Preparing for COVID-19: A Healthcare 
Guide for Survivors of Violence 

April 2020 

Violence can have unexpected effects for survivors, even after the 
violence has stopped. If you’ve survived child sexual abuse, sexual 
exploitation, or sexual assault, some everyday activities like visiting 
the doctor or going to a health clinic may be difficult. They may be 
especially challenging during this current health crisis. 

You’re not alone. Many survivors of violence and abuse find that 
seeing a healthcare provider can be anxiety producing and 
triggering. 

Going to a healthcare clinic or hospital can be hard because the staff 
may seem rushed, or unaware of how vulnerable it can feel. As a 
result, it may be difficult to connect and feel safe. This is especially 
true when many healthcare settings are experiencing an increased 
volume of patients. Going to the emergency room may be even 
more chaotic than usual. 

There are steps you can take to make medical visits a little easier. 
But first, let’s look briefly at some of the effects of abuse and why 
they might make this so challenging. 

Why is going to the doctor so hard for me? 

There are several reasons survivors struggle with health care 


appointments. 

1. Coping mechanisms can make it hard to feel and describe what 
we are experiencing. 


Suffering sexual abuse and exploitation as children, adolescents 
or young adults is traumatic. We use a variety of coping 
strategies to survive the emotional and physical pain; we may 
distance ourselves, minimize the experience, avoid thinking 
about it, and even sometimes deny to ourselves that what we 
are experiencing is painful. These ways of coping sometimes 
make survival possible. However, they can also become a 
routine way of thinking, or handling difficult situations, even 
when we no longer need them. This can affect our health when 
we ignore signs of illness that may require immediate attention. 
It can also make it difficult to articulate what is happening for us 
physically and what we need, as a result. 

2. The experience of the healthcare setting may be triggering and 
cause flashbacks. 


Healthcare settings like emergency rooms can be stressful and 
hectic and some procedures can leave us feeling vulnerable or 
remind us of the violence that we’ve survived. Both the chaos 
and the reminders of abuse can cause survivors to re-
experience painful memories of abuse. These experiences can 
leave us feeling a surge of anxiety and panic, or at times numb 


and in a trance-like state. 

What if I need to go to the emergency room? 

At home: Plan ahead 

Ask an advocate, friend, family member or partner to help you 
develop a plan in case you need to go to the emergency room. 

1. Discuss under what circumstances you will seek emergency 
room care. 
a. Most guidance says to go if you start to have trouble 
breathing. 
b. The Centers for Disease Control provides guidance on their 
website at CDC.gov. 



2. Discuss how you will get to the emergency room should you 
need to go. 
a. Will you call for an ambulance or have someone drive you? 
b. Consider whether it is safe to have someone drive you. Will 
you be exposing them to the coronavirus? 



3. Will you be able to communicate with the emergency room 
staff? 
a. Do you need an ASL interpreter or spoken language 
interpreter? 
b. Have you had problems accessing interpreters when you’ve 
gone to your community hospital? If so, there are two 






options: you can contact your local hospital if you start 
feeling sick to ask about language access or you can set up 
a plan for yourself, should you need emergency care. If 
your healthcare facility has struggled to meet your 
language access needs during previous visits, it’s likely 
they will struggle more during this unprecedented crisis. 
Develop a plan for yourself to ensure you can communicate 
with doctors and nurses should you need to. Is there 
someone you know that can help you? Can you arrange for 
someone to call or video chat with in the event that there 
aren’t interpreters available when you need care? 
4. Can someone go with you? 
a. Most hospitals have information about visit requirements on 
their websites. Review those and if you are still concerned, 
you might try calling or emailing the clinic with questions. 
b. Having a support person helps alleviate some of the stress 
of chaotic health care settings. However, it may not be safe 
for a person to go with you or stay with you. Discuss this 
with your support person ahead of time and set up a plan 
for if you go alone. What can you do to manage your 
anxiety and fear while in hospital care? 






5. Prepare yourself for the most likely medical procedures. There is 
a lot of information online about the common treatments used in 



theemergency roomtodiagnoseand treat COVID-19. Thesemayinclude nose swabs, blood draws, the use ofIV fluids and 
the placement of an oxygen tube,intubation,x-rays andcatscans.Ifanyof those procedureshas been challengingin thepast, identify calming strategies you might use shouldyou needany of theseprocedures. 

