1 in 5 women and 1 in 25 men have experienced sexual assault since the age of 16.
Sexual Assault Referral Centres (SARCs) provide care to adults and children in the aftermath of sexual assault or rape.
The MESARCH project is evaluating SARCs across England in order to understand benefits and costs to service users and those who have experienced sexual assault and rape. The project seeks to understand the work that SARCs do and its impact, and where their services sit within the broader context of supporting survivors of sexual violence. The study also addresses a gap in knowledge about long term support required and experiences of survivors of sexual abuse and violence; it will enable us to answer questions about the widespread impacts of violence on health and wellbeing over time along with a range of other outcomes considered important by those with lived experiences of abuse.
Sexual Assault Referral Centres (SARCs) offer a first point of call for victims of recent and non-recent sexual violence where victims can talk in total confidence about their experience in a safe, caring, environment and receive help, whether the police are involved or not. There are around 50 SARCs across England offering the option of a forensic medical exam to gather evidence of the assault and medical care; emergency contraception and advice and care for sexual health; connecting people with an independent sexual violence advisor and onward referrals for practical and emotional support. SARCs also offer support where someone wishes to assist in a police investigation of an offence against them and will help over the course of a legal process. A person who has experienced sexual assault can either directly contact the SARC themselves, or be referred to the SARC by another person or organisation such as a doctor, nurse, school or member of the police.
According to the NSPCC, 1 in 20 children experiences child sexual abuse.
Estimates suggest that child sexual abuse alone costs £182m in health spending annually, meaning that it is very costly to society in terms of lost work, health, police and legal costs.
Our research is also concerned with how SARCs support children and young people (CYP). We are working with young survivors of abuse to deliver MESARCH-CYP and using a range of visual, creative and participatory methods to engage young people and to understand how their lives have been affected by abuse and the support they are offered beyond that.
At present, the true impact of SARCs for survivors and their families is largely unknown. The way things are done at each SARC can vary from one centre to another, and it is not known what works best for different groups of people like men, LGBT service users, and people with particular vulnerabilities such as for a person with disability, for those who are migrant, refugee or seeking asylum, and for children and young people.
Over four years, we will work with those who have experienced sexual abuse, charities, Trusts , the police and staff working at SARCs, in order to understand best practice for SARCS. We will do this in four main ways:
Firstly, we will look at existing research and bring it all together to see what it says about supporting survivors, what therapies and treatments are most helpful and how does this vary for different groups of survivors.
We are building on currently available information about SARCs to develop a rich national ‘map’ of SARCs across England and to understand different models of care. To achieve this, we collaborated with the MIMOS team based at University of Leeds. We are also undertaking case studies, involving interviews with commissioning and SARC staff, service users, family members and third sector providers to gain insights into how SARCs care for service users, as well as how they work with other professional services in supporting survivors.
With their consent, we are following over 2 years a large group of adults aged 18 years and above who have attended SARCs, asking about the impact of different interventions and services on their mental and sexual wellbeing, quality of life and economic and emotional costs. We are also inviting a small group of children and young people (aged 13-17 years) to be involved at two paediatric sites. Follow-up of the adult and CYP cohorts will be done on three occasions over the course of the 2 years.
The final phase of our project will bring the various threads together and identify key ‘messages’ from the findings. We will share these with those who commission SARCs, deliver day-to-day SARC services, those who work with SARCs, and those who use SARCs or could benefit from attending SARCs but experience difficulties in accessing support more broadly.
Our project is developed with survivors of abuse and charities that support them to ensure our project will be conducted sensitively and ethically, and will lead to relevant changes in practice and policy.
The MESARCH project started in September 2018 and will run for just under 4 years. MESARCH is funded by the National Institute for Health Research (NIHR; 16/117/04), being commissioned by the NIHR’s Health Services and Research Delivery Programme.