Make assault prevention training mandatory on campus

Recent surveys at both Duke and UNC show alarming rates of campus sexual assault. A survey given to Duke undergraduates in 2018 showed that almost 48 percent of women respondents at Duke were sexually assaulted. Now, UNC reports similar numbers; by their fourth year, 45% of women have experienced non-consensual sexual touching or rape. While men and LGBTQ individuals face risks, as well; my experience as a physician for over 30 years has been primarily treating women who are victims of sexual assault.

I have sat with these women — female students raped, harassed and stalked by fellow students, touched inappropriately by their advisors or seduced by professors — their lives destroyed while their assailants went on unscathed. I learned to dread basketball championships; if a local team won, I would often get a call from a student who was assaulted afterwards. To be clear, this is not restricted to college campuses. I have seen women victimized by pastors, parents, mentors, and on and on. Sexual misconduct, for far too many women, is an expected occurrence, a part of being female in this world.

Reasons for staying silent are myriad: the perpetrator is in a position of power, disclosure is threatening to personal safety, social relationships or career. The victim is ashamed, blamed or not believed. Women are told to stay sober, don’t go out late, don’t wear certain clothes; this advice is misdirected, increases self-blame and is not effective prevention.

Survivors experience years of shame, guilt, depression, anxiety, PTSD, and related medical issues. Trauma changes the body, increasing susceptibility to illnesses such as diabetes or heart disease. For those fortunate enough to have access to mental health treatment, both time and money are spent attempting to heal. I have, in the confidence of my office, listened to these stories of great pain. It has been an honor to be trusted by these women in their private anguish. But I would prefer prevention to cure.

This has for too long been a vast and secret suffering. If one in two students contracted an illness impacting their current and future health, it would be a recognized as a public health emergency. Our universities, with their cutting edge research and lofty mission statements about integrity, curing disease and promoting leadership, should begin at home. The online training videos students are assigned prior to matriculation are insufficient and ineffective. Open discussion and live mandatory training regarding the dynamics and precursors of sexual assault are imperative.

In September, I wrote in the Duke Chronicle about the dynamics of how sexual assault can occur and a few lines on how to prevent it. A week later, I got an email from an old friend. Her cousin and his son Dan, a freshman at Duke, had read the essay and discussed it. When Dan went to a frat party and saw a drunk first year woman being hit on by a senior, he became concerned for her safety. Dan went over and gently intervened. He asked if he could walk her home, and did.

My small piece in the student paper might have made a difference for this one young woman that night. Imagine what sexual assault prevention training, starting in middle school, high school or college, might do? I challenge our esteemed institutions of higher learning to come up with research protocols and programs to address what is, and should be recognized as, a public health crisis.

Mindy Oshrain, M.D. is a Durham-based psychiatrist and a Consulting Associate in the Duke University Department of Psychiatry.