- Sexual assault occurs when someone is forced, coerced or tricked into sexual acts or exposed to sexual situations against their will.
- Sexual assault can also occur when a person is unable to consent, such as if they are intoxicated or asleep.
- ED staff should be aware that NSW Health provides a specialised response to children, young people and adults who have experienced recent and past sexual assault through the network of NSW Health Sexual Assault Services and Child Protection Services.
Sexual Assault of a child / young person
- Children / young people who have been sexually assaulted, or are suspected to have been sexual assaulted, might be referred to NSW Health Sexual Assault Services / Child Protection services by the Department of Communities and Justice (previously FACS) or NSW Police.
- However, many children or young people may attend EDs accompanied by a parent/carer who has a concern that their child / young person may have been sexually abused either recently or in the past.
Responding to concerns that a child / young person may have been recently sexual assaulted:
- Concerns may arise due to:
- A disclosure by the child / young person
- Injuries, such as genital or anal injury or bruising
- The presence of STIs
- There has been a witness to a sexual assault.
ED staff should:
- Gather sufficient information about the reason for the presentation (but not conduct a detailed interview about the sexual assault or undertake a genital examination) in preparation to make a child protection report.
- Inform the Medical Team leader who will support implementation of local protocols to consult with on call counsellors or medical and forensic examiners from your local Sexual Assault Service/Child Protection Unit .
- Consider consulting NSW Health Child Well Being Unit (see below for Child Protection reporting links).
- Make a child protection report to the Child Protection Helpline (see links below)
Mandatory Reporting for NSW Health Staff
NSW Health, including ED staff, are mandatory reporters of suspected risk of significant harm to children, young people and “classes” of children and young people .
If you suspect abuse or neglect (past or recent), please follow the steps below:
- Complete the Mandatory Reporters Guide (MRG) which only takes a couple of minutes and will help guide your next steps.
- Contact the Health Child Wellbeing Unit (CWU) on 1300 480 420 (Monday – Friday; 8:30am – 5pm) if directed by the MRG, or you are not sure what to do.
- Contact the Child Protection Helpline (24 hours / 7 days) as directed by the MRG on 132 111 and / or if you suspect a child or young person is at imminent risk of significant harm. Alternatively, if the child is at risk of significant harm but the threat is not imminent or urgent, you can complete a report via an online eReport which must be completed within 24 hours of presentation.
Document your concerns / interventions in the client file.
Responding to concerns that a child / young person may have been sexually assaulted in the past:
Concerns may arise due to:
- a disclosure by the child or young person
- information provided by a third party such as a parents/carer or other person.
ED staff should:
- Be aware that whilst this disclosure may not warrant an immediate medical and forensic response they may create a psychological crisis for the child / young person and their parent / carers which require a crisis counselling response.
- Consult their Medical Team Leader, who will know about local protocols to consult with on call counsellors from the local Sexual Assault Service.
- Consider whether other children may be at risk through contact with the alleged perpetrator.
- In these situations ED staff are also required to make a child protection report to the Child Protection Helpline (see links below).
Responding to adults and young people presenting to EDs after recent sexual assault
Adults and young people (16 years and over) may present to EDs after a recent sexual assault or they may be referred by NSW Police or other health workers.
ED staff should:
- Triage and evaluate for major injury, for intoxication and acute psychiatric illness in accordance with NSW Health triage policy.
- Refer all patients to the Sexual Assault Service so they can be offered an integrated crisis counselling and specialised medical and forensic response (with some urgency where the assault occurred in the last 5 days because of forensic collection guidelines).
Responding to disclosures by adults of sexual assault in the past or as children
Many adults or young people, who experience sexual abuse in the past, or as children, may not disclose this abuse until many years later because of feelings of fear or shame. This disclosure may occur within the context of seeking other health care including where medical treatment triggers memories of the sexual abuse.
ED staff should:
- Validate this disclosure as an important first step in the patient’s recovery and provide them with information about accessing their local sexual assault service for further support and counselling.
- Be aware that for adults, the decision to make a report to Police about the sexual assault generally rests with them, however there are some limited circumstances where NSW Health may be required to make a report to Police based on serious threat. ED staff may seek a consult with their local Sexual Assault Service about this.
Make a report to the Child Protection HELPLINE, preferably with the knowledge and support of the patient (See links above), if in the course of the disclosure, the patient provides information that the alleged perpetrator has current access to children or young people, or a class of children or young people, and that there is a concern that these children may be at risk of significant harm.
Referral to NSW Health Sexual Assault Services
In accordance with NSW Health Guide to the Role Delineation of Clinical Services, each LHD will have a 24 hour medical and counselling response for anyone who has been recently sexually assaulted (within 5 days), and who needs crisis counselling, medical care and medical and forensic assessment. Support is also provided to family/ carers and significant others.
Emergency departments will have referral processes in place for contacting their local Sexual Assault Service / Child Protection Service or on call Sexual Assault Service / Child Protection Service.
Your Body, Your Choice
This resource has been developed by the City of Sydney, Redfern Legal Centre and Study NSW in consultation with Rape Crisis NSW, NSW Health Sexual Assault Service and NSW Police. The factsheet is designed to be given in a supportive environment when people are seeking information and help for themselves or a friend who may have experienced sexual assault.
It has been translated into 11 different languages and these are available below:
Further References and Resources
 Note that in some Rural LHDs Assessment Centres are also available for consultation.
 Section B 19 pages 70-71.