When a person is sexually assaulted, they are confronted with many immediate decisions. Who do they tell? Should they get medical attention? Should they report it to the police? And if they make any of these choices, what in the world will happen next?

At the Sexual Assault Crisis Center, we believe that each person must make those decisions in his/her own best interest. While we are available 24 hours a day to provide information and help people identify and consider their options, we do not advocate a particular direction.

We do, however, recommend that sexual assault victims receive medical treatment as soon as possible.

Medical treatment can accomplish several things.

First, the victim can be immediately assessed and treated for any injuries sustained during the assault.

Secondly, they can receive preventive treatment for sexually transmitted infections and/or pregnancy.

And thirdly, they can have evidence collected to support a criminal prosecution of the crime. Even if the victim has not decided to report the crime to the police, evidence can be collected and stored for at least 90 days, allowing the victim time to think about that option.

Nationally, and in Maine, the post-assault medical forensic examination is done by a specially trained group of health care providers, primarily registered nurses, known as Sexual Assault Forensic Examiners.

To become a SAFE, a health care provider must complete an intensive training about sexual assault and the technical aspects of care, treatment and evidence collection. Providers then complete additional clinical requirements, observe a sexual assault trial to witness testimony about the medical findings, and connect with their local sexual assault crisis and support center, law enforcement and prosecutors.

All hospitals in the tri-county area have SAFEs working in their emergency departments. The SAFE explains the medical forensic exam process, and attends to the concerns of the victim.

Forensic evidence collection is not a requirement to receive medical treatment following a sexual assault. The hospital and SAFE also encourage the sexual assault advocate to accompany the victim through this process and provide emotional support, safety planning and follow-up.

The availability of SAFEs has dramatically changed the system’s response to sexual assault.

Before this program, victims might experience long delays in getting care at the hospital emergency department while other medical emergencies were cared for, before a provider could perform the medical forensic exam. Now, if a SAFE is not available on staff, one is called in specifically to care for the victim.

Formerly, health care providers were not trained in the care of sexual assault victims or evidence collection procedures, or did not perform exams frequently enough to maintain proficiency. With a SAFE Program in place, victims receive prompt, compassionate trauma care from providers who understand sexual assault issues.

The quality of the medical response is improved because a SAFE can identify physical injuries, knows how to take a history and collect evidence, and documents injuries and other evidence in the medical record.

Ultimately, the goal is to not re?traumatize the victim by the exam, but to promote healing.

In a sexual assault, the victim’s body is part of the crime scene. Normally, evidence from a crime would be collected by law enforcement, but in a sexual assault, the sensitive, personal nature of that evidence collection from the victim cannot be done by the police.

SAFEs provide appropriate medical assessment, know how to locate and retrieve the evidence, and understand and support the emotional reactions that sexual assault victims may have during the exam. SAFEs have that expertise, and have brought a more sensitive and compassionate response to what can be a difficult process.

SAFEs also participate in Project Response, our community’s Sexual Assault Response Team.

The group is composed of representatives from law enforcement, the court, the hospital emergency departments and SACC.

Project Response works to foster an informed, effective and supportive team response to sexual assault victims. The participation of SAFEs on the team allows for the exchange of information and feedback, which then helps to improve the system’s response to victims.

It is a large commitment on the part of hospitals to support the SAFE program. They must provide time and money for training of the nurses and then create a system to make sure that victims have access to services.

The availability of SAFEs demonstrates their commitment to using best practice to meet the needs of sexual assault victims, and we encourage them to continue and expand their support for this program.

On behalf of victims of sexual assault, we thank the SAFEs for their commitment, their dedication and their time. When a person has experienced a sexual assault, having the best possible response at the outset can help the survivor begin their healing journey.

Marty McIntire is executive director of the Sexual Assault Crisis Center.