetting, distressing or triggering. Links to support services will be discussed throughout the episode and can be accessed at any time through the episode transcription or Get Help page on www.bedsdv.org.uk.
Nikki
Today we’re highlighting sexual health with experts, and their work with victims and survivors. My name is Nikki Harding. I'm the Domestic Abuse Engagement Officer for Central Beds. And I'm joined by my colleague.
Helen
Hi, my name's Helen Green. I'm the Domestic Abuse Specialist Officer for Central Bedfordshire Council.
Nikki
Today we're having a chat with two ladies, we've got Debbie Liverpool from the Emerald Centre SARC, and Claire Knight from the ISVA service.
Helen
I wanted to start this morning, Debbie, by asking you about the SARC and if you could describe to us what a SARC is please?
Debbie
So the SARC stands for Sexual Assault Referral Centre. It provides a one stop forensic service for individuals that experience sexual assault and rape. We offer free support and practical help to anyone in Bedfordshire or Luton and offer referrals to services that meet their health and psychological needs.
Helen
Thank you. And I understand your SARC is called the Emerald Centre, is that right?
Debbie
That's correct, yeah.
Helen
Thank you. And, Claire, can you please describe the role of an ISVA for us please?
Claire
An ISVA is an Independent Sexual Violence Advisor. We are a service that cover all of Bedfordshire, so Luton, Central Beds and Bedford Borough. We support clients through the criminal justice system, for example. But people don't have to be going through the police process or the court process to receive our support.
Nikki
If a person has experienced sexual abuse, how and where can they reach out to you? And do timeframes matter?
Claire
For the Independent Sexual Violence Advisors, we’re a little bit further down the line. So timeframes don't matter to us in that sense. We can accept referrals for people who have been recently assaulted or raped, or they've experienced childhood sexual abuse. So there is no, kind of, time frame on the amount of time that has passed. I know some people do believe if it's not recently, they can't get support from us, but they can do. A lot of self-referrals generally come in from those people that have experienced childhood sexual abuse.
Nikki
Thank you, Claire. And is that the same for you Debbie?
Debbie
No time frames do matter for us. In order for someone to access our service, there's two routes. So there’s either through the police or as a self-referral. If a person reports via the police, the police will do all the arranging and book the appointment for them. If they come as a self-referral, they make that referral themselves, so they either contact our service, the Emerald Centre directly, or go through our pathway and support service. Professionals can refer in as well, however if a professional does refer, we need to speak to the actual individual just to make sure consent is in place. And with regard to timeframe, yes, these do matter. In order for us, we have to collect forensic evidence. Or if someone suspects that they've been alcohol or drug spiked, there are time frames for urine and blood samples.
Helen
In respect of the ISVA service Claire, what are the options available to victims/survivors who come to your service?
Claire
The ISVA service provides practical and emotional support, so we're not therapists, but we can link people into trauma counselling if they want to do that. People don't have to talk to us in detail about what's happened to them because I think it puts people off sometimes having to repeat and it retraumatises people, especially if someone is going through the criminal justice system, we don't get into any evidential matters. Just so the ultimate goal for that would be for us to go to trial with them and support them at trial. So, we have to be really very careful about what evidence we know about. So if someone said to us, I've remembered something, we stop them at that point and we make contact with the OIC, the officer in the case, and make sure that they speak to them about what they've remembered. Often once the first report is done, lots of the other stuff comes up then. So if there is no criminal justice system, an investigation or process going, we can still support them. A lot of that support then is around wellbeing, and we can talk to them about grounding techniques and kind of helping them understand exactly what's happened to them and their response to what's happened to them, because a lot of our role is around reinforcing that it’s really normal to feel that way, or it’s really common to experience that, like flashbacks and nightmares and sleeping problems. So a lot of our job is talking, really talking to people and having them having that space to ask those questions that they don't really want to talk to family and friends about at times as well. And then obviously those referrals on, like Debbie said, the signposting and the referral and so on, so that person has that all round support that they need.
Helen
And in respect of the SARC, what would that look like if and when a victim/survivor contacts the Emerald Centre Debbie?