6.Should youdevelop acard togiveto emergency roompersonnelregarding any trauma disorders?
a.Many survivors of child sexual abuse, sexual exploitationand/or assault areleft with trauma disordersbecauseof theabuse. Someof these arecomplex post-traumatic stressdisorder, post-traumatic stress disorder, dissociativeidentity disorder, other dissociative disorders aswell asanxietydisorders to name afew.(We’ve provided anexample of a card apersonwith dissociativeidentitydisordermaycreate and takewith themshould they needemergency roomcare.)
b.Survivorsmay havelearned how tomanage thesedisorders and sharing what theyknow and askingforwhatthey needwith healthcare providersmayhelp them andhealth care professionals.
c.Identify anylanguage access needs and prepare alistofcurrent medications, known allergies, and known triggers to

provide to the hospital staff that can be made available as 
important health details your care team would need to 
know. 


At the hospital: Build rapport 

Because child sexual abuse survivors weren’t in a position to stop 
the people in their lives from hurting them, healing often involves 
taking control, making decisions about your life and your body, 
including asking for help and setting boundaries. 

This pandemic has put a strain on our healthcare professionals and 
the strategies that may have helped in the past may not be 
available now. If you contract COVID-19 and need emergency room 
care, you may need intrusive life saving measures when arriving to 
the hospital and may not have time to establish a connection with 
the healthcare staff. Medical staff will be wearing face masks when 
interacting with you. This may also complicate your ability to build 
rapport before being treated or read body language during 
treatment. Let the healthcare professional know you need a few 
minutes to manage anxiety before they start working with you. Ask 
a few general questions to develop a connection. 

1. Tell them you have a history of abuse. 


If you feel comfortable, let them know that you are a survivor of 
violence. Explain how you think the violence may make it hard 
for you to get care. Let them know what you need in order to 


feel emotionally safe while they help you get physically well. If 
you have developed an emergency card identifying a diagnosed 
trauma disorder, this might be the best time to provide it to the 
doctor or nurse and discuss it with them. 

Trust your instincts during this discussion. Especially in a crisis, 
the relationship between you and the doctor or nurse should 
have open and caring lines of communication in order for you to 
feel comfortable being honest with them and relying on their 
help. It doesn’t take long to build it. If it doesn’t feel safe, trust 
yourself and either ask to talk with someone else or if that’s not 
possible, just ask for what you need. 

2. Take charge of your experience. 


Be clear about what helps you get through a healthcare exam or 
hospitalization and let the healthcare professionals working with 
you know. Lay out the consequences of not having their 
cooperation. For example, you may be claustrophobic, and any 
restraints may cause you to panic. Let them know this. Share 
your list of medications, allergies and triggers with them. Ask 
them to note this in your chart and health files just as they 
would any allergy to medications. Authorize the sharing of this 
information with your personal medical representative, so that 
they can phone in often and review that your wishes and needs 
are being addressed. In this time of crisis when nurses and 
doctors are working such long hours, you may need to tell each 


person that works with you especially after shift changes. 

3. Strategize with them over your care. 


Some of the strategies you’ve used in the past to get through 
medical appointments or hospitalizations may not be possible at 
this time. For example, in the past you might have had a 
support person with you at all times during a hospitalization. 
Explaining this and strategizing together about what is possible 
will be important. Although they may want you to have this, it 
may not be safe for your support person. It may also increase 
the spread of the virus. Talk this through with the healthcare 
providers. It’s possible that you might be able to have a cell 
phone to stay in touch. You might ask for a nurse to check in 
more frequently to help you feel safe. Many hospitals are 
arranging video visits with supportive family and friends. Work 
together to figure out what might be most helpful given the 
current crisis. 

 

 

Authors: Olga Trujillo, JD and Patricia Moen 

Caminar Latino/Latinos United for Peace & Equity 

 

 

This document was produced by the Vera Institute of Justice under award #2016-XV-GX-K015, 
awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of 
Justice. The opinions, findings, and conclusions or recommendations expressed in this 
document are those of the contributors and do not necessarily represent the official position or 
policies of the U.S. Department of Justice.