Spotlight 2

In years 4 and 5, Patient Ombudsman received 29 complaints reporting sexual assaults by other patients or staff in public hospitals. Most of the complaints occurred on mental health units or involved patients with a history of mental health or addictions problems, developmental disabilities, or other vulnerabilities.

Many people continue to believe that sexual assault necessarily involves violence or force, or that acquiescing to a sexual act always implies consent. This can affect the way people interact with those who report sexual assault, the kinds of questions they ask, and their responses to the answers.

This is further complicated in mental health settings, where reports are more likely to be perceived as lacking credibility or be attributed to symptoms of a patient’s psychiatric condition. Depending on how the incident is discussed with patients who are reporting assault, the patient may feel interrogated or sense that the person they are reporting the incident to does not believe them.

Trauma and violence-informed approaches are not about 'treating' trauma…Instead, the focus is to minimize the potential for harm and retraumatization, and to enhance safety, control and resilience for all clients involved with systems or programs. These approaches benefit everyone, whether or not they've experienced trauma in their lives or their personal history is known to service providers. – Public Health Agency of Canada, 2018

Sexual assaults are avoidable and HSOs should take every reasonable precaution to provide safe and secure environments for their patients, staff, and visitors. All reports of sexual assault should be taken seriously and undergo an appropriate investigation. Mental health status is not a reason to approach a report of sexual assault differently than for any other patient.

When receiving a report, it is important to recognize that it’s not up to a staff member or physician to believe or disbelieve a report of sexual assault or threat, but to follow a respectful and sensitive approach to receiving the information, an objective process for investigating what transpired, and to assess the safety of the care setting.

In addition to complaints about sexual assaults in hospital, Patient Ombudsman also received 18 complainants from patients who had experienced sexual assaults prior to their hospital admission and reported that insensitive care in hospitals had left them feeling retraumatized. Health care providers may not be aware of a patient’s history of trauma and how past trauma can affect their experience of care, for example, when undergoing a sensitive procedure such as an anal swab, vaginal examination, or catheterization.

Adopting trauma-informed approaches to care can reduce the risk of causing further harm to patients who have experienced sexual trauma. It is particularly important to imbed trauma-informed principles and approaches in policies and practices that guide HSOs’ responses to reports of sexual assault, including how complaints are managed.