Recognition and Management of Sexual Violence in Psychiatry Outpatient Clinics

Yıl 2024, , 683 - 690, 25.12.2024

Behice Han Almiş , Şeyma Sehlikoğlu

https://doi.org/10.18863/pgy.1415763

Öz

Sexual violence is defined as the act of forcing an individual to engage in sexual intercourse or perform sexual acts without their consent, whether by a partner or someone else. Victims often face considerable barriers to reporting these incidents, frequently due to prevalent myths surrounding sexual violence. Consequently, many victims end up seeking help in psychiatry outpatient clinics, where they encounter healthcare professionals. It is crucial for these settings to integrate routine inquiries about sexual violence into their protocols, ensuring that all patients are assessed in a consistent and sensitive manner. The primary goal of this review article is to underline the critical need for psychiatry outpatient clinics to acknowledge and address sexual violence effectively. This involves establishing clear guidelines for mental health professionals on how to routinely question patients about sexual violence, which will help in identifying those at risk more effectively. Furthermore, the review seeks to highlight the importance of identifying and addressing the psychological risk factors that may predispose individuals to become perpetrators of sexual violence. Understanding these factors can lead to better preventive strategies and therapeutic interventions tailored to the needs of this specific group. Additionally, the necessity of providing victims with immediate psychological support, known as psychological first aid, following an incident. is emphasized, This form of early intervention is vital for reducing the impact of trauma and assisting in the recovery process. By focusing on these key areas, the article aims to enhance the overall response to sexual violence within psychiatric settings, ensuring that victims receive the comprehensive support and care they need.

Anahtar Kelimeler

Sexual Violence, Sexual Abuse, Mental disorder, Perpetrator

Psikiyatri Polikliniklerinde Cinsel Şiddetin Tanınması ve Yönetilmesi

Öz

ÖZ Cinsel şiddet, bir kişinin partneri veya bir başkası tarafından rızası olmaksızın cinsel ilişkiye girmeye veya cinsel eylemlerde bulunmaya zorlanması olarak tanımlanmaktadır. Mağdurlar, çoğunlukla cinsel şiddeti çevreleyen yaygın mitler nedeniyle, bu olayları bildirme konusunda önemli engellerle karşılaşmaktadır. Dolayısıyla pek çok mağdur, sağlık çalışanlarıyla karşılaştıkları psikiyatri polikliniklerinde yardım arayışına girmektedir. Bu ortamların, cinsel şiddetle ilgili rutin sorgulamaları protokollerine dahil etmeleri ve tüm hastaların tutarlı ve hassas bir şekilde değerlendirilmesini sağlamaları çok önemlidir. Bu gözden geçirme makalesinin temel amacı, psikiyatri polikliniklerinin cinsel şiddeti etkili bir şekilde kabul etmesi ve ele almasının kritik bir ihtiyaç olduğunun altını çizmektir. Bu, ruh sağlığı uzmanları için hastaları cinsel şiddet konusunda rutin olarak nasıl sorgulayacaklarına dair net kılavuzlar oluşturmayı içerir; böylelikle risk altındaki kişilerin daha etkili bir şekilde tespit edilmesine yardımcı olunacaktır. İnceleme ayrıca, bireyleri cinsel şiddet faili olmaya yatkın hale getirebilecek psikolojik risk faktörlerinin belirlenmesinin ve ele alınmasının önemini vurgulamayı amaçlamaktadır. Bu faktörlerin anlaşılması, bu özel grubun ihtiyaçlarına göre uyarlanmış daha iyi önleyici stratejilere ve terapötik müdahalelere yol açabilir. Ayrıca, bir olayın ardından mağdurlara psikolojik ilk yardım olarak bilinen acil psikolojik destek sağlanmasının gerekliliği vurgulanmıştır. Bu erken müdahale biçimi, travmanın etkisini azaltmak ve iyileşme sürecine yardımcı olmak için hayati önem taşımaktadır. Makale, bu önemli alanlara odaklanarak, psikiyatrik ortamlarda cinsel şiddete yönelik genel müdahaleyi geliştirmeyi ve mağdurların ihtiyaç duydukları kapsamlı destek ve bakımı almalarını sağlamayı amaçlamaktadır.

