Determinants of Referral Outcomes for Victim–Survivors Accessing Specialist Sexual Violence and Abuse Support Services

Figures & data

Table 1. Categorization of dependent and independent variables.

Referral outcome
Engaged	active engaging with service; active to service; actively engaging with service; group only; infrequent; one off session; planned closure; unplanned closure; referred on
Waitlisted	advocacy and counselling waiting list; advocacy waiting list; counselling waiting list; assessment waiting list; initial assessment booked
Not engaged	contact us letter sent; declined service; deferred; did not engage; disengaged; information/advice only; referral incomplete; referral withdrawn; inappropriate referral; not brought to service; dual status client - service denied; service denied; service withdrawn
Type of abuse
Rape	rape; rape in partnership/marriage; rape by peer/trusted adult/adult/adult relative/child/child family member/group; gang related rape; attempted rape
SVA	assault by penetration; voyeurism; sexual assault by a trusted adult/adult relative/adult/child/child family member; sexual bullying; penetration by object; gang related sexual violence; forced sexual activity in public; exposed to sexual images; sexual harassment/violence/exploitation; (serious) sexual assault; female genital mutilation
CR, CSA, other CA	forced into as child; childhood physical abuse; childhood sexual assault/exploitation; child abduction/domestic slavery
Other SVA	witnessed sexual violence; prostitution; pornography; sexualized behavior; exposure; trafficking; revenge porn; making indecent images; sexting; distributing indecent images
Non-sexual violence and abuse	abduction; verbal abuse; stalking and harassment; psychological abuse; internet related abuse; grooming; forced imprisonment; physical abuse; harassment; institutional abuse; financial abuse; emotional abuse; domestic violence; control; torture; stalking
Harmful practices	honor crime; harmful practices; forced marriage; ritual abuse; dowry related abuse; peer exploitation; isolation
Support needs
Mental health	anxiety; depression; PTSD; agoraphobia; OCD; claustrophobia; hearing voices; post trauma symptoms; delusions; hallucinations; triggers; panic attacks; intrusive thoughts; compulsions; dissociation; obsessive thoughts; flashbacks; mental health; phobias; self harm; severe and enduring mental health; personality problems; prescription medication
Suicide	overdose; suicidal thoughts; suicide attempts
Substance misuse	alcohol misuse; drug misuse
Physical health	memory loss; physical injuries; body problems
Sexual health	gynae disorder; sexual problems; sexual transmitted illness; pregnancy as a result of abuse; forced termination of pregnancy; termination of pregnancy
Social	bullying; work difficulties; parenting problems; family relationship breakdown; homelessness; interruption to education; loss of work/income; relationship problems; interruption to employment; social isolation; isolation; school truancy; bereavement/loss; study difficulties; relationship breakdown; adoption
Emotional	anger/aggression; mistrust; fear; self-blame; confusion; guilt/shame; hyper-vigilance; stress; lack of insight/understanding; low mood; low self-esteem; negative self-image
Behavioral	bed wetting; restrictions to movements/activities; sleep problems; nightmares; eating problems; sexualized behavior; behavioral issues; mimicking abusive behavior; sexuality issues; gender issues

SVA = sexual violence and abuse, CR = child rape, CSA = child sexual abuse, CA = child abuse, CJS = criminal justice system.

Table 2. Descriptive statistics of victim-survivors not engaged with, waitlisted for, or engaged with Rape Crisis England & Wales Services.

