Sexual violence, health and humanitarian ethics: Towards a holistic, person-centred approach

AbstractSexual violence and rape in armed conflicts are widespread phenomena, with devastating consequences. Over the last thirty years, our understanding of these phenomena has significantly improved. Today humanitarian and health professionals understand better the reality, scale and impact of sexual violence on the personal, physical, social and mental health of individuals and communities. Rape is recognized to have a dehumanizing effect, as much as torture or mass violence. Major efforts are put into providing an effective and ethical response, with respect and sympathy to the survivors. Health and humanitarian assistance contribute to the healing and resilience of survivors and communities. Looking forward, programmes must be centred on the person, promoting their autonomy and dignity, and integrating medical, psychosocial and socio-economical responses.

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Developing EMDR Therapy in Pakistan as Part of a Humanitarian Endeavor

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.8.4.233 ◽

2014 ◽

Vol 8 (4) ◽

pp. 233-239 ◽

Cited By ~ 6

Author(s):

Derek Farrell

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

Health Professionals ◽

Humanitarian Assistance ◽

Northern Pakistan ◽

Research Projects ◽

Assistance Program ◽

Active Participant ◽

Richter Scale ◽

Emdr Therapy

The empirical justification for the use of eye movement desensitization and reprocessing (EMDR) therapy as part of the repertoire of interventions used in response to humanitarian endeavors continues at a pace. A devastating earthquake, measuring 7.6 magnitude on the Richter scale, occurred in Northern Pakistan in October 2005. In response, the first EMDR Humanitarian Assistance Program to be facilitated by an academic institution was established. This article highlights how 3 research projects assisted in the continued development of EMDR therapy in Pakistan to the point where presently more than 125 Pakistani mental health professionals have now been trained; it now has its own EMDR National Association and is an active participant within EMDR Asia.

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Health professionals’ perceptions of how gender sensitive care is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence

BMC Health Services Research ◽

10.1186/s12913-019-4812-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Carol O’Dwyer ◽

Laura Tarzia ◽

Sabin Fernbacher ◽

Kelsey Hegarty

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Health Professionals ◽

Psychiatric Inpatient ◽

Models Of Care ◽

Normalisation Process Theory ◽

Biomedical Model ◽

Case Study Methodology ◽

Psychiatric Units ◽

Inpatient Units

Abstract Background Sexual violence is a global public health issue. It is a form of gender-based violence commonly experienced by women accessing mental health services. The biomedical model has been the dominant model of care in acute psychiatric units, however, there has been a global movement towards more gender-sensitive and trauma-informed models. To date, only a small amount of research has focused on evaluating these models of care and health professionals’ experiences of providing this care. The aim of this study is to gain an in-depth understanding of healthcare professionals’ perceptions of how Gender Sensitive Care (GSC) is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. Methods This study used case study methodology and the Normalisation Process Theory (NPT) conceptual framework. NPT is a practical framework that can be used to evaluate the implementation of complex models of care in health settings. It included semi-structured interviews with 40 health professionals, document and policy reviews, and observations from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic and content analysis. Results Themes were developed under the four NPT core constructs; 1) Understanding GSC in acute psychiatric units: “Without the corridors there’s not a lot we can do”, 2) Engagement and Commitment to GSC in acute psychiatric units: “There are a few of us who have that gender sensitive lens”, 3) Organising, relating and involvement in GSC: “It’s band aid stuff”, 4) Monitoring and Evaluation of GSC in acute psychiatric units: “We are not perfect, we have to receive that feedback”. Discussion Many health professionals held a simplistic understanding of GSC and avoided the responsibility of implementing it. Additionally, the competing demands of the biomedical model and a lack of appraisal has resulted in an inconsistent enactment of GSC. Conclusions Health professionals in this study enacted GSC to varying levels. Our findings suggest the need to address each NPT construct comprehensively to adequately implement GSC.

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Turkish Mental Health Professionals' Experiences and Perspectives toward Family and Sexual Violence

Journal of Family Violence ◽

10.1007/s10896-017-9926-3 ◽

2017 ◽

Vol 32 (7) ◽

pp. 731-740 ◽

Cited By ~ 2

Author(s):

Fevziye Dolunay-Cug ◽

Ezgi Toplu-Demirtaş ◽

Christine E. Murray

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Mental Health Professionals ◽

Health Professionals

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Health professionals’ experiences of providing care for women survivors of sexual violence in psychiatric inpatient units.

10.21203/rs.2.13595/v1 ◽

2019 ◽

Author(s):

Carol O'Dwyer ◽

Laura Tarzia ◽

Sabin Fernbacher ◽

Kelsey Hegarty

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Mental Health Professionals ◽

Health Professionals ◽

Professional Training ◽

Psychiatric Inpatient ◽

Public Mental Health ◽

Structured Interviews ◽

Trauma Informed ◽

Inpatient Units

Abstract Background Survivors of sexual violence commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units.Methods This qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis.Results Three main themes were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing. Discussion Gender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences.Conclusions Health professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perception and promote trauma-informed and gender-sensitive care across all disciplines, genders, and levels of experience.

