How can I effectively assess the psychological impact of sexual assault on a patient during a consultation?

To effectively assess the psychological impact of sexual assault during a clinical consultation, start by creating a safe, private environment where the patient feels comfortable to disclose sensitive information, ensuring they are seen alone in future appointments if possible.

Use a trauma-informed approach by asking about symptoms commonly associated with trauma such as anxiety, depression, post-traumatic stress disorder (PTSD), intrusive thoughts, nightmares, flashbacks, low mood, and disturbed sleep.

Assess for clinically important symptoms of PTSD using validated screening tools if available, and evaluate the degree of distress and functional impairment (mild, moderate, or severe) caused by these symptoms.

Regularly inquire about thoughts of self-harm and suicide as part of the psychological assessment, especially if the patient shows signs of severe distress or functional impairment.

Explore the patient’s psychosocial needs, including their social support network, living arrangements, recent life events, coping strategies, and any safeguarding concerns such as ongoing abuse or risk to dependents.

Provide validation and reassurance to the patient, acknowledging the difficulty of disclosure and the commonality of psychological distress following sexual assault.

Consider referral to specialist services such as sexual assault referral centres (SARCs), mental health services, or psychologists with expertise in trauma, especially if psychological problems are adversely affecting rehabilitation or daily functioning.

Document and coordinate care with multidisciplinary teams, ensuring ongoing monitoring of mental health symptoms and providing follow-up support tailored to the patient’s needs.