A service evaluation of current practices in the assessment of mental-health and referral for support following disclosure of sexual violence

Sexual violence (SV) has significant impacts on physical, social and psychological wellbeing, with associated mental illness and suicide. Despite no specific guidelines regarding mental health and SV, recommendations suggest all patients should have the opportunity to discuss their mental health and be offered referrals for support. A service evaluation was performed at a large Sexual and Reproductive Health Service (SRHS) with n = 179 patient records reviewed between 30/07/2021 to 01/10/21, who had disclosed SV including n = 83 referred from Sexual Assault Referral Centres (SARC). Patient exclusions included duplicates and non-attendances. Data on patient demographics, mental health assessment and referral services were analysed. Referral services included Independent Sexual Violence Advisors (ISVAs), a specialist third sector organisation Rape and Sexual Violence Project (RSVP), and an inhouse specialist SV clinic, Abuse Survivors Clinic (ASC). Demographic analysis demonstrated that 43% of cases were aged over 25 years, 47% were 18-25 and 10% under 18. Females comprised 85% of cases. Mental health history was documented in 91% of SARC referrals, compared to 77% of patients who directly attended SRHS. Current mental health was assessed in 83% of SARC referral patients, compared to 75% of direct SRHS patients. RSVP was offered to 81% of patients, more than any other service. ISVA was offered to 40% of patients, and ASC was offered to 3% of patients. In total, 11% of patients were offered no service referrals. Findings suggest improvements should be made to ensure all patients have discussions around their mental health and are offered support services following SV disclosure. Further research is required to determine whether these changes improve patient outcomes.