Debbie
The options that victim/survivor has for the Emerald Centre is that they can come into the police referral or a self-referral. With the self-referrals, they can attend any SARC that they feel comfortable to attend. With the police referrals they tend to be in the area that the crime took place. So slightly different for a self-referral. All individuals have autonomy throughout their appointment, so this means that they can engage with as much of the service as they wish to. At the Emerald Centre, all our nurses and support workers are females at the moment. There are male support workers throughout the organisation, but you know, this isn't something that's done nationally.
Nikki
Thanks, Debbie. And we talked a little bit about referrals anyway, but if you can just tell us how people are accessing your service, whether you see that as more self-referral or professionals, and do you think that there's any reluctance or barriers to that access?
Claire
The majority of our referrals come from either the SARC or police. We're trying to encourage other agencies to refer in as well, and then our self-referrals are slowly building as well. Majority, though SARC and police are coming through to us. One of us is based here every day at the SARC with Debbie and her team, so we've built up a really good relationship and we can have those chats about those cases as they come in if need be. Because I know the SARC get a lot of calls just in general, that maybe not be from the forensic side of things but for support so we have a lot of those conversations as well. So yeah, we're building up those good relationships with people. I think one of, like I mentioned earlier, is that people think if they're not going through the police process they can't get any support. And that's something that we really want to push that we can still support you even if you don't want to report to police or even if you've got questions about reporting, we can ask for that person and give them the advice. This is the process, we can come along with you. So it might be that they're just reluctant or that they just don't want to do it at all, which is really common, and if you see the statistics, you can see why people don't want to necessarily report to the police. But the good thing about the SARC is they can still get their tests done and have those in storage for if they do ever change their mind, which is a really good thing about a SARC.
Nikki
Thank you, Claire. And Debbie, you've obviously made it clear that there doesn't have to be police involvement, are there the same kind of barriers and reluctance that you find?
Debbie
Like Claire, most of our referrals are via the police. We do get referrals from other agencies, but the majority are police. For me, the reluctance, there is reluctance because obviously, you know, the patients suffered this traumatic experience, so they don't know what to expect, you know, who to talk to, are they going to have to repeat the story, so on and so forth. But like Claire says, we've got specialist staff who are there to support them through the process. Not knowing, you know, if you say to people ‘do you know what a SARC is?’ the majority of people will say no. So the sheer fact that people don't know what a SARC is, that's a barrier in itself. And the self-referral pathway was set up because of barriers. For one reason or another people decide, you know, that they don't want to go via a police route, so that was set up in order to sort of overcome that barrier and that people could still report and have the aftercare support and referrals made for ongoing support.
Helen
You spoke a little bit about statistics there, and some of us are quite interested in statistics, so I wondered if you could tell us how many victims/survivors do you see coming through who are reporting harm from their intimate partner relationships, whether that's a current partner or previous partner?
Debbie
I've got figures from 2020. So in 2020 we saw 72 victim/survivors come through the service. In 2021 the figures dropped, and we think that was due to lockdown, but we saw 46 individuals. This rose again in 2022 when 63 victims/survivors came through the service.
Helen
Ok, and in respect of the ISVA service Claire, what are your statistics for that?
Claire
My last full year was 2022, so in that whole year we had 568 referrals and 163 were DV related and 28.7% of those that came through to us were experiencing it as part of an intimate relationship. Out of that 568 that year, 431 were adults and 137 were children or young people.
Helen
Just to add that DV stands for domestic violence. And in respect of the Rape Crisis statistics overall for 2022?
Claire
Sadly, it’s one in four women have been raped or sexually assaulted as an adult. One in eighteen men have been raped or sexually assaulted as an adult, and one in six children have been abused, which are horrible figures. And then just around reporting of rape, so in that year 67,619 rapes were recorded by police. That works out at less than two in one hundred resulted in rape charges, so that doesn't even mean that they were found guilty of it, but it was just that it went to that level. So that is another barrier that we were talking about just now, is that’s what people hear a lot.
Helen
And it's interesting to hear those and they are in the national figures, is that right?
Claire
The 568 they were Onyx, so that’s Bedfordshire. But those one in four, one in eighteen and one in six are all national figures.
Helen
And as you said, it's very difficult listening to those figures and understanding how many people are reporting and how many cases are getting through. But in no way should discourage anybody from coming forward and making those reports and speaking about their experiences.
