What are the benefits of having an advocate present during a medical forensic examination or law enforcement interview?

While research is somewhat limited, the consistent conclusion is that advocacy services facilitate the recovery of sexual assault victims and increase access to other services in the community response system, including the criminal justice system. For example:

• One statewide study of rape crisis center services found that survivors rated advocates as supportive and informative (Wasco et al., 2004).

• Another study found that victims who worked with an advocate experienced less distress after contacting legal and medical systems (Wasco et al., 1999).

A third study was conducted with victims of sexual assault who presented to the Emergency Department of their local hospital (Campbell & Bybee, 1997). Results indicated that when an advocate was involved:

• Victims were more likely to have a police report taken (59% vs. 41%), and

• The case was more likely to be investigated by police (24% vs. 8%).

With respect to medical services:

• Victims were more likely to receive information on STDs (72% vs. 36%) and HIV (47% vs. 24%), as well as prophylactic treatment for STDs (86% vs. 56%).

• Victims were more likely to be tested for pregnancy (42% vs. 22%) and receive emergency contraception to prevent pregnancy (33% vs. 14%).

• Victims were less likely to be treated “impersonally or coldly” (36% vs. 69%).

• Medical professionals were less likely to refuse to conduct the examination because the assault occurred “too long ago” (24% vs. 36%). [All the sexual assaults in the study were reported within 96 hours.]

As a result of their contact with police and physicians, most of the sexual assault victims in this study experienced considerable distress (Campbell, 2006). However, some responses were seen less often among those victims who worked with an advocate (e.g., feeling bad about themselves, guilty, depressed, or reluctant to seek further help). In other words, victims who worked with an advocate were less likely than others to blame themselves for the sexual assault and less reluctant to seek further help from community response systems. As a result, they received more services from community professionals and had better recovery outcomes.

Based on such findings, the International Association of Chiefs of Police (IACP) released a resolution in 2019 declaring that law enforcement agencies should integrate victim services into their day-to-day operations so crime victims have immediate access to professionals who understand the complexities of trauma and victim needs. This resolution is titled: The Importance of Law Enforcement-Based Victim Services in the United States.

For more information, EVAWI offers an Online Training Institute (OLTI) module on the topic of victim advocacy. Breaking Barriers: The Role of Community-Based and System-Based Victim Advocates offers a broad overview of victim advocacy, including its purpose and parameters. It covers the differences and similarities between community-based and system-based victim advocates, the nuances of confidentiality, and how victim advocates can support victims during medical forensic exams, the criminal investigation process, and prosecution. The module also offers information and tips for non-advocates for how to integrate and work with victim advocates, including common concerns and best practices for advocacy.

Also relevant is an EVAWI training bulletin entitled, Advocates and Law Enforcement: Oil and Water, which explores the tension sometimes experienced between these two professional disciplines. After offering a detailed description of the advocate’s role during the criminal justice process, this training bulletin goes on to address the common reluctance of law enforcement to involve advocates in this process, by exploring some causal factors and outlining strategies to resolve them. 

Campbell, R. (2006). Rape Survivors’ Experiences with the Legal and Medical Systems: Do Rape Victim Advocates Make a Difference? Violence Against Women, 12, 30-45.

Campbell, R. & Bybee, D. (1997). Emergency Medical Services for Rape Victims: Detecting the Cracks in Service Delivery. Women’s Health, 3, 75-101.

Wasco, S.M., Campbell, R., Barnes, H., & Ahrens, C.E. (1999, June). Rape Crisis Centers: Shaping Survivors’ Experiences with Community Systems Following Sexual Assault. Paper presented at the Biennial Conference of the Society for Community Research and Action, New Haven, CT.

Wasco, S.M., Campbell, R., Howard, A., Mason, G., Staggs, S., Schewe, P., et al. (2004). A Statewide Evaluation of Services Provided to Rape Survivors. Journal of Interpersonal Violence, 19, 252-63.

How do I measure the impact of my program services for persons impacted by crime?

The iMPRoVE (Measures for Providers Responding to Victimization Experiences) platform is a free customizable outcome measurement platform. It has built-in data collection and visualization tools for providers, agencies, and organizations that offer help or support for persons impacted by crime.

• iMPRoVE measures the impact of program services, including the extent of the the physical, emotional, social, economic, and legal needs of persons impacted by crime were met by the services they received
• iMPRoVE measures service quality, including perceptions of accessibility and utility of services, referrals, and staff
• iMPRoVE allows providers, agencies, and organizations to select measures that best fit the intended outcomes of their programs
• iMPRoVE uses best practices in survey research and accounts for different types of service providers, agencies, and organizations having different intended outcomes of services

Why is it important to collect outcome measures?

• Improve service delivery by identifying strengths and challenges.
• Boost staff/team morale by demonstrating areas of excellence.
• Redirect unsuccessful work practices by identifying areas for improvement and training.
• Give clients a voice in services and how they are delivered.
• Demonstrate responsible stewardship of public and private financial support.
• Prove that funds are making a difference for persons impacted by crime with empirical data.

What if I don’t have time to analyze the data or know how?

The iMPRoVE platform offers an easy-to-use built-in data dashboard that automatically presents your data for you in real time. Aggregate survey responses are displayed in charts and graphics that can be easily exported for use in presentations and reports.

Do victims have the legal right to have an advocate present during a medical forensic exam, law enforcement interview, or other steps taken during an investigation or prosecution?

Several states have legislation in place that specifically addresses the presence of an advocate in sexual assault cases. AEquitas has prepared a Statutory Compilation of the states that have any laws specific to the presence of an advocate.

In California, state law (Penal Code Section 679.04) gives victims of sexual assault the right to have an advocate present during any stage of the investigation and prosecution. This means an advocate cannot be excluded by law enforcement or prosecutors, if the victim wants the advocate to be present. California law also gives victims the right to have an additional support person of their choosing present at all interviews and other investigative procedures, unless the law enforcement professional or prosecutor deems that the support person is likely to be disruptive.

In Oregon, state law (OR 70.125.060) provides victims who are at least 15 years old with a legal right to have a “personal representative” present with them during most phases of a law enforcement investigation, including the medical forensic examination. This personal representative could be either an advocate or a personal support person. They must be 18 years or older, not be a suspect, witness, or party to the criminal case, and their role must be solely to provide emotional support. The personal representative may not be prohibited from accompanying a victim unless a health care provider, law enforcement agency, protective service worker, or court believes the personal representative would compromise the process.

Other examples of state laws protecting the victim’s right to have an advocate present are described in the Statutory Compilation prepared by AEquitas. In states without such a law, this simply means the presence of an advocate is not protected as a legal right, so protocols will need to be established by local jurisdictions.

For more information, EVAWI offers one Online Training Institute (OLTI) module on victim advocacy and another on Sexual Assault Response and Resource Teams (SARRTs). Both modules can be accessed from the OLTI page on EVAWI’s website.