Anahtar Kelimeler

Cinsel şiddet, fail, mağdur, cinsel istismar, ruhsal bozukluk

Kaynakça

• Alvarez C, Fedock G, Grace KT, Campbell J (2017) Provider screening and counseling for intimate partner violence: a systematic review of practices and influencing factors. Trauma Violence Abuse, 18:479-495.
• Arkins B, Begley C, Higgins A (2016) Measures for screening for intimate partner violence: a systematic review.J PsychiatrMent Health Nurs, 23:217-235.
• Bacchus LJ, Bewley S, Vitolas CT, Aston G, Jordan P, Murray SF (2010) Evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital. Reprod Health Matters, 18:147-157.
• Barbara G, Buggio L, Micci L, Spinelli G, Paiocchi C, Dridi D et al. (2022) Sexual violence in adult women and adolescents. Minerva Obstet Gynecol, 74:261-269.
• Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C (2013) Psychological therapies for chronic post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Syst Rev, 12:CD003388.
• Campbell R, Dworkin E, Cabral G (2009) An ecological model of the impact of sexual assault on women's mental health. Trauma Violence Abuse, 10:225-246.
• Capaldi DM, Knoble NB, Shortt JW, Kim, HK (2012) A systematic review of risk factors for intimate partner violence. Partner Abuse, 3:231-280.
• Casteel C, Martin SL, Smith JB, Gurka KK, Kupper LL (2008) National study of physical and sexual assault among women with disabilities. Inj Prev, 14:87-90.
• Chandra PS, Deepthivarma S, Carey MP, Carey KB, Shalinianant MP (2003) A cry from the darkness: women with severe mental illness in India reveal their experiences with sexual coercion. Psychiatry, 66:323-334.
• Chapman A & Monk C (2015) Domestic violence awareness. Am J Psychiatry, 172:944-945.
• Chivers-Wilson KA (2006) Sexual assault and posttraumatic stress disorder: A review of the biological, psychological and sociological factors and treatments. McGill J Med, 9:111-118
• Colombini M, Mayhew SH, Ali SH, Shuib R, Watts C (2012) An integrated health sector response to violence against women in Malaysia: lessons for supporting scale up. BMC Public Health, 12:458.
• Dartnall E, Jewkes R (2013) Sexual violence against women: the scope of the problem. Best Pract Res Clin ObstetGynaecol, 27:3-13.
• De Oliveira HN, Machado CJ, Guimarães MDC (2012) Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil. Soc Psychiatry Psychiatr Epidemiol, 47:1567-1579.
• Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 291:2581-2590.
• Dworkin ER & Schumacher JA (2018) Preventing posttraumatic stress related to sexual assault through early intervention: A systematic review. Trauma Violence Abuse, 19:459-472.
• Echeburúa E, Corral PD, Amor PJ (2003) Evaluation of psychological harm in the victims of violent crime. Psychology in Spain, 7:10-18.
• Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R et al. (2009) How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. Health Technol Assess, 13:16.
• Fulu E, Jewkes R, Roselli T, Garcia-Moreno C (2013) Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN multi-country cross-sectional study on men and violence in Asia and the Pacific. Lancet Global Health, 1:e187-e207.
• García-Moreno C, Hegarty K, d'Oliveira AFL, Koziol-McLain J, Colombini M, Feder G (2015) The health-systems response to violence against women. Lancet, 385:1567-1579.
• Gölge ZB, Yavuz MF, Korkut S, Kahveci S (2013) Psychological and social issues observed in adult female victims following sexual assault. Adli TıpBülteni, 18:82-91.
• Güvenç R, Yıldırım MH, Yıldırım EA (2022) Yakın Partner İlişkilerinde Kadının Maruz Kaldığı Cinsel Şiddet Ölçeği Türkçe versiyonunun geçerlilik ve güvenilirlik çalışması. Noro Psikiyatri Ars, 59:151-157.
• Hegarty K, Tarzia L (2019) Identification and management of domestic and sexual violence in primary care in the# MeToo era: an update. Curr Psychiatry Rep, 21:12.
• Hegarty K, Tarzia L, Hooker L, Taft A (2016) Interventions to support recovery after domestic and sexual violence in primary care. Int Rev Psychiatry, 28:519-532.
• Howard LM, Trevillion K, Agnew-Davies R (2010) Domestic violence and mental health. Int Rev Psychiatry, 22:525-534.
• Jonas S, Bebbington P, McManus S, Meltzer H, Jenkins R, Kuipers E et al. (2011) Sexual abuse and psychiatric disorder in England: results from the 2007 adult psychiatric morbidity survey. Psychol Med, 41:709-719.
• Jones L, Hughes M, Unterstaller U (2001) Post-traumatic stress disorder (PTSD) in victims of domestic violence: A review of the research. Trauma Violence Abuse, 2:99-119.
• Kelly L, Westmarland N (2015) Domestic Violence Perpetrator Programmes: Steps Towards Change. Project Mirabal Final Report. London and Durham, London Metropolitan University and Durham University. .
• Khalifeh H, Moran P, Borschmann R, Dean K, Hart C, Hogg J et al. (2015) Domestic and sexual violence against patients with severe mental illness. Psychol Med, 45:875-886.
• Khalifeh H, Oram S, Osborn D, Howard LM, Johnson S (2016) Recent physical and sexual violence against adults with severe mental illness: a systematic review and meta-analysis. Int Rev Psychiatry, 28:433-451.