	Not engaged (n = 4,076)		Waitlisted (n = 701)		Engaged (n = 3,451)		Total (n = 8,228)
	N	%	N	%	N	%	N	%
Rape
Not mentioned	1650	40.5	307	43.8	1636	47.4	3593	43.7
Mentioned	2426	59.5	394	56.2	1815	52.6	4635	56.3
Pearsonchi2(2) = 36.4, p-value = 0.000
Sexual violence and abuse
Not mentioned	2729	67.0	389	55.5	2034	58.9	5152	62.6
Mentioned	1347	33.0	312	44.5	1417	41.1	3076	37.4
Pearsonchi2(2) = 67.9, p-value = 0.000
CR, CSA and other CA
Not mentioned	2467	60.5	387	55.2	1774	51.4	4628	56.2
Mentioned	1609	39.5	314	44.8	1677	48.6	3600	43.8
Pearsonchi2(2) = 63.5, p-value = 0.000
Other sexual violence and abuse
Not mentioned	4037	99.0	695*	98.7	3378	97.9	8107	98.5
Mentioned	39	1.0	N<10		73	2.1	121	1.5
Pearsonchi2(2) = 17.5, p-value = 0.000
Non-sexual
Not mentioned	3669	90.0	607	86.6	3011	87.3	7287	88.6
Mentioned	407	10.0	94	13.4	440	12.7	941	11.4
Pearsonchi2(2) = 17.0, p-value = 0.000
Harmful practices
Not mentioned	4047	99.3	695*	99.1	3418	99.0	8160	99.2
Mentioned	29	0.7	N<10		33	1.0	68	0.8
Pearsonchi2(2) = 1.4, p-value = 0.503
Mental health need
Not mentioned	749	18.4	69	9.8	389	11.3	1207	14.7
Mentioned	3327	81.6	632	90.2	3062	88.7	7021	85.3
Pearsonchi2(2) = 89.6, p-value = 0.000
Suicide-related need
Not mentioned	3540	86.8	476	67.9	2910	84.3	6926	84.2
Mentioned	536	13.2	225	32.1	541	15.7	1302	15.8
Pearsonchi2(2) = 161.3, p-value = 0.000
Substance misuse need
Not mentioned	3655	89.7	617	88.0	3179	92.1	7451	90.6
Mentioned	421	10.3	84	12.0	272	7.9	777	9.4
Pearsonchi2(2) = 18.9, p-value = 0.000
Physical health need
Not mentioned	3891	95.5	640	91.3	3244	94.0	7775	94.5
Mentioned	185	4.5	61	8.7	207	6.0	453	5.5
Pearsonchi2(2) = 22.7, p-value = 0.000
Sexual health need
Not mentioned	3970	97.4	677	96.6	3341	96.8	7988	97.1
Mentioned	106	2.6	24	3.4	110	3.2	240	2.9
Pearsonchi2(2) = 3.0, p-value = 0.227
Social need
Not mentioned	3177	77.9	363	51.8	2380	69.0	5920	71.9
Mentioned	899	22.1	338	48.2	1071	31.0	2308	28.1
Pearsonchi2(2) = 229.0, p-value = 0.000
Emotional need
Not mentioned	2382	58.4	239	34.1	1560	45.2	4181	50.8
Mentioned	1694	41.6	462	65.9	1891	54.8	4047	49.2
Pearsonchi2(2) = 216.7, p-value = 0.000
Behavioural need
Not mentioned	3113	76.4	349	49.8	2347	68.0	5809	70.6
Mentioned	963	23.6	352	50.2	1104	32.0	2419	29.4
Pearsonchi2(2) = 222.9, p-value = 0.000
Referral source
Self-referral	1133	27.8	230	32.8	1190	34.5	2553	31.0
Healthcare referral	952	23.4	180	25.7	833	24.1	1965	23.9
Police/Court/CJS referral	1060	26.0	173	24.7	660	19.1	1893	23.0
Social care/education referral	407	10.0	45	6.4	301	8.7	753	9.2
Voluntary sector referral	311	7.6	41	5.8	226	6.5	578	7.0
Individual	213	5.2	32	4.6	241	7.0	486	5.9

Pearson chi² (10) = 94.8, p-value = 0.000.

Notes: Based on Rape Crisis England & Wales data from three centres (2016–2020). CR = child rape, CSA = child sexual abuse, CA = child abuse, CJS = criminal justice system.

Table 3. Referral outcomes based on type of abuse and support needs. Results from multinomial logistic regression analyses, relative risk ratios (RRR) and p-values are presented.

