Much of what is known about rape survivors' experiences with the legal and medical systems has come from victims' accounts; rarely have researchers collected "the other side of the story" to find out what system personnel say did or did not happen in these interactions. In the current study, rape survivors who sought emergency medical care were interviewed before their hospital discharge about what services they received and how they were treated by social system personnel. Corresponding accounts were then collected from doctors, nurses, and police officers. There was significant interrater reliability between the survivors and legal and medical system personnel regarding what services were or were not provided ("service delivery") and if system personnel engaged in "secondary victimization" behaviors (i.e., statements/actions that could be distressing to victims). However, police officers and doctors significantly underestimated the impact they were having on survivors. Victims reported significantly more post-system-contact distress than service providers thought they were experiencing.
Keywords: rape; sexual assault; help-seeking; legal; medical; validity
After a sexual assault, rape survivors may need the assistance of both the legal and medical systems (Hazelwood & Burgess, 2001 ; Ledray, 1999). Victims may file a police report and pursue prosecution of the crime. They may also need postrape medical care, such as an injury exam and forensic evidence collection, as well as information and treatment options for pregnancy and sexually transmitted diseases. Understanding these victim-system interactions is an emerging focus in the rape victimology literature. Do victims receive the services they need? How are they treated by social system personnel in these contacts? What is the impact of these interactions on women's psychological wellbeing? Rape survivors' accounts of their experiences with the legal and medical systems suggest that many victims do not receive needed services and are often treated poorly by social system personnel (Campbell, Wasco, Ahrens, Sefl, & Barnes, 2001; Martin, 2005; Ullman & Filipas, 2001). Yet these issues are rarely studied from the perspective of community service providers, or better yet, from the point of view of both the survivors and system personnel. If a victim said she did not receive services and was treated poorly, what would the police officer, doctor, or nurse say happened? As literature on the community response to rape develops, it is important to understand, from multiple perspectives, the processes and outcomes of formal help seeking. The focus of the current study was to assess the degree to which rape survivors, police officers, doctors, and nurses agree about what happened in their interactions, thereby testing the accuracy of rape survivors' accounts of their experiences with the legal and medical systems.
Research on the community response to rape has focused primarily on two aspects of victim-system interactions: What services were or were not provided to survivors ("service delivery") and whether survivors were treated poorly by community service providers ("secondary victimization"). Legal service delivery-what "services" or steps of the prosecution process were initiated-is perhaps the most thoroughly investigated topic in this literature. Researchers have collected survivors' accounts (Campbell et al., 2001; Cluss, Boughton, Frank, Stewart, & West, 1983; Frazier & Haney, 1996), surveyed rape victim advocates who worked with the survivors as a proxy source of information (Campbell, 1998a; Sloan, 1995), interviewed criminal justice officials (Martin, 1997), conducted ethnographic observations of victim-system interactions (Frohmann, 1991, 1997, 1998), and reviewed official police/ court records (incident reports, affidavits, closeout memoranda; Spohn, Beichner, & DavisFrenzel, 2001). These studies have generated replicated, triangulated findings, which suggest that approximately 22% to 25% of reported rapes are prosecuted, 10% to 12% of which result in some type of conviction. …