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forensic compliance, forensic nurse, nonreport option, rape, sexual assault, sexual assault nurse examiner



  1. Heffron, Laurie Cook LMSW
  2. Busch-Armendariz, Noel Bridget PhD
  3. Vohra, Shetal S. PhD
  4. Johnson, Regina Jones DrPH
  5. Camp, Victoria MEdPsych


Background: Forensic nurses, sexual assault nurse examiners (SANEs), and victim advocates have long recognized the trauma of sexual assault crimes and the significance of survivors' decisions around reporting these crimes to law enforcement agencies. Until recently, survivors who didn't report the crime were not entitled to a free medical forensic examination. In a significant policy shift, the Violence Against Women and Department of Justice Reauthorization Act of 2005 provided an additional decision option with regard to the medical examination for survivors of sexual assault. This provision, referred to here as the nonreport option, was established to offer survivors a full range of reporting options and to ensure exemplary health care, with evidence collection as an important secondary goal.


Objectives: This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process.


Methods: A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data.


Results: The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified.


Conclusions: Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research is warranted. The authors also present recommendations to improve health care delivery.