Treating survivors of sexual and gender-based violence in Delhi

  • Assessment and management of injuries and pain.
  • Provision of HIV post-exposure prophylaxis (PEP).
  • Prevention if unwanted pregnancy with emergency contraception or intrauterine device (IUD).
  • Offer of contraception counselling and contraceptives.
  • Identification, prevention and treatment of sexually transmitted infections (STIs).
  • Vaccination for Hepatitis B and Tetanus.
  • Complete forensic examination and evidence collection.
  • Offer and provision of medical certificate or medico-legal certificate.
  • Referral for specialized care, based on patient needs, like Emergency medical care, Gynecology and Psychiatry.

In addition to psychosocial care, survivors are able to receive more specialized counseling that includes helping them process and express their thoughts and feelings, working towards overcoming feelings of guilt, self-blame and symptoms of trauma, making decisions about what to do next, and developing stress management and problem solving skills to improve their day-to-day functioning. Problem Management + and Cognitive Behavioral Therapy are the most commonly used models of therapeutic care. While most survivors of SGBV heal and recover on their own or with psychosocial and counseling support, some may have pre-existing psychiatric conditions or develop psychiatric problems. Some survivors develop psychiatric illness such as severe anxiety disorder, moderate to severe depression, self-harming or suicidal thoughts or acts, psychosis, acute stress disorder or PTSD. For these survivors, ongoing counseling is strongly encouraged and provided and referrals to psychiatric care are facilitated, when required.

Psychosocial support is a key component of providing comprehensive quality care for survivors of SGBV. The psychosocial support provided by the project’s mental health team (counselors/social worker) is guided by key principles: ensuring confidentiality and privacy, restoring choice and control, respect, non-judgment, patience, empathy, allowing the survivor to show emotion and active listening. Counsellors provide psychoeducation about common emotional, psychological and behavioural responses to SGBV and support survivors to reflect on their own strengths to explore self-care and coping strategies. Risk assessments including assessing for suicidal risk, and safety planning are done with every survivor. The clinic’s social worker assesses the practical needs of survivors and works as bridge between our clinic and services in the larger community that can be difficult to access and navigate. Survivors are supported to access legal support, vocational training, long-term shelter homes, and the existing commissions and NGO’s that support women and children. Follow up is done regularly to assess if survivors are benefitting from these referrals.