Sexual assault, stigma, health, and society

Content warning: discussions of sexual assault, violence, and rape

How does society handle sexual assault? What are the health implications for victims and for populations? Did the Pelicot case change attitudes and what can we do to address stigma? 

Gavin is joined by Professor Betsy Stanko OBE and Professor Katrin Hohl OBE, who together worked on the London Metropolitan Police's Operation Soteria to change how the police deal with sexual assault cases. 

In this episode, we explore the global burden of sexual violence, its profound impact on women's health, the systemic challenges in addressing the hidden dimensions of sexual violence, the difficulties in measuring its prevalence, and the critical need for a trauma-informed and holistic approach in both healthcare and criminal justice systems.

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Transcript

This transcript was automatically generated using speech recognition technology and may differ from the original audio. In citing or otherwise referring to the contents of this podcast, please ensure that you are quoting the recorded audio rather than this transcript.

Gavin: Hello, welcome to The Lancet Voice. It's March 2025, I'm Gavin Cleaver, and today I'm joined by Professor Betsy Stanko and Professor Katherine Hull to discuss the pervasive issue of sexual assault and gendered violence. It's a topic that has far reaching implications for public health and individual well being.

We're going to talk about the global burden of sexual violence, its impact on women's mental and physical health, and the systemic challenges that victims face in addressing these issues when dealing with institutions. It's an important conversation, and I'm grateful to have Professors Svanko and Hull here to share their insights.

I hope you enjoy the conversation.

Professor Svanko, Professor Katun Hull, welcome to the podcast. Thank you both so much for joining me. It's a real pleasure to have you both here. I wanted to do a podcast for the Lancet talking about the burden of sexual assault, of gendered violence. Especially in the light I'm sure all of our listeners will have heard of the Palico case in the last few months.

But I think it bears talking about what a worldwide burden that sexual assault, rape, gendered violence is. So perhaps we could start off by just talking about the kind of the level of that burden on like a societal level. How does this affect health of women worldwide? 

Betsy: It is a global issue. I do think that sexual violence as well as Domestic and intimate violence is the most important issue facing women across the globe.

It's historically based. It is so much a part of our core. Because basically if you ask women who haven't experienced sexual assault, if they glibly walk down the street, they all say that they are cautious and careful, that fear still steers their lives. And to me, that's an indication of the Implications of what sexual violence is.

It's built in, built into the way in which we live in the world. That said, it's also probably one of the most key issues in terms of the influence over health, and particularly bad health. Substance misuse, drug misuse self harm, mental health issues, all of which dovetail in a very strong way with sexual abuse.

Both of women and also of young men who have been, who experience this through institutionalized abuse largely and also being targeted by other sexual predators. So it's sadly also an indication for women of inequality because much of what they experience has been presumed to be just. The way it is.

It's just the way we live in the world. 

Gavin: I think it's interesting that you talked about not just the act itself, but the threat of that. 

Betsy: Yeah, what it does, to me, what's important about both experiencing sexual violence, supposedly those who don't experience sexual violence, is it has an impact across the board on all women, which is One of the things, why it is that sexual abuse is connected to the feminist challenge 

Katrin: around equality.

You started off asking about the scale of it. That's an interesting question because that in itself is revealing about the lack of systematic measuring and making visible sexualized violence in society. So for other types of harms, we have much better ways of measuring it. While when it comes to sexual assault and sexual violence, the perhaps most universally acknowledged finding is that we only know the tip of the iceberg.

It's systematically underreported. It tends to not be captured well at all in the sort of gold standard ways in which we measure victimization. So in the UK, that would be the Crime Survey for England and Wales. That is excellent at counting how many bikes have been stolen and terrible at counting sexual assault.

The other aspect of it is when we look historically, over time, and I don't mean the last 10 years, but let's say the last 300 years, we see a global decline in the amount of violence, by and large. Obviously, there are areas of conflict and war where we know sexual violence always spikes up hugely. But by and large, The finding is that violence has gone down.

Can't say this for the types of violence that systematically disproportionately impact women, because these studies have never measured domestic abuse. They've never measured sexual violence. And in fact, we think that hasn't gone that way. We don't think it's less now than it was before, but we can't be sure because it's difficult to measure for all the reasons.

Sexual violence is so harmful. 

Gavin: So it's interesting, so what are some of the reasons that it's so difficult to measure that we don't have a handle on the scale of it? 

Katrin: One is there is still a lot of shame and stigma attached to sexual violence. So it's not something people would necessarily disclose.

There's also a lot of difficulty in even framing what happened to you, a sexual assault. For example, in the context of domestic abuse, which we believe is where a huge amount of sexual assault and rape takes place, is between people married to one another or within families. Even when victim survivors go to the police and report the domestic abuse, the thing that often is least acknowledged and last mentioned is the sexual violence.

And it often isn't framed as say, he raped me. It would be framed as there was sex that I really didn't, that was against my will. So it's. knowing what it is, finding, feeling comfortable associating with it. And often victims and survivors also don't really want to attach to that label. And then there is the fear of the consequences when you disclose it, that forever you will be labeled as the rape victim.