• Knight M, Nair M, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P et al. (2016) Saving Lives, Improving Mothers’ Care - Surveillance of Maternal Deaths in the UK 2012-14 and Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-14. Oxford, University of Oxford.
• Krug EG, Mercy JA, Dahlberg LL, Zwi AB (2002) The world report on violence and health. Lancet, 360:1083-1088.
• Långström N &Grann M (2007) Severe mental illness and risk of sexual offending in men: a case-control study based on Swedish national registers. J Clin Psychiatry, 68:588-596.
• Li L, Shen X, Zeng G, Huang H, Chen Z, Yang J et al. (2023). Sexual violence against women remains problematic and highly prevalent around the world. BMC Womens Health, 23:196.
• Lombardi BN, Jensen TM, Parisi AB, Jenkins M, Bledsoe SE (2023). The relationship between a lifetime history of sexual victimization and perinatal depression: A systematic review and meta-analysis. Trauma Violence Abuse, 24:139-155.
• McLindon E & Harms L (2011) Listening to mental health workers' experiences: Factors influencing their work with women who disclose sexual assault. Int J Ment Health Nurs, 20:2-11.
• Mendes K, Ringrose J, Keller J (2018) # MeToo and the promise and pitfalls of challenging rape culture through digital feminist activism. Eur J Womens Stud, 25:236-246.
• New York Times (2018) #MeToo brought down 201 powerful men. nearly half of their replacements are women. https://www.nytimes.com/interactive/2018/10/23/us/metoo-replacements.html. (Accessed 20.06..2023).
• NICE (2014) Domestic Violence and Abuse: Multi-Agency Working. London, National Institute for Health and Care Excellence.
• Oram S, Capron L, Trevillion K (2016) Promoting Recovery in Mental Health: Evaluation Report. London, King’s College London.
• Oram S, Khalifeh H, Howard LM (2017) Violence against women and mental health. Lancet Psychiatry, 4:159-170.
• Oram S, Trevillion K, Khalifeh H, Feder G, Howard LM (2014) Systematic review and meta-analysis of psychiatric disorder and the perpetration of partner violence. Epidemiol Psychiatr Sci, 23:361-376.
• Ormon K, Sunnqvist C, Bahtsevani C, Levander MT (2016) Disclosure of abuse among female patients within general psychiatric care-a cross sectional study. BMC Psychiatry, 16:79.
• Pietrzak RH, Goldstein RB, Southwick SM, Grant BF (2011) Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from wave 2 of the national epidemiologic survey on alcohol and related conditions. J Anxiety Disord, 25:456-465.
• Regehr C, Alaggia R, Dennis J, Pitts A, Saini M (2013) Interventions to reduce distress in adult victims of sexual violence and rape: a systematic review. Res Soc Work Pract, 23:257-265.
• Romito P, Turan JM, De Marchi M (2005) The impact of current and past interpersonal violence on women's mental health. Soc Sci Med, 60:1717-1727.
• Rose D, Trevillion K, Woodall A, Morgan C, Feder G, Howard L (2011) Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study. Br J Psychiatry, 198:189–194.
• Ruzek JI, Brymer MJ, Jacobs AK, Layne CM, Vernberg EM, Watson PJ (2007) Psychological first aid. J Ment Health Couns, 29:17-49.
• Semrau M, Evans-Lacko S, Alem A, Ayuso-Mateos JL, Chisholm D, Gureje O et al. (2015) Strengthening mental health systems in low-and middle-income countries: the Emerald programme. BMC Med, 13:79.
• Shackelford TK, Goetz AT (2004) Men’s sexual coercion in intimate relationships: development and initial validation of the sexual coercion in intimate relationships scale. Violence Vict, 19:541-556.
• Stewart DE, MacMillan H, Wathen N (2013) Intimate partner violence. Can J Psychiatry, 58:e1-e15.
• Tetik S, Mutlu A, Unlubilgin E (2021) Psychological first aid in sexual assault cases. Psikiyatride Güncel Yaklaşımlar, 13:751-762.
• Thompson MP (2006) Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools. Atlanta, GA, Centers for Disease Control and Prevention.
• Trevillion K, Oram S, Feder G, Howard LM (2012) Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS One, 7:e51740.
• United Nations (2014) UN sounds alarm to end ‘global pandemic’ of violence against women. UN News [Internet]. 2014 1/10/18. https://news.un.org/en/story/2014/11/484692#. (Accessed 10.05.2023).
• Vickerman KA & Margolin G (2009) Rape treatment outcome research: Empirical findings and state of the literature. Clin Psychol Rev, 29:431-448.
• WHO (2011) Psychological First Aid: Guide for Field Workers. Geneva, World Health Organization.
• WHO (2013) Responding to Intimate Partner Violence and Sexual Violence Against Women: WHO Clinical and Policy Guidelines. Geneva, World Health Organization.
• WHO (2016) Global Plan of Action to Strengthen the Role of the Health System within a National Multisectorial Response to Address Interpersonal Violence, in Particular against Women and Girls, and Against Children. Geneva, World Health Organization.
• WHO (2021) Sexual violence. https://apps.who.int/violence-info/sexual-violence/ (Accessed 02. 01. 2024).