Thread of things you may not know about visiting an emergency room for a sexual assault/domestic violence related incident in Ontario*:

(CONTENT WARNING: thread includes health care services available & offered for people who have experienced sexual assault/domestic violence**)

*this thread assumes that the user of services is 18 years of age or older.

**specific services may vary by region. Please check https://www.sadvtreatmentcentres.ca/find-a-centre/to find your closest treatment centre, and services available.

In Ontario, there are 37 Sexual Assault (SA)/Domestic Violence (DV) treatment centres. What does this mean? In 37 hospitals across Ontario, there are nurses working inside the emergency department 24/7 to provide immediate and follow-up care to patients who have experienced SA/DV

What do the nurses do?
Overall, they provide medical and forensic care to patients.

Medical care examples: treating injuries, testing & treating STIs, providing emergency contraceptives

Forensic care examples: documenting & taking photos of injuries, collecting a “rape kit”

Common misconceptions:
Just because you allow a nurse to complete a Sexual Assault Evidence Kit, it does NOT mean that you are now forced to get the police involved at ANY point in time.

Nurses do not have ANY communication with police unless you CHOOSE to involve the police.

So, what happens to the evidence kit if it’s not handed over to the police?

It is held in storage. However, not indefinitely. Some centres discard of the evidence kits within 1 year of being held in storage, and can keep them for longer if you request. ASK for how long kits are

held in storage, and ASK them what is needed from you (e.g. documentation, letters, etc.) if you would like to keep your kit in storage for longer than the standard period.

Nurses make follow-up appointments with patients, so do not worry about needing to ask this all at once.

Handy information:
-Nurses collect forensic information and document it in multiple ways.
They take photos of the injuries.
They document where the injuries occurred on a body map.
They also write down non-visible injuries (e.g. tenderness and swelling), mood and general

presentation of the patient in the Electronic Medical Records system. They do all of this WITH YOUR CONSENT at immediate and follow-up appointments.
Let’s say you do not feel comfortable with pictures being taken of your injuries. That is OK— you will not be forced to record any

forensic information if you don’t want to. If you simply want to go to a nurse for medical care, that’s perfectly fine as well, and you will not be refused service if you decline having forensic information recorded.

However, for forensic information that IS recorded— it stays on a patient’s Electronic Medical Record indefinitely, so no need to worry about time limits on that.
AGAIN— this information is NOT!!! shared with the police without the patient’s consent.

Nurses also make follow-up appointments with patients who visit the ED for sexual assault/domestic violence.
This is helpful for health AND forensic reasons.
Health reasons:
-Follow-up medical treatment and care. Any medications that are provided to the patient through the ED

are offered free of charge. This is especially helpful for patients who may need emergency contraceptive or prophylaxis medication. Post-exposure prophylaxis (PEP) medication for HIV is especially expensive to pay for out of pocket. At a treatment centre? Free.

Other health reasons why follow-up appointments are helpful:
-Nurses refer patients to social workers who are a part of the team & offer FREE trauma-focused counselling, in addition to assistance with navigating related social issues (e.g. housing, income support, legal support)

These social workers can also offer free short-term counselling to family members, relationship partners, or friends of the person who was affected by domestic violence or sexual assault.

Forensic reasons as to why follow-up appointments are helpful:
-We all bruise, scar and attain injuries differently!!
Immediately after an injury, a person’s skin may look completely untouched. However, you look at that same skin a few days later... HUGE, serious bruises!

It is important for a patient to go to a follow-up appointment to receive medical care for these bruises/injuries, no doubt.
However from a forensic standpoint, if pictures of bruises/injuries are only taken at the 1st appointment, information of severity may be lost.

I hope that nobody ever has to go through the excruciatingly difficult experience of visiting a treatment centre for domestic violence or sexual assault.
However, I thought I would create this thread so that people are better informed about what supports ARE available, if so.

When you experience trauma in any of those ways, your autonomy is taken away from you. The staff at treatment centres know this, & thus work from a trauma-informed focus. Meaning: they will never force you to answer a question you don’t want to/complete a procedure you don’t want

Oh!! Another thing. You don’t need to have immediately experienced sexual assault/domestic violence to receive free trauma-informed counselling at a treatment centre.

You are still eligible and allowed to receive free counselling, if the abuse happened years ago.