UHS Committed to Aiding Sexual Assault Victims

To the editors:

The mission of Harvard University Health Services (HUHS) is "To Heal…To Care…To Educate." Actualizing this mission, our role is to provide the very best care to the community we serve. We acknowledge that sexual assault is a horrific crime that extends well beyond the initial assault. It impacts the lives of its survivors and the community at large. We care about our campus community and are committed to consistently evaluating our sexual assault services in order to offer the highest quality of care.

If you or someone you know should need help, you can call HUHS 24 hours a day. A nurse will speak with you immediately and encourage you (or the patient) to come to HUHS. Once a sexual assault survivor comes to HUHS the physician and nurse provide immediate support and physical and emotional assessment. Our mental health clinicians are on call 24 hours a day and are available for immediate crisis intervention as well as comprehensive long term counseling to assist survivors recovery and healing. The mental health clinicians at HUHS are trained in sexual assault counseling and are available for emergency visits. HUHS has always and will continue to provide expert counseling and follow up for survivors of sexual assault. The role of the clinical physician and nurse is to provide acute assessment. The evaluating clinician at HUHS explains the plan of care and why it is important to have the services that a SANE (Sexual Assault Nurse Examiner) site can provide. The SANE site that HUHS has chosen is the Beth Israel Deaconess Medical Center in Boston (BIDMC). We then arrange for transfer and notify the Beth Israel Deaconess Medical Center to ensure a smooth transfer and continuity of care.

We have changed our policy of administering the sexual assault exam in response to the creation of a sexual assault program in Massachusetts. In 1997, a study was conducted by the Massachusetts Department of Public Health (DPH) that assessed the quality of care for survivors of sexual assault in Massachusetts. The recommendations of that study resulted in the development and implementation of The Sexual Assault Nurse Examiner Program (SANE Program). Sexual assault survivors need an emergency response system that provides immediate comprehensive and compassionate care, and ensures proper collection of forensic evidence. The Sexual Assault Nurse Examiner Program (SANE) has dramatically changed how healthcare institutions throughout the state respond to sexual assault. HUHS recommends the use of a SANE program because we want the very best care for our patients.

The SANE program nurse is one of a team of professionals from the medical, counseling, advocacy and law enforcement fields who will provide care and services at the designated SANE site. They will assess a patient for injuries and provide treatment and protection from unplanned pregnancies and sexually transmitted diseases.

The SANE provides expert testimony to assist with prosecution. Thus, SANEs provide sensitive, compassionate, and expert care to survivors of sexual assault in designated SANE sites. The Massachusetts Department of Public Health (DPH) has been very careful to designate emergency departments as SANE sites. This DPH decision was based on many hours of research regarding the best sites for the SANE program. There are medical as well as legal reasons for choosing emergency departments. SANEs must practice in designated emergency departments. Other health care settings, including HUHS, aren't allowed to offer the services of the SANEs. To be a designated SANE site, the hospital must pass a rigorous credentialling process. There are extensive requirements for special laboratory tests, equipment and services to the patient. The DPH made the determination that these requirements could only be met in a setting that an emergency department provides. In addition, a SANE site must have the ability to care for at least 100 sexual assault survivors per year.

This model of care provides physical, psychological support to sexual assault survivors in the acute phase of sexual assault. It is the gold standard of care in Massachusetts that all ambulatory settings are encouraged by the DPH to transfer their patients to designated SANE sites such as the BIDMC. HUHS services can then support the survivor by offering mental health counseling, medical follow-up, and support throughout the recovery process.

HUHS is committed to its mission to identify and respond to the health care needs of all segments of the Harvard University community. Education on sexual assault and domestic violence is offered through our Center for Wellness & Health Communication. This year we have addressed a variety of health education topics on campus as part of our outreach efforts. We welcome the opportunity to continue to provide comprehensive education regarding sexual violence and domestic violence.

If there are any questions regarding sexual assault, domestic violence, related HUHS services or to request education or outreach services in this area, I would encourage you to call Deborah D'Avolio, chief of nursing and Center for Wellness and Health Communication here at HUHS. Deborah is a nurse practitioner and is a certified sexual assault examiner. She serves on the Governor's Domestic Violence Task Force, the DPH Sexual Assault Advisory Committee and the American College of Emergency Physicians Sexual Assault Task Force. She can be reached at 495-2095.

David S. Rosenthal, M.D.

March 12, 1999

The writer is director of the University Health Services.