Army Battles Sexual Assault Within Troops, Improves Follow-Up Care of Victims

by U.S. Medicine

May 20, 2011

WASHINGTON—Not that long ago, a woman who had been sexually assaulted might have gone to an Army Military Treatment Facility (MTF), had a forensic examination and then would go home without anyone at the MTF knowing what became of her.

That scenario is no longer the norm, according to Col. Henry Spring, MD, commander of the Army’s U.S. Southern Command Health Clinic. “Prior to 2004 how Army Medicine responded to sexual assault is different to how we respond to it today,” he said. “I have seen change.”

Spring was among the officials who spoke at the Army’s 2011 “I A.M. Strong” Sexual Harassment Assault Prevention Summit. The summit focused on achieving cultural change, which is the third phase of a strategy launched by the Army in 2008 to prevent sexual assault and harassment within the military.


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Thomas R. Lamont, assistant secretary of the Army for manpower and reserve affairs, who also addressed conference participants, said that the long war has stressed troops and plays a role in the problems arising.

“There is no doubt that, after 10 years of war, it has stressed our force,” he said. “We are seeing the stress manifest itself in many ways, such as an increase in alcohol and drug abuse and domestic violence and suicide and in sexual assault.”

Although reported sexual assault actually decreased in 2010, there is a “significant rise” in the behavioral- health needs of soldiers and families that the Army is trying to address, he said. He also asked that leaders take the time to watch for risky behavior in soldiers in their units.

“Don’t mind your own business,” he said. “Cultivate a climate where every soldier is treated with the utmost respect, and do not tolerate any behavior that is less than respectful of any individual.”

Spring, who spoke specifically about the role of the Army Medical Department’s (AMEDD) in caring for victims, said that the new policy recognizes that care should be driven by the needs of the victim. “So it is not when the forensic exam is over the care is ended,” said Spring. “No, we have changed the paradigm and changed the approach and realize that it is continual.”

What helped bring about that change was MEDCOM Regulation 40-36, initially released in 2004 to guide health-care providers on how they should respond to sexual assaults. That regulation emphasizes the provision of timely, accessible and comprehensive medical management to victims who present at Army MTFs and indicates that these victims must be provided with all of the necessary follow up care they need.

The regulation requires MTF commanders to ensure that all patients who present with an allegation of sexual assault receive a uniform standard of care, which should be monitored and tracked until completed.

Ongoing Issues

Spring emphasized that victims of sexual assault deserve the same attention as someone who is suffering from multiple Improvised Explosive Devices (IEDs. Like victims of war, he said, they too have ongoing emotional and psychological issues.

Part of AMEDD’s agenda is to make sure that providers have a basic understanding of how to manage issues of sexual assault, whether the victims present in a hospital setting or outside of a clinical setting. To that end, the MEDCOM regulation requires that MTF commanders ensure that all health-care providers and MTF personnel participate in annual sexual assault awareness and responder training.

“Don’t be surprised that there are a lot of health-care providers out there who have no wherewithal about managing the issues around sexual assault,” he said. “Part of our agenda is to make sure that people have a core basic understanding, because you never know when a person is going to present.”

The Army is also working to address the challenge of providing medical response to these victims during deployment. “We are really challenged when these incidences happen in theater,” he said. “How do we manage that? Where are the right services at the right time at the right place for that right person? These are some of the challenge we are working out.”

In general, providers play an important role in treating and collecting evidence of a sexual assault. In 2005, DoD updated its sexual-assault policies to help get more sexual-assault victims to report crimes and seek care. As part of that effort, it developed an avenue for victims to seek medical care after sexual assault without the involvement of law enforcement, known as restricted reporting.

Strategy Aims At Eliminating Sexual Assault

Sexual assault is a threat to the cohesion of units, Secretary of the Army John McHugh told conference participants “I A.M. Strong” Sexual Harassment Assault Prevention Summit (SHARP).

“It is a threat to our readiness and, as you know, it is a threat to our very humanity,” he said. “From my perspective, there is nothing more contrary to the values of being a soldier or a civilian within the Army family than sexually assaulting or abusing a fellow officer or any person, for that matter.”

McHugh said that the Army’s five-year campaign to eliminate sexual harassment and sexual assault appears to be “headed in the right direction.” In 2010, he said the Army experienced an 8% drop in the reported sexual assault cases.

Still, with 1,1689 victims reporting a sexual assault to the Army in 2010, that hardly means the issue is resolved, he said, adding that SHARP needs to be taken to the next level with a focus on cultural change to prevent these crimes.

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