SANE cases. All victims received complete medical forensic exams, and the exam results 14 NIJ JourNal / Issue No. 264 were analyzed by the state crime laboratory for DNA evidence. SANE fACTS SANE nurses receive a minimum of 40 hours of classroom training and 40 hours of clinical training. The training covers evidence collection, injury detection methods, chain-of-evidence requirements, ways to avoid re-traumatizing a victim during an examination and other topics. Most SANE teams use specialized equipment such as a colposcope, a lighted magnifying tool that can detect small cuts, bruises and other injuries. The colposcope is also equipped with a camera to document any injuries. ▼SANE programs have grown partly because the need is great. A 1998 report by the National Institute of Justice and the Centers for Disease Control and Prevention included results of a survey of 16,000 adults of both sexes. Some 17.7 percent of women and 3 percent of men reported being the victim of a completed or attempted rape at some point in their lifetimes. ▼Although some SANE programs have relied on grant funding to get started, they often become selfsustaining because they provide reimbursable medical services. ▼ Most SANE programs are based in hospitals, although a few are based in rape crisis centers. In some places, mobile SANE teams are set up to go to various hospitals or other locations as needed. ▼SANE programs now exist in every state of the union, with about 500 programs in all. The programs treat adults and adolescents, and about half treat children as well. SANE programs typically handle sexual assault victims of both sexes. Rebecca Campbell discussed the findings of her study in more detail at an NIJ seminar. Go to http://www.ojp.usdoj.gov/ nij/pubs-sum/video-sane.htm to view her presentation. Historically, sexual assault cases have been underreported and had low prosecution rates. These particular SANE programs — and perhaps many others — are contributing to higher prosecution and conviction rates. To discover how the programs led to increased prosecution, the researchers looked at the details of cases and interviewed law enforcement officers, prosecutors and assault victims. SANE programs provide forensic evidence that is critical for successful investigations. One supervising detective noted that the quality of the evidence produced by medical forensic exams is higher with the SANE program. “I know the quality of documentation has improved from what we’ve seen in the past. Particularly with the addition of … photographs of injuries; we never had that from an ER.” Participants in the study were granted anonymity and will not be identified by name or agency. it became more confident about building a case. The researchers found that in cases where the victim had a medical forensic exam, police collected more kinds of other evidence from the crime scene and from interviews with the suspect and possible witnesses. “Evidence begets more evidence,” the researchers report. The cumulative effect was that more cases progressed further through the criminal justice system. Another detective noted that the SANE program produced evidence quickly and made it available to law enforcement. “SANE information is received rather quickly, if not the same day, the following day ... With the hospital it took time to go through their records to obtain any additional reports, which made it difficult for us to proceed with our investigation.” A prosecutor noted that the evidence collected helped to elicit guilty pleas in some cases and trial convictions in others. “I’m sitting here thinking to myself, I’ve got a good case. In addition, once a law enforcement agency knew that evidence would be forthcoming, 15 NIJ JourNal / Issue No. 264 Even after accounting for other influences, the effects of the SANE program were still statistically significant. I’ve got corroboration, I’ve got medical, I’ve got a good case, and I’ll use that with talking to the defense attorney.” Besides providing forensic evidence, SANE teams are also available to testify in court as expert witnesses. SANE programs in this county do not pressure their patients to contact law enforcement and pursue prosecution. Nurses and advocates strive to minimize victim trauma, and they focus on providing high-quality patient care and attending to the emotional needs of the victim. The nurses and advocates take the time to answer all the victim’s questions about evidence and the legal system. One victim told researchers that the SANE program’s involvement played an important role in her decision to file criminal charges. “That’s part of the reason [that I continued] … Because that will just show that he did things to me, and I have proof.” By not focusing on legal concerns right away, victims were more willing and able to continue with a criminal case. Some assault victims said the SANE experience was a turning point. “It was the first time where I felt … human, after going through such a horrendous experience and made to feel I was just a bitch in heat … or a pig being led to the slaughter … and people like the advocates and the nurse examiner, they … make you feel like they’re more interested in you, in helping you cope with what happened, and that makes it easier, too, because they’re looking at you like a person … I didn’t feel like another body on a slab.” HOW SExUAL ASSAULT CASES PROGRESS fURTHER WITH SANE: