Sexual Assault in NYC: how to address medical incompetence and find better resources for women?

August 3, 2009 12:28 PM

Awful Filter: What are the best women's crisis centers in NYC who address rape survivors? How can I locate affordable therapy in New York for a rape survivor? How do I call attention to hospital incompetence and unqualified social workers? Much, much more inside.

A friend, "Jane," was raped last week by a guy she met through work who asked her out for drinks under the pretense of discussing job opportunities. They got very drunk and wound up at his place, but Jane firmly said "no" when he initiated sex. He ignored her even when she repeated "no" multiple times as he raped her. Afterward he was clearly unaware of (or uninterested in) the damage he'd perpetrated, as he suggested they go out again before he moved to another state in a few days. Jane said she never wanted to see him again and went home.

Over the next two days, our friend persuaded Jane to go to the hospital for an examination and potentially to contact authorities. They went to the Coney Island hospital because a reputable website listed it as a S.A.F.E. center. They were directed to a special room where Jane told her story again and again, only to be asked as many times if she was "sure" she wanted a rape kit because it took 3 hours and Jane had waited almost 3 days to seek medical attention. The doctor and secretary also misinformed Jane that if she took the rape kit, she'd be forced to contact authorities. Jane balked because she didn't know yet what pressing charges entailed, but luckily our friend knew better and corrected the situation. She then waited 4-5 hours for a time-sensitive test that is only useful during the first 96 hours after a rape. During the examination, hospital staff repeatedly and rudely badgered her to make up her mind about pressing charges. She also met with a social worker, aka the S.A.F.E. adviser assigned to offer "psycho-social and legal support," but the woman didn't even know what date rape was. The hospital coordinator curtly asked her--in the middle of the ER--if she was "sure" she wanted to call the cops. He incorrectly chastised her for coming into the hospital earlier and then leaving (untrue--so one wonders if another woman was too alienated by this incompetence and changed her mind). When Jane decided to notify the police, the staff didn't call them for much longer. No one offered her the required information about counseling services, but suggested that she could visit the same social worker again (the one who couldn't define date rape) in another week or two.

In the aftermath: Surely there are better services in New York City for sexual assault survivors. Jane has been remarkably calm and sanguine given the circumstances, but obviously she still needs solid, specialized therapy, especially if she crashes. She's not employed, so we need information about affordable/free counseling. My friend and I are also willing to jointly pay for a good private therapist if you have any suggestions.

As a rape survivor and women's center volunteer, I know that Jane didn't receive adequate care from a hospital that is purportedly an accredited S.A.F.E. center. Jane, our friend and I want to address this hospital's incompetence and insensitivity as quickly and effectively as possible. I've already called NYC Alliance to get it removed from their list as a S.A.F.E. center. We want to make sure that social worker never counsels another rape victim again. I want to know how SAFE centers are certified and why a hospital can so manifestly fail at helping women. How do I go about this?

Lastly, Jane decided to not immediately press charges. I understand her decision, but everyone is naturally concerned that the guy could repeat his actions on someone else. If she decides to let him off the hook, she has expressed interest in contact him to let him know that he did indeed rape her and that she was seriously considering pursuing legal recourse. She'd probably email him from a throwaway account and then spam his email at her regular email address. To me, this sounds therapeutic but potentially damaging, especially he finds a way around that spam filter.

Apologies for this diffuse question. To sum up, I'm looking for:

-ways to address hospital incompetence in the wake of sexual assault
-recommendations for resources tailored to victims of sexual violence
-recommendations for therapists, either free or private and sliding scale
-any advice whatsoever regarding the final paragraph.

Thanks in advance.

posted by zoomorphic to health & fitness (25 comments total)

I strongly, strongly recommend calling the RAINN hotline. They're a non-profit national organization, and can direct you to any of the resources you need.

They're also incredibly sensitive to not only survivors, but friends of survivors (my friend was the one who was reacting to a near-rape, and was already getting counseling for it, but I was the one who called RAINN because I had a flail-y moment of "but am I doing all I can????" and they actually gave me advice on that situation as well, even).

RAINN has a big network, and the hotline is open 24-7. Good luck.
posted by EmpressCallipygos at 12:48 PM on August 3 [5 favorites]

I'm really sorry your friend has to go through this.

It won't necessarily help your friend immediately, but spreading the word about the hospital's poor care could maybe help to effect some change. My sister's working in a hospital PR department now, and her hospital pays a lot of attention to things like Yelp reviews. I'm assuming this is the hospital you're talking about? They already have a lot of negative feedback, but maybe if you shared the gist of this story (anonymously, of course), you could save some other woman from getting substandard care after a rape.
posted by oinopaponton at 12:52 PM on August 3

As for taking care of the complaint: I find that a letter of complaint against the specific individuals involved, written to the president of the hospital, cc'ing the HR, the board of directors, the NYC board of health, the NY State board of health, and anyone else you can think of who would even be tangentially connected to this, would get their attention.

Plus the attention of everyone you cc'd on this.
posted by EmpressCallipygos at 12:57 PM on August 3 [7 favorites]

I'm so sorry.

Sadly I think this is the case in lots of cities. The fact that you experienced this in New York of all places is even sadder. I don't even want to know what it must be like for rape victims in Nebraska.

I urge your friend to pursue legal action. I know its hard and stressful and can be traumatic- which is why most rape victims choose not to pursue legal action - but pursuing legal action will 1) wake this dude up to the fact that what he did was not ok, 2) prevent another woman from going through this with this man, and 3) raise awareness that date rape is a serious issue - and even if you're drunk no means no. The treatment your friend got is just proof that the public at large doesn't get the gravity of this issue.

And yes, spread the word about this awful hospital.

I wish you and your friend the best.
posted by Lutoslawski at 12:59 PM on August 3

Seconding RAINN. Especially for advice on what to do regarding that last paragraph.

Coney Island Hospital is a public hospital operated by the city. Call 311 and find out the correct place(s) to contact to register a complaint. Don't procrastinate, but take the time to craft your complaint effectively so that it will make an impact. Consider taking the complaint public (via blogs that cover the city like Gothamist or the New York Times' City Room) if it can be done in a way that protects Jane's anonymity.
posted by ocherdraco at 1:00 PM on August 3

Social workers tend to either be completely awesome because they are people who were capable of doing anything but chose to be social workers despite the crap pay because they believe in the mission behind the profession or they are people who just couldn't get anything better than a job with crap pay. The problem is you never know in advance which you will get, and you probably have little to no choice in the matter because in many settings and circumstances if you are seeing a social worker you are either under or uninsured and accessing public services for the poor. I'm sorry your friend saw a shitty social worker and not an awesome one.
posted by The Straightener at 1:14 PM on August 3

I was coming in here to suggest RAINN
posted by nadawi at 1:16 PM on August 3

I'm sorry for both you and your friend.

May I suggest a couple of points in the hospital part of the story that you may want to rephrase (or re-remember exactly what happened) before you pass it on to other authorities and/or the public? I do not mean to nitpick, but I do think the following do somewhat undermine the point the need to get across in your letters/blogs/whathaveyou:

1 - She then waited 4-5 hours for a time-sensitive test that is only useful during the first 96 hours after a rape.

When Jane decided to notify the police, the staff didn't call them for much longer.

If Jane waited nearly 72 hours to go to the hospital, complaining that the hospital delayed a few hours in administering care sounds a bit petty. I understand that Jane experienced trauma and the staff are supposed to be professionals, but if you want to push the "only 96 hours" idea, you need to have an answer for why the hospital's delay is so much worse than Jane's.

2 - She also met with a social worker, aka the S.A.F.E. adviser assigned to offer "psycho-social and legal support," but the woman didn't even know what date rape was.

This is, frankly, unbelievable. I expect you mean that the adviser's definition of date rape was incongruous with yours, but you make it sound like the adviser had never even heard the term. How exactly did this verbal exchange go?
posted by and hosted from Uranus at 1:31 PM on August 3

If Jane waited nearly 72 hours to go to the hospital, complaining that the hospital delayed a few hours in administering care sounds a bit petty. I understand that Jane experienced trauma and the staff are supposed to be professionals, but if you want to push the "only 96 hours" idea, you need to have an answer for why the hospital's delay is so much worse than Jane's.

I see what you're trying to say, and hosted...., but it is not unheard of for victims of rape to be so shocked and traumatized in the immediate aftermath that it takes them a day or two to "snap out of it" enough to even think of going to the police or to a hospital. And competent rape crisis centers KNOW this, which is why they ordinarily do NOT continue to delay things another 4 to 5 hours asking the victim if she's REALLY sure she wants to go through with this.....
posted by EmpressCallipygos at 1:35 PM on August 3

2 - She also met with a social worker, aka the S.A.F.E. adviser assigned to offer "psycho-social and legal support," but the woman didn't even know what date rape was.

This is, frankly, unbelievable. I expect you mean that the adviser's definition of date rape was incongruous with yours, but you make it sound like the adviser had never even heard the term. How exactly did this verbal exchange go?
posted by and hosted from Uranus

I mean that Jane said, "I was dated raped by this guy," and the social worker looked up from her notes and said, "What's that?" Jane said, "... uh, I was date raped?" And the social worker said, "What is that? Can you define 'date rape' ?"

I have all sorts of problems with the term "date rape" because it connotes a rape under mitigating circumstances, like it's somehow better or easier to deal with being raped by someone you initially trusted enough to get drinks with, or accompany to a party. Regardless, Jane's account conveys that woman was not asking her to define date rape to see if Jane knew what she was talking about, but literally could not parse the term "date rape," a phrase my senile grandmother can handle.

And Uranus, while I do appreciate your advice, I'll politely ask you not to judge my friend for taking time to seek out an invasive medical procedure. 84% of women don't get as far as a rape kit because rape is emotionally, psychologically and physically traumatic. It's understandable that many victims feel too violated and raw already to ask a bunch of strangers to poke and prod their bodies, and it is absolutely not an excuse to treat a rape victim as if she's an inconvenience or at fault because she didn't immediately zip up her jeans and walk to the nearest S.A.F.E. center. The hospital obviously felt that Jane was more of a hassle than her case was worth and had no problem telling her so.

Thanks, everyone else, for your great advice. I'm currently on hold at RAINN.
posted by zoomorphic at 1:44 PM on August 3 [1 favorite]

About your friend emailing the rapist: Please have her consider this carefully. Off the top of my head, with very little imagination, I can think of at least 10 ways this could go very wrong for your friend.

It completely makes sense to me if she wants to press charges, and it completely makes sense to me if she does not want to press charges. But, giving the rapist a heads-up, possibly frightening him into running out of state or doing more damage... that does not make sense. It would feel great until about 2 seconds after she clicks Send.

Do you have anyone in your network who is a police officer, a lawyer, a district attorney? If you do, ask him/her: If you tell a police officer of a crime, does he have to file a report? The reason this might be important is to find out what happens to the rape kit (where is it now? where will it be 6 months from now?), and how many years she has to consider whether or not she wants to press charges.
posted by Houstonian at 1:48 PM on August 3

This is, frankly, unbelievable.

Believe me, it's believable.

On preview...

And the social worker said, "What is that? Can you define 'date rape' ?"

...and there you have it.
posted by The Straightener at 2:08 PM on August 3 [1 favorite]

For the letter I dearly hope you will write, here's a list of "who's who at HHC" (Coney Island is part of HHC): Board of Directors, Senior Executive Staff, Executive Directors, Medical Directors, Public Affairs Directors, and of course the HHC President.
posted by Houstonian at 2:10 PM on August 3 [1 favorite]

"Health Department Fines Coney Island Hospital $46,000 for Deficiencies in Sex Assault Case: Hospital Failed to Provide Police with Proper Rape Kit; Results in Lack of DNA Evidence Against a Serial Sexual Predator"
posted by Houstonian at 2:31 PM on August 3 [1 favorite]

I think you mean this, Houstonian.

New York City, July 26, 2000 -- State Health Commissioner Antonia C. Novello M.D., M.P.H., Dr. P.H. was joined by Katherine N. Lapp, New York State Director of Criminal Justice, today to announce that Coney Island Hospital will be fined $46,000 and must hire a consultant to review and improve their policies related to services provided to patients who have been sexually assaulted. Director Lapp attended to emphasize the critical importance of the proper collection of biological material in providing DNA evidence to prosecute sexual predators. She noted that in this case the rape kit delivered to the Office of the Medical Examiner contained no usable samples. More at the link.
posted by Optimus Chyme at 2:38 PM on August 3

Are you absolutely certain that the social worker was not trying to get Jane to clarify what happened to her, as in "what do you mean by "date rape"? The term encompasses a lot of scenarios- being drugged, drunk, or even just being under duress from someone known to the victim. I certainly wouldn't ask the question in the way you're reporting, but if I was in that position and someone said "I was date raped" I would want the victim to clarify what they meant by that phrase.

I'm not trying to make excuses here. I just know far more people with terrible interviewing skills than people who don't know the term "date rape". I think it is worth letting the social worker know that it was an awful question, no matter what.
posted by oneirodynia at 2:41 PM on August 3

Yes, oneirodnynia. As I stated in my earlier comment, she was not asking my friend to define "date rape" so everyone was clear on the definition, or to make sure Jane knew what it meant, or because she'd misheard. The social worker literally needed to be briefed on the most basic vocab term in the litany of sexual assault definitions, and looked, to quote Jane, "bewildered," when provided with a definition. It's hard to wrap our heads around anyone, let alone someone employed to help the victimized and abused, who would not know that term, but hey, that's a fun excursion into the incompetence of medical bureaucracy that lots of uninsured and poor people face. See also, The Straightener's comments.

