A team approach to healing sexual, domestic violence

Sad female patient at the doctors office

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(NewsNation) — Los Angeles patrol officers arrived at Jane’s home to a chaotic scene: Her husband had survived a gunshot to the head; Jane had thrown the gun out the window; the couple’s two children were terrified.

The evidence easily pointed to Jane as the aggressor. That’s until she was brought to the local family justice center, where a specialized team of therapists trained in child trauma heard a different story from Jane’s kids. It’s teams like these that are paving the way for better care of victims of domestic and sexual violence.

NewsNation is using a pseudonym to protect Jane’s identity as well as her family’s.

One in four women worldwide experiences sexual or intimate partner violence, according to the World Health Organization. In the U.S., these women must often navigate complex and disjointed legal and health care systems by themselves — resulting in poorer care, fewer convictions and cycles of violence. 

Yet there’s a model that for decades has proven a better way: Sexual Assault Response Teams (SART). Nurses, advocates, lawyers and detectives come together as one team to serve sexual assault, domestic violence, child abuse and trafficking victims. 

Numerous studies show these teams lead to more convictions, and patients are also more likely to take advantage of free therapy, housing or legal services.

Still, despite years of success, many areas have been slow to create SART teams, particularly in rural areas where resources and funding are already stretched thin.

‘That case could’ve gone tragically’

At the Los Angeles center, Jane’s children told police their father had played Russian roulette with their mom, then passed out drunk and the gun went off. Jane tossed the gun to keep it away from their dad.

It was key information that very likely would not have been related to uniformed officers, said James Nuttall, who worked for 10 years as a homicide detective in LA before joining the center. Jane’s husband was later convicted of assault with a deadly weapon.

“A woman who was mistrusting of the police, you put her prints on a gun … that case could have gone tragically, tragically, in another direction,” Nutall said. 

While extreme, this case is not unique. Domestic and sexual violence have skyrocketed across the country since the beginning of the pandemic, as families have been more likely to be isolated and under stress and to face financial difficulty. 

Detective James Nuttall, center, stands outside a Los Angeles restaurant to announce a reward for information in an unsolved murder. (Courtesy of James Nuttall)

But the siloed way hospitals, police officers and prosecutors traditionally work to serve crime victims often hurts survivors, who may already mistrust the system, experts say. 

Malinda Wheeler, who has worked as a forensic nurse for almost 30 years, said she’s seen nurses, officers and doctors badger patients to comply with an investigation.

“There’s no doubt in my mind why so many sexual assault victims declined to prosecute, or drop out of the whole prosecution effort after reporting — because they were treated like that,” Wheeler said.

A Unified effort

Survivor interviews are different under the SART model. A single member interviews the survivor in a quiet and relaxing space while the rest of the team monitors, family justice center forensic nurse Regina D’Aquilla explained.  

D’Aquilla said the interviewer is given questions from all involved. They consider if the police need to arrest someone, what kind of evidence is on their body the forensic nurse can collect, how much information is there for a prosecutor to build a case and whether the person needs an advocate to find a safe place to stay the night.

“A lot of people have told us if they knew that this is what the end result of their exam was going to be, they would have reported last time or they would have reported sooner,” D’Aquilla said.

The nonprofit, government and medical workers then pool resources to guide the survivor from the 911 call to their day in court, Nuttall said.

“They may have a need for simply the basics of buying diapers, buying food, grocery vouchers,” he said. “The fact that our resources will help them obtain court orders, restraining orders … the (Los Angeles Police Department) doesn’t have that kind of time.”

A bright and colorful interview room at the family justice center helps children feel more relaxed. (Courtesy of Regina D’Aquilla)
‘Game changers’

Studies show the creation of a SART team, sometimes also called a multidisciplinary team, can help cut through the “inadequate and uncoordinated” systems traditionally in place to help survivors.

Victims are more likely to report violence, leading to more arrests, and the programs reduce the stigma surrounding law enforcement, medical workers and the general public.

“I described (SART teams) as game changers — they’re that critical,” Nuttall said.

Yet without a tireless, local leader to persuade people to work together and go after funding, these efforts often fall apart, many SART members told NewsNation.

While an increasing number of states have passed legislation mandating SART and forensic nursing programs, crucial to the success is the wraparound services, which may not be funded at all centers. And while millions in federal funding has been directed to states to use for crime services under the Victims of Crime Act and the Violence Against Women Act, it is up to the state to choose where to direct that.

Little federal funding goes directly to SART programs, according to the Office of Justice Program’s funding database.

Without consistent financing, local police departments can be left with bills of thousands of dollars per case. In rural areas, there may only be one forensic nurse for several counties, a growing problem made worse by nationwide nursing shortages.

While the model is meant to be holistic, “there’s no way that we can address (homelessness, addiction or domestic violence) in a comprehensive manner when we only see this person for three or four hours,” Wheeler said.

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