By Sara Eichstaedt, LICSW
April 5, 2021

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Each April, Sexual Assault Awareness and Prevention Month (SAAPM) is an important time to renew our commitment to supporting survivors of sexual assault and sexual harassment. Service members from all backgrounds have experienced sexual trauma, including all genders, sexual orientations, ages, races or ethnicities, and branches of service. Sexual trauma can affect physical and mental health, even years later, and many survivors try to "go it alone" or struggle in silence. Therefore it's vital that we are vocal in letting survivors know a community of support is available to help them on their path to recovery and that they are not alone.

In support of SAAPM each year, the Department of Veterans Affairs (VA), like the Department of Defense (DOD), engages in additional efforts to raise awareness about the needs of survivors of sexual assault and harassment during military service and to support them in their healing process. As health care providers, you are involved in helping sexual trauma survivors every day — sometimes with awareness of their experiences, sometimes not. We are grateful for your partnership in making sure they get support and assistance when needed.

Oftentimes the ways we provide support for survivors in routine, "small" moments and interactions are important to help set the stage for disclosures and opportunities to respond to them. Here are some helpful recommendations:

• Many survivors are understandably hesitant to disclose their experiences of sexual trauma, which commonly can include experiences of sexual assault and/or sexual harassment. How might your verbal and nonverbal behavior encourage them to share this information with you? What might make it harder? Is there anything in your physical space and environment that might affect their willingness to share?
• Survivors often do not know the extensive support available to them for coping with a sexual assault. Ensure that the informed consent document for your facility highlights your responsibilities should a patient make a sexual assault disclosure in treatment.
• Patients have a right to know that they have reporting options and resources available to them. A Sexual Assault Response Coordinator (SARC) can confidentially discuss these services with a victim. In the absence of safety concerns, the survivor may decline to meet with a SARC and/or decline to make a report. However, DOD health care providers must notify the SARC that a sexual assault has been disclosed; the survivor's identifying information is only provided to the SARC with consent of the survivor. Providers should note the disclosure, the contact with the SARC, and the patient's wishes to report or not report in the medical record (this may be the only military documentation that a survivor has about the sexual assault should they later file with the VA for a claim of benefits). See the DOD Sexual Assault Prevention and Response Office (SAPRO) Victim Reporting Options Guide for more information about the sexual assault response process.
• When you respond to a disclosure, acknowledge the risk it took to share. Ask about how the experience has impacted them and what you can do to help, while also affirming their strengths and resiliency.
• Communicate both verbally and nonverbally that you believe what they have shared.
• Re-establishing a sense of power and control is often a key part of recovery. Consider things you can do in your relationship with the survivor to facilitate this. For example, offer choices, explicitly ask for survivors' opinions, and remember there is more than one way to recover.
• Recognize that many survivors may be struggling with additional stress related to the pandemic and an increased public focus on racism and social injustices. This can worsen feelings of powerlessness and isolation for some. In addition, societal oppression and discrimination can affect how sexual trauma is experienced, particularly to the extent that racism, the survivor's cultural background, or other personal variables played a role in the experience or aftermath. It can be helpful to explicitly ask how cultural factors or life history intersect with their sexual assault experience and their recovery needs.

Together, we all can play a part in making sure members of the DOD community know about services and options available to them. DOD Safe Helpline is a completely anonymous, confidential, 24/7 specialized service providing help and information anytime, anywhere, to members of the DOD community affected by sexual assault. Safe Helpline personnel can confidentially discuss the full range of services and reporting options with survivors. Safe Helpline can even provide contact information for civilian support services in the community around your installation.

In addition, VA offers many services to assist in recovery from sexual assault or sexual harassment experienced during military service, or military sexual trauma (MST) as it is known in VA:

• Current service members, including members of the National Guard and reserve components, can receive MST-related counseling without a referral at VA's community-based Vet Centers. Service member identity and records of the counseling are not shared with the DOD. Contact your local Vet Center to learn more.
• Current service members can also receive certain MST-related services at VA medical facilities. However, a service member's use of VA medical center services may be reported back to DOD. To learn more about services available, please call a local VA medical center and ask to speak to the MST Coordinator.
• Veterans do not need to have a VA disability rating and may be able to access MST-related services, even if they are not eligible for other VA care. Former service members with an other-than-honorable discharge may also be able to receive MST-related services.
• No documentation or other proof of the sexual assault or sexual harassment experiences is needed to get MST-related VA care, and survivors do not need to have made a formal report at the time they occurred. They also do not have to disclose incident details or make a police report for the VA to assist them. Learn more about VA's MST-related services at mentalhealth.va.gov/msthome.
• If a survivor is in crisis and needs immediate assistance, they can connect with the Military & Veterans Crisis Line by calling 988 and selecting option 1, or chatting online at VeteransCrisisLine.net/Chat.

Thank you military health care providers for all you do and for reminding survivors they are not alone, healing is possible, and sexual assault is never their fault.

Ms. Eichstaedt is a clinical social worker and the Clinical Education and Resources Lead for the National Military Sexual Trauma Support Team in the Department of Veterans Affairs Office of Mental Health and Suicide Prevention.