Claire
I would just say as well, with regards to Beds police, a lot of our cases are going through the criminal justice system. They are really good in Bedfordshire at supporting victims, making sure they've got us, making sure they know that that the SARC's here, so we've got a good kind of multi-agency kind of approach to it I think, in Bedfordshire.
Debbie
I think what's good to hear as well, as Claire mentioned, that there are ISVA staff that sit in. So for us, when we're dealing with a patient they're taking in a lot of information, we're talking about introducing them to another service. So it's really helpful having them in the same building because we can actually introduce them to an ISVA, you can explain there and then. So it's not so daunting for, you know, the patient to then have to go and meet them because they've kind of met them already.
Claire
We just kind of pop in and do it, because it's obviously a hugely exhausting and traumatic experience for them, we just kind of say, hi this is what we could do for you, little bullet points. And then they know that they will expect a call from us to offer that support properly. We don't go in and kind of do assessments there and then or anything like that, but this is what you could have if you felt you needed it.
Nikki
And that kind of leads me onto my next question, because we're going to be talking about collaborative working, which you've touched on, obviously with the police. So wider, with other professionals, you've said about your two services working together. Do you work with other professionals in the community as well?
Debbie
With the Emerald Centre, we've said that we work closely with the police and the ISVA service. We work with sexual health services, mental health, talking therapies, social care and any other services that we feel would be necessary and can provide ongoing support for the patient once they've left our service.
Claire
And then MARAC as well if there’s domestic abuse, we feed into the MARAC agenda. We do work closely with IDVAs. We also spend time speaking to GP and supporting people at GP appointments so they can talk about it properly.
Nikki
Could you just help us out with the MARAC and IDVA?
Claire
MARAC is the Multi-Agency Risk Assessment Conference; a meeting where high-risk victims of domestic abuse are discussed. Sexual violence and domestic abuse, we obviously get a few of those crossovers, so we work closely with the IDVAs, Independent Domestic Violence Advisors, and we are Independent Sexual Violence Advisors. So yeah, it's all lots of acronyms. So all of us get our accreditation from Lime Culture who are the specialists in providing that training and accreditation for sexual violence support services.
Nikki
What I was going to ask you, Debbie, is obviously you offer the forensic medical examination. Would victim/survivors still need to go down those usual physical routes to get any support from GP's or A&E? What do you advise there?
Debbie
So with regards to physical health, a top to toe assessment is undertaken as part of the forensic medical examination. However, if there is medical attention needed, we’d always recommend that that is dealt with first. So we’d suggest A&E, the GP, you know, for us it is making sure that they are fit and well in order for us to be able to undertake the element of the forensic medical.
Helen
Claire, I wonder, obviously we have been talking about the services and emotional support. I really wanted to bring this to a person, and somebody who has experienced sexual assault and who has accessed your service and support from your agency. I wonder if you're able to tell us about a specific victim/survivor that has accessed your support?
Claire
We have recently had someone come in who experienced childhood sexual abuse from a parent, but she's never had any support until now. Sadly, with those cases, it usually is the case that the perpetrator passes away as well. There’s no kind of I'm going to report this to the police for them. So she came to us, she self-referred to us, which is a really big thing to do I think, she'd been desperately trying to find some kind of help for about twelve months. And then in a very short amount of time, we did some very specific things for her. We've written, together, a letter of support for her GP to rerefer her back through the mental health services because it's so complex, that I think there is no specific service that feel they can support because it’s just too much has happened. So in addition to what happened to her as a young person, she's had further trauma, further trauma, further trauma on top of that. So she was just kind of coming to us, kind of can you help me? So we’ve really work with her to build her confidence up. So this letter now, the first thing she said after she read it was ‘I actually feel like I've been heard and listened to’, which often when people talk about rape, sexual assault, people don't listen, they just, kind of, in their heads probably ‘la la la’ you know, because it's difficult, isn't it? And I just think that made a real impact on me. And so our support is very tailored to what people need. For her she lives in her house, she doesn't want to go out because she's so anxious. So I offered to go to her universal credit appointment with her and she didn't know that I could do that. But just because she was so anxious about it, I knew she wouldn’t listen, so I just sat taking notes, you know, and it just gives that person a little bit of breathing space in their head. So she's just written to us to say she just doesn't know what she would do without that support. And it's really simple stuff for us because it's we’ve written a letter, we’ve gone to an appointment with her, so that's very early on in the support but already she's feeling feeding back that she's feeling heard, which a lot of people don’t.