And holy shit, Houstinian, that is a fantastic find. It sounds eerily similar to Jane's situation despite the nearly 10 years and massive fines they racked up.
posted by zoomorphic at 2:53 PM on August 3

I asked a social worker friend about the "What is date rape?" question. Apparently it is considered standard practice to ask a client to define the terms they are using to describe a trauma (or pretty much anything else). Your follow up description of the exchange seems to fit in with this practice.

It's quite possible that the social worker posed the question badly (and may not be a particularly good social worker), but it was very likely not asked out of ignorance.
posted by NormieP at 2:53 PM on August 3

And by follow up description, I don't mean the one that you posted at the same time as my last comment.
posted by NormieP at 2:54 PM on August 3

What's terribly ironic is that SAFE came about partially in response to the issue in 2000 with Coney Island, and also one other case in Woodhull Hospital in Queens (according to this article).

SAFE is funded through the NY State Dept. of Health. At the bottom of this page is the name, address, phone number, and email address of the woman who is in charge of answering questions about the program. She works in the Rape Crisis Program, for the Bureau of Women's Health, which is part of the NY State Dept. of Health.

I'd add her to the letter I hope you write. Because, yeah, you've got questions about that program.

Also on the same site, this is a list of SAFE hospital requirements. You could use it as a checklist, in that letter.
posted by Houstonian at 3:30 PM on August 3

I'm not sure, but I think the "Sexual Assault Forensic Examiner (SAFE) Programs" section on this page is implying that all SAFE hospitals have people on staff who have received special training. But then it gives a link to this page, which lists (all?) the people who have received the special training. I do not see anyone listed for Coney Island hospital, even though that hospital clearly is a SAFE hospital.

I would really ask some questions about where the rape kit is, and where it goes next month (chain of custody), so your friend will know what time frame she has to make a decision about pressing charges.
posted by Houstonian at 3:59 PM on August 3

I am so sorry for your friend. You have received some good advice here.

As a former hospital patient representative, I have a few other thoughts.

Also lodge a complaint with The Joint Commission. This is the NGO that accredits hospitals. The hospital in question does appear to be accredited by them. Scroll down to the bottom of the page where it says "Have a Complaint?"

The NY State Department of Health licenses hospitals in the state of New York and part of their role is to investigate complaints. I haven't worked in NY, but the state boards can be pretty aggressive in investigating complaints.

Given the situation, I would lodge a complaint with the hospital, but I would not leave it there. Sometimes it is appropriate to try to work things out with the hospital before dealing with all the regulatory agencies. This, IMHO, is not one of those times. Complain to as many authorities as you can.

The advice to complain directly to the agency that oversees the SAFE program is also very good.
posted by jeoc at 4:37 PM on August 3

Wow, this hospital totally has a reputation, and was fined for botching exactly this situation previously. I'm sorry, but if you really think it was not possible the social worker was this clueless I don't think you have much experience with health and mental health services to the poor. I was just going over some community mental health stuff with another user over email, the user was saying they thought a friend could benefit from cognitive behavioral therapy. I told the user that if their friend wound up seeing a social worker at a Medicaid funded community mental health site it would be a miracle if the social worker even knew what that was.

And as far as "special training," unless you've sat in on a SAFE training session recently and know standards are being maintained you have no idea what the training consists of. I've sat in on city and state health and behavioral health trainings where half the room was asleep for six hours but everyone walked out with certification at the end of the day.

This is also why I cringe when I see users sharing links to social service, health or mental health agencies with users halfway across the country. Unless you know the local landscape in a city you are really not qualified to make a referral for these kinds of services based on your Google skills, the variation between good and bad service providers is so broad and changes so regularly that unless you know for a fact that a provider is providing quality services right now you aren't really doing anyone a favor by throwing up the first link that comes up in Google. Just an AskMe pet peeve.
posted by The Straightener at 7:00 PM on August 3 [5 favorites]

The more I think about this, the angrier I get, especially in light of their past citation.

I yield to your friend's wishes in this, first and foremost -- but if you ever do get the idea to launch any kind of public protest or campaign against these fuckers, let me know, because I would be ALL. OVER. THAT.
posted by EmpressCallipygos at 7:04 PM on August 3

Agreed. I wish I had specific info to give you but if you or your friend need any help or public support, please let me know. Jesus.
posted by Dormant Gorilla at 7:50 AM on August 4