To report concerns about harm or neglect of a child or teenager, call your local law enforcement agency or the Washington Child Protective Services hotline at 1-866-END-HARM. For help obtaining a referral to the Providence Abuse Intervention Center, or for other questions about our services, call our staff at 360-493-7469.

We offer children and their caregiver's expert, compassionate medical care when there are concerns of abuse of any kind. Our staff also provides trauma-informed support for caregivers, connections to community partners and other resources. We believe that everyone has the right to feel safe and to be treated with respect.

Patients from infancy through age 17 are referred to our center by medical providers, law enforcement or Child Protective Services when there are concerns about physical abuse, sexual abuse, neglect, child torture or any other form of child maltreatment. We serve children and families in Thurston, Mason, Lewis, Grays Harbor and Pacific counties.

Our medical providers take a thorough medical history and conduct a physical exam to evaluate a child for general health and specific health risks related to abuse. They can identify and document new and old injuries, test for possible infections and provide any needed treatment.

The medical visit is an opportunity to reassure the child and the caregiver about the child’s health. This visit is important even when the abuse occurred a long time ago. Children are empowered to make decisions about their bodies throughout this process, and all aspects of the physical exam are done with permission from the child.

The medical visit also provides information for caregivers on how to support a child who has experienced a trauma such as abuse. Staff can help answer any questions the child or caregiver may have. Our goal is to support the child and caregiver where they are, identify any medical concerns and provide treatment, offer education about normal responses to trauma and make referrals for ongoing services.

A medical visit with our providers can lead to more in-depth information about abuse. Our providers have advanced training in the specialty of child abuse assessments. This high level of expertise leads to more accurate diagnoses of child abuse. Our providers may also identify conditions that might be mistaken for abuse.

Child abuse evaluations are covered by the state Crime Victims Compensation Program. This includes the medical visit and any tests that are ordered, such as urine tests, blood tests or X-rays. Our staff can also provide information about other services that might be covered by the program, such as counseling or lost wages due to time off work for medical or other visits.

To ease a child’s fears or anxiety, take these steps before their medical visit:

• Talk with our staff beforehand about the best way to explain the visit to your child.
• Assure your child that we see many children just like them. We understand.
• Tell your child they can choose an adult to be with them during their examination.
• Reassure the child that this is not a physically painful or invasive exam. Your child will participate in deciding what happens during their exam.
• Encourage older teens to talk directly with our staff about their upcoming visit.

A community advocate is available to you at your appointment and beyond. Advocates answer questions, provide emotional support, connect you to community resources and help you navigate next steps.

Advocacy groups in counties we serve include:

• SafePlace (Thurston) 360-754-6300
• Hope Alliance (Lewis) 360-748-6601
• Beyond Survival (Grays Harbor) 888-626-2640
• Turning Pointe (Mason) 877-923-1212
• Crisis Support Network (Pacific) 800-435-7276

The Providence Abuse Intervention Center is part of Monarch Children’s Justice and Advocacy Center. Monarch provides children and caregivers with coordinated services, all in one location. These include advocacy, forensic interviews, counseling and supportive interactions with law enforcement, special victims prosecutors and Child Protective Services.

For more information about Monarch, call 360-923-1884, ext. 1102, or visit the center’s website.

Crisis Clinic of Thurston & Mason Counties 24-hour crisis line, 360-586-2800

Washington Coalition of Sexual Assault Programs (WCSAP), 360-754-7583

Rape, Abuse and Incest National Network (RAINN), 800-656-HOPE

Getting prompt medical attention after a sexual assault or strangulation assault is very important. Adults and adolescents who have been affected by sexual assault in the past five days or strangulation assault within in the past two weeks can receive specialized care 24 hours a day, seven days a week, from forensic nurse examiners in the emergency departments at Providence St. Peter Hospital and Providence Centralia Hospital.

If it has been more than five days since a sexual assault, or more than two weeks since a strangulation assault, we recommend seeking care from your primary care provider. We also advise contacting one of the local advocacy groups listed below for support and resources.

If you are experiencing physical symptoms at any time that may be related to an assault, we recommend seeking care as soon as possible from your primary care provider, an urgent care clinic or an emergency department.

Sexual assault is any type of sexual contact that occurs without your consent. Consent should be freely given, reversible, informed and specific. Sexual assault can happen to anyone no matter their age, race, gender or sexual orientation. The offender can be someone known or a stranger. The person who is sexually assaulted is never to blame.

Strangulation is any external pressure put on the neck with the intent to block either airflow or blood flow, even if it does not actually block this flow. Strangulation can happen during either a physical assault or a sexual assault.

Forensic nurse examiners and other emergency department providers can:

• Take a medical history, including information about the assault
• Evaluate, document and treat injuries
• Order tests and imaging as needed
• Provide emergency contraception and other medications when indicated to reduce the risk of pregnancy and sexually transmitted infections, including HIV
• Give emotional support in a compassionate and trauma-informed manner
• Engage advocacy groups that can assist survivors of sexual assault and strangulation
• Collect forensic evidence, such as clothing and skin swabs

Choosing to have a medical exam after a sexual assault or a strangulation is about your health and safety. All the services above are voluntary. Patients may choose to receive some of the services and decline others. No patient, regardless of age, will be made to complete any part of a sexual assault exam against their wishes.

Under Washington state law, the cost for sexual assault and strangulation examinations is paid by the state Crime Victims Compensation Program. There is no charge to the patient.

Go to an emergency department as soon as possible. You may bring a friend or family member with you for support.

Before you go to the emergency department, it is best to avoid:

• Bathing, showering or cleaning up. If you have already done so, an exam can still be done.
• Changing your clothes. If possible, bring a change of clothes for after the exam. If you have already changed, bring in any clothes you were wearing at the time of the assault.
• Smoking, vaping, chewing gum, eating and drinking, urinating, and having a bowel movement. If you have already done any of these things, an exam can still be done.

If you are 18 or older and are not a vulnerable adult (a person who cannot take care of themselves without help from others), you do not have to report the assault to law enforcement. If you are a minor or a vulnerable adult reporting sexual assault, strangulation or other abuse, health care providers must make a report to law enforcement or to Child Protective Services or Adult Protective Services.

You can choose to have evidence collected even if you do not report the assault to law enforcement. If you choose not to report the assault at the time of your medical exam, evidence can be collected and stored anonymously in case you decide to report the assault later.

It is normal to have many different emotions after an assault. Local professionals, including forensic nurse examiners, community advocates and counselors, have special training to provide support. You are not alone.

During business hours, questions about sexual assault or strangulation exams can be directed to the Providence Abuse Intervention Center at 360-493-7469.

Advocates can provide emotional support, assist with needs such as safety planning and shelter, and offer other resources. Local advocacy groups include:

• SafePlace (Thurston County), 360-754-6300
• Hope Alliance (Lewis County), 360-748-6601
• Beyond Survival (Grays Harbor County), 888-626-2640
• Turning Pointe (Mason County), 877-923-1212
• Crisis Support Network (Pacific County), 800-435-7276

These county, state and national groups also provide support and advocacy services:

• Crisis Clinic of Thurston & Mason Counties 24-hour crisis line, 360-586-2800
• Washington Coalition of Sexual Assault Programs (WCSAP), 360-754-7583
• Rape, Abuse and Incest National Network (RAINN), 800-656-HOPE