SAFE Clinic Opens to Victims of Sexual Violence
By MELANIE KILGORE-HILL
New Clinic Available through Nashville's Sexual Abuse Center
Forty years ago, Nashville's Sexual Assault Center (SAC) was founded as a crisis hotline for abuse victims. Today, more than 700 men, women and children visit the multi-faceted facility each year for long-term counseling and holistic therapy services designed around healing.
The stats are sobering: One in four girls and one in six boys will be victims of sexual abuse before age 18, and only one in 12 child sexual abuse victims will ever report it. Meanwhile, one in six women will experience rape or attempted rape in her lifetime.
While the consequence of abuse is often life-long, SAC President Rachel Freeman, LCSW, hopes to improve outcomes for victims through the center's new SAFE (Sexual Assault Forensic Exam) Clinic. "We've been working on providing more choices for rape survivors for a decade or more because until now, there's only been one place to get a rape exam," Freeman said.
In Davidson County, that one place was Nashville General Hospital's Emergency Department. And while rape victims need the support of medical professionals, 80 to 90 percent don't need emergency care. "An ER is not the most trauma informed place or the most comfortable place to start recovering from rape," Freeman said, noting the citywide desire to create a non-hospital clinic for rape survivors.
That reality led to ongoing conversations with the Mayor's office and leaders from the District Attorney's office, Metro Police, Nashville General, the Office of Family Safety and Our Kids to discuss what the city could provide for survivors of rape. SAC was the logical choice for a non-hospital environment ... and within nine months, $2.5 million was raised through a successful capital campaign to fund a secure, 1,100-square-foot clinic specifically for these victims.
"The majority of people who contributed were most excited about the community-wide collective impact since we weren't duplicating services but creating a safe, nurturing and peaceful environment that didn't exist in Nashville," Freeman said.
The SAFE Clinic utilizes Nashville General's sexual abuse experts, who have decades of experience working with victims, testifying in court and understanding the chain of custody. "We're not reinventing the wheel but replicating what was already working well at Nashville General in a new space focused exclusively on the healing of survivors," Freeman said.
The highly secure unit with the Sexual Assault Center includes a small waiting room and reception area, consultation room, two exam rooms and a spa-like restroom with shower. The SAFE Clinic held a June ribbon cutting, and doors officially open in early July.
"Nationally, it's estimated that only one-third of all rapes are reported to law enforcement, and of those, only a small fraction lead to a conviction and incarceration," said Freeman. "By making rape exams more accessible, we hope to make Nashville a safer community by collecting the evidence that will get offenders off the street, and therefore reducing the occurrences of rape and sexual violence.
"Walking into this building is the hardest first step, which is why it's so important to have this facility," Freeman said. "Victims need to see they're not alone, to feel validated and know they don't have anything to be ashamed of."
Freeman said the mental and emotional toll of sexual abuse is typically the most devastating. In fact, more than half of SAC patients are adult survivors of childhood abuse who kept their secret for decades. While no two survivors respond the same way, many experience years of depression, sleep disorders, anxiety, relationship issues, fear, embarrassment, guilt and shame.
"Sexual assault doesn't cause mental illness, but the body's reactions to it can lead to bigger problems if the story is held inside for a long time," Freeman said. That tension manifests itself through headaches, GI problems, fibromyalgia and other physical ailments. "The best prognosis for healing is if you're believed and supported, and that's the message we try to promote so the potential for long-term negative impact is lessened," Freeman noted.
The center provides prevention and outreach programs for children, teens and college students, while their Safe Bar training program has been adopted by several Middle Tennessee establishments. "There's a strong correlation between alcohol and sexual violence, and we want to make sure bar staff feel equipped to act if they see something suspicious," Freeman explained. The Tennessee Department of Health, the Tennessee Coalition to End Domestic and Sexual Violence, and the Sexual Assault Center developed the online training, which takes 20 minutes to complete.
SAC staff members also work with Middle Tennessee's medical community to provide awareness, education and insight on how to talk to patients about sexual violence.
"Primary care and OB/GYN providers need to know we're here, not only to help survivors but to support other professionals in the community," said Freeman. "A lot of survivors disclose multiple times before they're finally heard or believed ... and the sooner we help them disclose, the less long-term impact it will have on their lives and their overall physical and mental health."
She encourages providers to ask the tough questions - those not typically included on medical history forms. For example, many include questions related to domestic violence. "Are you safe at home?" is a common inquiry that fails to address sexual abuse. "We assume the domestic violence question will answer it, but most sexual abuse victims are currently safe, so we're not asking the right questions to encourage people to disclose," Freeman said. "If you look at the stats and the prevalence of sexual assault, it's happening whether we ask questions or not. Survivors need to know it's not their fault and that we believe them and are here to help."