2.5.9 Survivors with Mental Health Issues

Often, people within the general population have misconceptions and biases about mental illness that create a stigma.

As a result, people with serious mental illness may be treated poorly or differently from others, even by health service providers.

It’s important to show respect to all survivors, including those with serious mental illness. It’s inappropriate to use language such as ‘crazy’, ‘psycho’ or ‘nuts’ either directly with a survivor suffering from mental illness or indirectly when discussing them with other people, including health service providers.

Be aware of how you communicate as survivors with mental illness have special needs that need to be addressed in specific ways.

Someone with a mental illness or mental health issues may be especially vulnerable to sexual assault. The stress of experiencing sexual assault can worsen or intensify a survivor’s prior mental health condition.

If a survivor is extremely agitated, distracted, uncommunicative or displaying inappropriate emotional responses, notify a health service provider immediately as the survivor may be experiencing a psychiatric crisis.

As an advocate, it’s important to recognize when you are no longer able to support a survivor because of their mental health issues and to be willing to refer them to a qualified healthcare provider.

If you are comfortable advocating for a survivor with mental health issues, approach them as you would any other survivor. Try to establish trust and a feeling of sympathetic understanding; present a calm, nonthreatening and reassuring manner. You may need to spend additional time in the beginning establishing rapport or helping the survivor understand your role.

Given that some survivors may be overwhelmed with trauma reactions in addition to pre-existing distressing symptoms, keep your interactions simple and brief. Survivors may not be capable of rational discussion on some or all topics.

Survivors may be overwhelmed by delusions, paranoia or hallucinations and may feel threatened by you or afraid of you. They may have had prior negative experiences with other people in your role or a similar role.

As much as possible, help survivors feel they are in control of the situation.

Introduce yourself by name first and explain your role as a sexual assault advocate.

However, even survivors who are experiencing delusions, paranoia or hallucinations may still be able to accurately provide information and informed consent to medical treatment and forensic exams.