Sexual assault victims should get psychological support from first contact, says study

Five SATU patients required hospitalisation because of mental health difficulties according to HSE research from 2025. Stock picture

Psychological support must be made available to victims of sexual abuse when they present to a sexual assault treatment unit (SATU), according to a new study.

The researchers called for a brief psychological intervention at the first point of contact with a SATU, alongside the development of a national pathway for trauma-informed psychological and psychiatric care.

They said that while SATUs provide “essential acute medical, forensic, practical, and emotional support”, they are not designed to provide comprehensive ongoing psychological or psychiatric care.

Citing HSE research from 2025 showing that five SATU patients required hospitalisation because of mental health difficulties, the authors said: “A trauma-informed response should therefore combine compassion at first contact with continuity thereafter: Careful assessment of risk, attention to prior trauma and existing mental health difficulties, practical information about available supports, and active facilitation of follow-up.”

They argued that sexual assault should be viewed not only as a medical or forensic event but also as a potentially life-altering psychological trauma.

The study, entitled Psychological care after sexual assault in Ireland: Towards a trauma-informed pathway, was undertaken by Andrea Holmes and Brendan D Kelly of the Psychiatry department of University of Dublin Trinity College and published by Cambridge University Press.

The authors write: “For some people, distress will reduce with time, safety, social support, and practical assistance. For others, sexual violence will be followed by post-traumatic stress symptoms, depression, anxiety, self-harm, substance misuse, deterioration in pre-existing mental illness, or complex interactions between new trauma and earlier adversity. 

"This means that care following sexual assault needs to be understood as a pathway, rather than as a single appointment, intervention, or referral. The acute SATU encounter is a vital starting point, but it cannot, by itself, meet the full range of longer-term psychological and psychiatric needs.” 

The authors also warned that long waiting lists and uneven geographical access to services risk deepening existing inequities and called for greater investment in counselling, specialist staff, training, interpretation services, and links between SATUs, GPs, mental health services, and An Garda Síochána.

Rather than requiring every victim to see a psychologist or psychiatrist, they proposed a stepped-care national pathway post-sexual assault.

They said: “Rather, it would set out proportionate, stepped levels of care based on need, risk, preference, age, existing mental health history, and safeguarding concerns.” 

The pathway should include “specific provisions for adolescents, older adults, men, people with intellectual disability, people with dementia, migrants, LGBTQ+ people, and those assaulted in institutional or care settings".

They concluded: “The goal is not to make SATUs responsible for all subsequent care but to ensure that the first contact after sexual assault opens the door to the right support at the right time. 

"In this way, Ireland can build on the strengths of its SATU system while developing a more complete, trauma-informed model of psychological and psychiatric care following sexual assault, in which early intervention, specialist support services, and integrated care pathways work together to meet the individual needs of patients.”