Impacts

Trauma and the impact of sexual misconduct

Sexual misconduct, assault and/or violence can be a traumatic event to those who experience and witness it, and it is important to understand what effects this can have on the people we work with. Everyone is different and trauma may not impact everyone in the same way.

In wider society, studies show that 1 in 4 women and 1 in 18 men have been sexually abused or assaulted some studies show this number for men to be closer to 1 in 6

In the NHS, the NHS Staff Survey 2023/24 responses showed that:

3.7% of women reported being the target of sexual harassment at work, compared to 3.5% of men
when we look at age ranges, the most impacted were 21 to 30 and 31 to 40, 6.6% and 4.35%, respectively
when we look at ethnicity, colleagues from a mixed ethnic background report higher than average incidents of sexual harassment, ranging from 4.6% to 6.7%. Gypsy or Irish Traveller colleagues also experienced unwanted behaviour at a disproportionate rate of 11.8%.

Sexual misconduct can be very difficult to talk about. People who have been harassed at work may experience shame and anxiety. Witnesses to the incident(s) can also experience negative impacts on their wellbeing.

Some impacts of sexual misconduct can be long lasting, often continuing for months or years after the incident(s). Sometimes, they will never go away.

Social impacts

Social impacts include but are not limited to:

isolation
concerns about working relationships
concerns about relationships outside of work (partner, friends, family)
concerns about career prospects
inability to function effectively at work
missing work or unexplained absences

Psychological impacts

Psychological impacts include but are not limited to:

feeling worried about personal safety
anxiety
panic attacks
flashbacks
nightmares
depression
post-traumatic stress disorder (PTSD)
dissociation (feeling detached from reality) and numbness
trouble eating, sleeping or taking care of yourself
changes in usual behaviour: becoming withdrawn or not enjoying things you used to
being sensitive to 'triggers' (things that remind you of the traumatic event)

Physical impacts

Physical impacts include but are not limited to:

pain, both widespread and in specific places such as headaches or back pain
indigestion, heartburn and upset stomach
chest pains and high blood pressure
weight gain or loss
memory loss including difficulty recalling the event

However, it is important to remember that if you see evidence of these impacts, it does not necessarily mean sexual misconduct has occurred.

Another traumatic event, life change or something else could be affecting that person. So always be mindful and approach someone with care if you raise anything you have noticed.

Sometimes, the impact of sexual misconduct can lead people to develop behaviours that help them cope with what has happened including:

avoiding activities they used to enjoy
spending more or less time at work
over or under eating
self-harm
substance misuse including using drugs and/or alcohol

Sadly, some victim-survivors have ended their lives or attempted suicide because of experiencing sexual misconduct, assault, abuse and/or violence

Sexual misconduct at work also has wider consequences.

Organisational

Organisational:

poor relationships in the workplace
reduced productivity
increased absenteeism
recruitment and retention challenges
reputational damage

Patient

Patient:

increased waiting times due to staff absences
reduced quality of care

Financial

Financial:

increased costs from absenteeism and recruitment
time and cost of investigating cases
legal fees defending tribunals

Case study

Please note that in this case study we discuss themes and impacts of sexual misconduct that might be upsetting. Please remember there are support organisations and services available to you. If you need specialist support, you can use this government directory of specialist support for victims and witnesses of sexual violence and abuse. There are also links to support services at the end of this session.

Jess is a first responder at the XL Team. Jess has just had approval to enrol onto an emergancy care support worker course. Leo is a paramedic with several years' experience and is well known and respected throughout the organisation.

Leo has been supporting Jess to develop their clinical skills to advance Jess' career and this included spending time with Leo, looking at research papers and discussing the job role.

At one Event, Leo plonked a bunch of papers on Jess' lap and pointed out different papers whilst prodding Jess' groin.

Jess did not know what to do; asked to be excused and went to leave the first aid post. Leo blocked Jess' excit and attempted to try and kiss Jess.

Jess goes home after the working day. Jess feels unable to tell anyone what Leo has done and so many thoughts are going through Jess' head.

"Nobody will believe me"

"I wanted to go for that promotion after finishing my course but there is no way they will give me a look in if I say anything about this."

"If I do say something, I will ruin Leo's career, Leo has a family to look after too."

Jess cannot sleep that night. Jess' partner asks if something is wrong, but Jess does not say anything.

The next morning

Jess gets up for work the next morning. Jess has barely slept and cannot eat.

Jess' head is pounding. Jess stands in the first aid post awaiting her event briefing, but cannot focus and is looking around, wondering if any colleagues know what's happened and what they think.

Jess misses half the briefing report but gets onto the tasks of the shift.

The medication error

Jess asks to work in minors, in the hope that it will help avoid Leo who is working within majors and resus. Jess is distracted and administers pain medication to a patient without checking when their last dose was.

It is a near miss, and the patient isn't seriously hurt but they need increased monitoring which is agitating them. It is taking lots of the team's time to take the patient's vital signs and manage their behaviour.

When leaving the first aid post, Jess overhears colleagues saying Jess is to blame for the extra work.

Jess' health and wellbeing

Jess' health and wellbeing is badly affected by these events.

After a visit to the GP Jess is signed off sick for a period.

Jess was supposed to be working the next day at a two person event, but this has to be cancelled as there are no staff available to meet the customers needs.

Learning from the case study

This case study shows the serious impact that experiencing sexual misconduct can have on the individual, their families, colleagues and the patients they care for.

Jess' physical and emotional wellbeing has been affected by Leo's actions. Because of Jess' headache and poor sleep, Jess is unable to fully concentrate at work which has caused an error in patient medication. This has put additional pressure on the team on shift. Jess is unable to speak to their partner which could cause issues within their relationship.

Jess is now off sick which means that there is a safe staffing issue, affecting the xl team's ability to admit and care for patients.

This cycle of impact could continue further. The impacts above show that sexual misconduct at work can have serious consequences that go well beyond the victim-survivor.

We all react to trauma differently; there is no 'right' or 'wrong' way to feel.

By taking a trauma-informed approach, we seek to prevent re-traumatisation and trauma compounding (getting worse). We understand the impacts of sexual misconduct not only on victim-survivors but also on responders and witnesses.

You have reached the end of this chapter on trauma and the impact of sexual misconduct. Please remember there are support organisations and services available to you if any of this content has been upsetting. If you need specialist support, you can use this government directory of specialist support for victims and witnesses of sexual violence and abuse. There are also links to support services at the end of this session.

The next chapter will help you understand how to give trauma-informed support when someone shares an experience of trauma or abuse with you.

It is important that when you respond to sexual misconduct, you communicate clearly and sensitively, manage confidentiality, and signpost to specialised support.

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