Helen
I'm really pleased to hear that she reached out to you for support and that by giving her that space and giving her that voice to talk about her experiences, it sounds like you've been able to identify clear routes and the support that she actually needs for her, and like you say, that’s individual to her. So it's really good to hear that she's on that journey. And as you say, we don’t know where she is along that journey but the fact that she's found that identified route for her sounds really positive.
Nikki
Really good to hear Claire as well that however many layers of that trauma she’d experienced, like you said it was abuse upon abuse and she's experienced all of that. But there's still avenues and that's really, really comforting, you know, it doesn't matter what you've been through there are avenues of support.
Helen
For you, Debbie, in relation to the SARC, obviously we understand that you don't follow a person all the way through their journey, but when they come to you for that initial support and that initial interaction with you, just tell us a little bit about what happens there please?
Debbie
We do undertake the forensic examination and following the examination we do what we call aftercare. So we look for ongoing support that they could perhaps have, with their consent. For anybody over the age of 18 their follow up call is done six weeks later. And again it's the same thing, a check in and confirming that the services have been in touch. So whilst our contact is limited, that's kind of like the end of the contact that we have with the patient, we do get feedback from them, and we get really lovely feedback that they felt believed, they were dealt with with dignity and respect, they felt cared for and put at ease. So for us, we might not find out what happens at the end, but along the journey we have been able to make them feel believed, make them feel cared for, treated with dignity and respect, shown compassion, and I think they're all really powerful words that demonstrate we've helped people along their journey.
Helen
I think it's really positive to hear that you will reach out and check in to see if the routes and the pathways that you've given have actually been useful for people.
Debbie
And we do also tell them that if at a later stage that they need to contact us for anything, they're welcome to call us via our Pathways Support Service or to call direct into the service. So we don't definitely cut them off, the contact is there if they need it and if they want it.
Nikki
I think this is probably a really good point to share all your details for contacting the ISVA service. If I can just give out a phone number and an email address which is 0300 002 0004, with the email address of Onyx@ecpbedford.org. And for the SARC Emerald Centre, that is www.emeraldcentre.org and they've got an email address of admin.emeraldcentre@nhs.net.
Debbie
Our Pathway of Support service telephone number is 0330 223 0099 and that is a 24/7 telephone number, so we can be contacted at any point and a forensic nurse, a doctor will be available to speak to a patient.
Nikki
Thank you, Debbie, that's really important to share. And we'd like that on some additional support services for anybody listening. Certainly most of the services are listed through www.bedsdv.org.uk, which is the BDAP website.
Helen
Nationally, Rape Crisis can be contacted at www.rapecrisis.org.uk.
Nikki
Young Minds is www.mind.org.uk.
Helen
For males who have experienced sexual violence, they can contact Survivors UK who can be found at www.survivorsuk.org, and also for anyone who has experienced rape or sexual abuse, they can contact the Survivors Trust at www.thesurvivorstrust.org.
Nikki
And there's two specific ones that Claire kindly gave to us, which is NAPAC, the National Association for People Abused in Childhood which is www.napac.org.uk. And also the Mothers of Sexually Abused Children, which is www.mosac.org.uk.
Helen
And also just to add to that we’ve said about the BDAP website, which is the Bedfordshire Domestic Abuse Partnership, and that website again is www.bedsdv.org.uk
Nikki
Thank you so much for joining us.
Debbie
Thank you for inviting us.
Claire
Yeah, thank you
Thank you for listening to Relationships Shouldn’t Hurt. If you or someone you know has been affected by domestic abuse or the issues raised in this podcast, there is support available. For women, contact the 24-hour National Domestic Abuse helpline on 08082000247. For men experiencing domestic abuse, contact Men’s Advice Line on 08088010327 or ManKind Initiative on 01823334244. And for members of the LGBTQ+ community, the Galop LGBT+ Helpline is available on 08009995428. You can also find lots of information about domestic abuse on our website, www.bedsdv.org.uk, and if you’re in the Bedfordshire area, you can find local support services on the Get Help page of this website. All of the telephone numbers mentioned are also listed. If someone is in immediate danger, please call the Police on 999.