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Health professionals’ experiences of providing care for women survivors of sexual violence in psychiatric inpatient units.

10.21203/rs.2.13595/v2 ◽

2019 ◽

Author(s):

Carol O'Dwyer ◽

Laura Tarzia ◽

Sabin Fernbacher ◽

Kelsey Hegarty

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Mental Health Professionals ◽

Health Professionals ◽

Professional Training ◽

Psychiatric Inpatient ◽

Public Mental Health ◽

Structured Interviews ◽

Trauma Informed ◽

Inpatient Units

Abstract Background: Survivors of sexual violence, who are predominantly women, commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units. Methods: This qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis. Results: Three main typologies were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing. Discussion: Gender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences. Conclusions: Health professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perceptions and promote trauma-informed and gender-sensitive care across all disciplines, genders and levels of experience.

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‘They came with two guns’: the consequences of sexual violence for the mental health of women in armed conflicts

International Review of the Red Cross ◽

10.1017/s1816383110000251 ◽

2010 ◽

Vol 92 (877) ◽

pp. 177-195 ◽

Cited By ~ 17

Author(s):

Evelyne Josse

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Social Status ◽

Deleterious Effect ◽

Negative Impact ◽

Intrinsic Value ◽

Armed Conflicts ◽

Community Level ◽

The Past ◽

Social Circle

AbstractSexual violence has serious and multiple consequences for the mental health of women. At the psychological level, it leads to radical changes in the image that the victim has of herself, in her relations with her immediate social circle and beyond, in the community as a whole, and in the way in which the victim sees the past, present, and future. It thus has a lasting negative impact on the victim's perception of herself, of events, and of others. At the community level, it stigmatizes the victim, depriving her of any social status or intrinsic value as a person (she is seen as unfaithful or promiscuous), and thereby modifies relationships within the community with an overall deleterious effect. This article discusses these consequences of sexual violence for the mental health of women, especially those who are its victims during armed conflicts.

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Barriers and facilitators to physical and mental health help-seeking among Congolese male refugee survivors of conflict-related sexual violence living in Kampala

Social Work and Social Sciences Review ◽

10.1921/swssr.v19i3.1196 ◽

2018 ◽

Vol 19 (3) ◽

pp. 152-173

Author(s):

Peninah Kansiime ◽

Claire Van der Westhuizen ◽

Ashraf Kagee

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Help Seeking ◽

Service Providers ◽

Democratic Republic Of Congo ◽

Armed Conflicts ◽

Barriers And Facilitators ◽

Care Seeking ◽

Physical And Mental Health ◽

Mental Health Barriers

In Uganda, over 1.3 million refugees have fled armed conflicts from neighbouring countries, with about 251 730 refugees from the Democratic Republic of Congo (DRC) alone. In this article we report on a qualitative research study on the help-seeking behaviour of Congolese male refugee survivors of conflict-related sexual violence (CRSV) living in Kampala, Uganda. We recruited 10 Congolese male survivors of war-related rape and 6 Ugandan service providers (psychologists, social workers and physicians) who participated in individual interviews focused on barriers and facilitators to care seeking in Kampala, Uganda. We found that the major barriers to help-seeking were socio-cultural and political factors, health system and infrastructural barriers, poverty and livelihood barriers, physical effects of CRSV, fear of marital disharmony and breakup, and self-sufficiency The major facilitators were social support, symptom severity, professionalism among service providers, availability of free tailored services and information, education and communication. On the basis of our findings, we recommend that a multidisciplinary and multisectoral approach is important to address these barriers. In addition, we suggest that the Ugandan government should develop legislation and health policies to create protection for men who have experienced sexual violence.Keywords: armed conflict; conflict-related sexual violence; male refugee survivors; help-seeking; physical and mental health; barriers; and facilitators

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Health professionals’ experiences of providing care for women survivors of sexual violence in psychiatric inpatient units

BMC Health Services Research ◽

10.1186/s12913-019-4683-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Carol O’Dwyer ◽

Laura Tarzia ◽

Sabin Fernbacher ◽

Kelsey Hegarty

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Mental Health Professionals ◽

Health Professionals ◽

Professional Training ◽

Psychiatric Inpatient ◽

Public Mental Health ◽

Structured Interviews ◽

Trauma Informed ◽

Inpatient Units

Abstract Background Survivors of sexual violence, who are predominantly women, commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units. Methods This qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis. Results Three main typologies were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing. Discussion Gender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences. Conclusions Health professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perception and promote trauma-informed and gender-sensitive care across all disciplines, genders, and levels of experience.

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