Home > Resource > Create Safer Spaces in Primary Health Care

Practice Tool

Practice Tool

Create Safer Spaces in Primary Health Care

Safer spaces must be created with an awareness that primary health care practitioners and providers engage with persons who have lived and living experience of child sexual abuse and/or sexual violence daily.

Primary Health Care provided in the community includes a broad range of services and practitioners across diverse environments such as dentistry, pharmacy, speech pathology, physiotherapy, nursing and general practice. Practitioners in these services have a unique opportunity to contribute to improved health outcomes and provide a supportive and safe experience for people who have experienced sexual violence and/or child sexual abuse by creating safer spaces to improve engagement and enhance health outcomes¹.

The needs of people may be different depending on the service being provided, and it’s important to consider intersectional factors such as age, developmental level, disability, language, and/or if people have had multiple experiences of trauma.

Consultation includes active listening and consciously seeking feedback from a diverse range of people who have different lived and living experience. It is critical to consciously seek feedback from a broad range of people with diverse experiences who access your service.

Trauma informed care includes the design of patient and service user areas to improve safety. Safer spaces are those that are accessible and available to all people who access your service and are informed by persons from diverse backgrounds who have lived and living experience of child sexual abuse and/or sexual violence throughout the design and implementation.

We all have a responsibility to contribute to online, physical, and emotional safety in primary health care for victim survivors of sexual violence, including child sexual abuse.

_{1 | Adopting a Trauma-Informed Approach to Improve Patient Care: Foundational Organizational-Level Steps | Playbook}

Let’s make our spaces safer.

The physical environment refers to inside and outside your premises. It includes entryways, waiting areas, bathrooms, and specialist, therapy, or consultation rooms.

The online environment includes websites, telehealth, and booking systems.

The emotional environment is how someone feels in the physical environment. It refers to an overall ‘feeling’ of safety and can relate to the way people interact and are supported in trauma responsive ways. This can be different for everyone.

Download Graphic

Application to practice examples:

DENTISTRY

You work as a dental nurse in a small clinic with three staff. You see many children and adults each day, some who appear distressed or scared about receiving dental services. Many clients book appointments and do not attend, or attend in emergency dental situations due to pain.

Things to consider:

How do you provide information to people accessing your services about what to expect? Are there multiple ways for people to access the information?
Do you have knowledge about trauma related to sexual violence, including child sexual abuse?
Do you talk about consent, and offer people multiple opportunities and ways throughout treatment to pause or postpone, such as raising their hand?

Do you know what to do if you receive a disclosure of sexual violence, including child sexual abuse?
How do you explain who is present in the room, and what is happening that they cannot see whilst in the dental chair?
Do you offer music, television, or invite patients to bring their own sensory items as standard practice?

PHARMACY

You work in a pharmacy that offers a wide range of services including consultations for vaccination and contraception. You want to provide a private area for people coming into the pharmacy but are limited by space restrictions.

Things to consider:

What are the needs of people in your community who access the pharmacy?
Does your pharmacy provide a way for people to engage in private conversations with staff?

Are staff aware they engage with many people each day who have experienced child sexual abuse and/or sexual violence?
How would you know if people feel safe in the pharmacy?

SPEECH PATHOLOGY

You are a Speech Pathologist and have just opened a new clinic. As a sole practitioner that is co-located with other services, your clients wait for appointments in a shared area. The waiting area is small, has limited seating, and there are many pamphlets and posters on the walls about services and supports. There is a small kids activity board on one wall near the door, and you are conscious of the noise this made when in appointments.

One of your clients has recently left before their appointment, and gave feedback that they couldn’t wait in the space provided. This isn’t the first time you have this from someone accessing the waiting area.

Things to consider:

How would you ask for feedback from this client? Are there ways to ask that don’t include verbal responses, or enable time for the response to be expressed?
What other ways could you support this client, that don’t require them to meet you in person?
What could easily be changed/added in the waiting area that could make it feel safer, both physically and emotionally?

NURSING

You work in aged care and often see the same patients. Today you have been asked to support a new patient who is presenting as distressed during personal care. The patient does not want support and appears distressed.

Things to consider:

What are your first thoughts about what could be happening?
How could you respond to this patient?
Do you know how to respect and protect the patient’s autonomy and comfort levels to try and prevent further distress and trauma?

Are you aware of the different types of sexual violence, including child sexual abuse, that can contribute towards a trauma response?
How could you find out about the way other Nursing staff have supported this patient?

GENERAL PRACTICE

You work in an administration role in a GP Clinic with 8 General Practitioners, and 2 Nurses. The clinic is always fully booked, and this can often result in longer waiting times for appointments.

You have noticed that some people accessing the clinic appear to be nervous or worried, are unable to sit calmly, and appear startled when the door opens and closes.

Things to consider:

How do administration/reception staff welcome people into the clinic, and provide them information on where they can wait, where the bathrooms are, and general information about the clinic?
Are there areas people can access if they would like privacy or a smaller space when waiting, or that allow for people to sit without having their backs to a doorway?

Do staff ask the preferred names and pronouns of people accessing the clinic?
Do staff ask and record sex assigned at birth, in addition to gender, to ensure tailored care?
Does the clinic seek feedback from a diverse group of people who access the clinic, outside of accreditation requirements, about their patient experiences?

Create Safer Spaces in Primary Health Care

Let’s make our spaces safer.​

Application to practice examples:​

DENTISTRY

PHARMACY

SPEECH PATHOLOGY

NURSING

GENERAL PRACTICE

Subscribe tonews and updates

Understanding child sexual abuse

Response to child sexual abuse

Needs of victims and survivors

Prevention of child sexual abuse

Identification of child sexual abuse

Disclosure of child sexual abuse

Let’s make our spaces safer.

Application to practice examples:

Subscribe to
news and updates