	Model a		Model b		Model c
	Waitlisted vs. not		Engaged vs. not		Engaged vs.
	engaged (base)		engaged (base)		waitlisted (base)
	RRR	p	RRR	p	RRR	p
Type of abuse
Rape	1.041	0.729	0.998	0.979	0.959	0.716
Sexual violence and abuse	1.446	0.000	1.25	0.000	0.864	0.143
CR, CSA and other CA	1.089	0.470	1.186	0.011	1.089	0.470
Other sexual violence and abuse	N<10		1.692	0.013	N<10
Non-sexual	1.199	0.182	1.152	0.084	0.961	0.765
Harmful practices	N<10		0.822	0.472	N<10
Support needs
Mental health need	1.330	0.048	1.604	0.000	1.206	0.203
Suicide-related need	1.615	0.000	0.915	0.245	0.566	0.000
Substance misuse need	0.741	0.032	0.641	0.000	0.865	0.308
Physical health need	1.002	0.992	0.96	0.715	0.958	0.796
Sexual health need	0.873	0.574	1.064	0.676	1.219	0.408
Social need	1.900	0.000	1.28	0.000	0.674	0.000
Emotional need	1.509	0.000	1.394	0.000	0.924	0.444
Behavioral need	1.762	0.000	1.117	0.074	0.634	0.000
Referral source
Self-referral (Ref.)
Healthcare referral	1.049	0.677	0.944	0.387	0.900	0.354
Police/Court/CJS referral	1.096	0.446	0.733	0.000	0.668	0.001
Social care/education referral	0.643	0.019	0.814	0.032	1.265	0.215
Voluntary sector referral	0.747	0.125	0.795	0.025	1.064	0.746
Individual referral	0.788	0.274	1.055	0.630	1.338	0.175
Gender
Woman (Ref.)
Man	0.901	0.484	0.722	0.000	0.802	0.143
Age
Under 16	5.515	0.000	1.243	0.103	0.225	0.000
16–25	1.118	0.417	0.778	0.003	0.696	0.01
26–35 (Ref.)
36–45	0.928	0.586	1.152	0.079	1.241	0.117
46–55	0.786	0.134	1.441	0.000	1.833	0.000
56 and over	0.910	0.668	1.723	0.000	1.893	0.003
Ethnicity
White (Ref.)
Asian (British)	2.330	0.005	2.240	0.000	0.962	0.890
Black (British)	1.112	0.657	1.135	0.329	1.021	0.932
Mixed/Multiple	1.121	0.63	1.069	0.627	0.954	0.841
Sexual orientation
Heterosexual (Ref.)
Bisexual	1.100	0.643	1.155	0.269	1.05	0.812
Gay or lesbian	1.029	0.908	1.341	0.047	1.303	0.283
Other	1.486	0.255	1.239	0.373	0.834	0.596
Undisclosed	0.413	0.000	1.168	0.029	2.828	0.000
Accommodation status
Homeowner/family (Ref.)
Social housing	0.775	0.049	0.712	0.000	0.919	0.513
Private renter	1.071	0.586	0.768	0.001	0.717	0.009
Other/temp	0.603	0.001	0.729	0.000	1.209	0.236
Employment status
Employed (Ref.)
Unemployed	0.632	0.000	0.510	0.000	0.808	0.074
Student	0.59	0.001	0.806	0.015	1.366	0.054
Unable to work or retired	0.663	0.018	0.621	0.000	0.936	0.703
Disability
No disability (Ref.)
Disability	1.265	0.015	0.968	0.56	0.765	0.006
Primary perpetrator
Current partner (Ref.)
Ex-partner	0.926	0.663	0.933	0.509	1.008	0.967
Relative	0.964	0.830	1.012	0.907	1.050	0.777
Acquaintance	0.920	0.581	0.987	0.887	1.074	0.643
Stranger	0.560	0.007	0.779	0.029	1.392	0.127
Dependents
None (Ref.)
One	1.012	0.935	0.960	0.617	0.949	0.711
Two	0.891	0.459	0.741	0.001	0.831	0.241
Three	1.021	0.921	0.845	0.176	0.828	0.363
Four or more	1.034	0.885	0.657	0.003	0.635	0.059
Benefits
No benefits (Ref.)
Receives benefits	1.626	0.000	1.631	0.000	1.003	0.977
Constant	0.070	0.000	0.596	0.000	8.510	0.000

Analyzes based on Rape Crisis England & Wales data from three centers (2016–2020). Ref. = reference category. N<10 for those waitlisted of those who have experienced other sexual violence and abuse and harmful practices. CR = child rape, CSA = child sexual abuse, CA = child abuse, CJS = criminal justice system.