You will be looked at differently. The stigma and shame attaches to you. Not the perpetrator, which is one of the things I think there was much more public awareness of this aspect of it through the Petticoat case is who the shame attaches to. So all of those are barriers to disclosing it, not just to the police, but to anybody, and including to academic studies.

Gavin: So what strikes me from what you said there is the kind of, the nature of the pervasiveness of it. The idea that so much of this happens between intimate partners, long trusted spouses, that sort of thing. How then could we even begin to get a handle on it? It sounds like such a huge nebulous issue.

Betsy: Depends on what you mean by getting a handle and particularly around issues around health and good health. If that's one of the things that we would like to attach the impact of sexual violence to you get a handle on it because you have to put a stake in the ground to say what is and what is not acceptable.

And that itself has evolved over time. 

Gavin: As grape used to be. Feels like quite a societal led definition of 

Betsy: Yes, but also in terms of understanding your own experience. So if your lived experience is that you just, you're raised in a way to expect that something could happen to you. Again, it's one of the things I was saying earlier about women.

Managing their own safety, their own, not only do they manage their own safety, but they are made to be responsible for their own safety as well. So those things go hand in hand. Trying to think about putting a stake in the ground, in modern, so called modern society. Again, I peg it to women's equality. If you say this is an acceptable way of living, this is not an acceptable way of treating half of the population, then we have to then stop treating it as if it's just part of And the way you do that, and there has been an evolution of the crime over the last couple hundred years.

Winning from a crime of property against the father, basically, because he's claiming redress for the defilement of a valuable commodity that he can trade to another country for a good dowry or whatever, allegiance and loyalty. It's much more important to think about women having their own rights and their own integrity and their own right to their sexual integrity.

Then, you have to begin to start placing law, crime, redress, understanding, and healing connected to that. And it's a really long road. Part of what we've done is try to set up in this current day and age, if women decide that what happened to them was wrong, You don't get up and read a law book in the morning.

You don't know what rape has really defined us. You go to the police because something bad has happened to you. But we know that has increased, that rapes are reported more and more. The more we talk about it, the more the women understand what happened to them as being bad. And they start using the state for redress.

And that's really the space that we came into. is that if you're going to have a redress in a democratic society what should that be? Because at the moment, and then, even five years ago, even now the redress was couched in a really antiquated way of understanding women's sexual integrity.

Very much what we said is that men are entitled to sex with women, and just as Dominic Pillicole, he was entitled to his wife, not only entitled to his wife, but entitled to handing her out to other men. And indeed, that was the defense for many of the other. Men that he gave permission that was good enough for them.

So nobody ever asked her So it's it's really important to then if we are in a society now where we feel we have equal rights Then we need to create a system that enables women to claim that what happened to them is illegal 

Gavin: I'm interested in your thoughts broadly on the Pelico case about the trial that happened obviously Dominique Pellicot had the option to have that trial conducted in private and chose to have it conducted in public with all of the accusers in full view.

What were your thoughts on the trial itself and how it was handled by the press and what kind of public reaction there's been? 

Betsy: I thought it was journalistic porn if you want to my opinion in many ways. It became quite salacious and sensational. I'm not sure some of the lessons, to me, the important lessons about what really happened, aside from, the horrific rapes and the fact that his, he being now a known predator.

The interesting thing is that information did exist in the French police service already. But it, to me, one of the things that's quite important. is that it was a domestic situation. It was forgiven because of domestic situation. There was online, this was all online porn that was available.

Nobody protected the wife, including, I have to say, not to be accusatory, but the children suspected something weird, but they didn't. They didn't really know what was going on, and none of their friends did either. So I think there's some things about the trial itself, it just to me became just voyeuristic in many ways.

And I'm yet to wait to see what impact it's had on French, the French legal system, which I don't think it has. 

Katrin: I would agree, like the voyeurism, the morbid curiosity, the wanting to hear the detail, it speaks to the point that when sexual violence appears extraordinary and it's this extreme case, then there is great interest.

But not in the everydayness, how it laces in and out of women's lives and boys lives and men's lives. And even the Pellico case had this distinction, so before it all came to light, The everydayness of it is striking, isn't it? It was an everyday family living in an everyday type of setup. There was nothing about this family that would look extraordinary.

And then the trial and learning the detail shifted it into something else and only then did it become interesting. And that is, I think, part and parcel of the problem is that the everydayness of sexual violence doesn't make the headlines when it absolutely should. 

Gavin: I'm interested to hear about your work with the police in the UK.

You were running Operation Soteria and I'm interested to hear how that came about, the angle that you approached it from, how you worked with Metropolitan Police. I guess what the issues were in the first place with the police and how you progressed over the time that you were running the operation.

Betsy: As part of my career I worked inside the Metropolitan Police as a staff person for 13 years. And during that time, this was after 26 years as an academic career, doing work on violence against women I was able to focus specifically on rape and sexual violence, only because I chose to. I was given an assignment in 2005 to take a look at why rape was so hard to charge.

I did that work, but I also chose to follow that up. Almost every other year or four, I did seven reviews of rape outcomes in the Metropolitan Police. Some surreptitiously, some not so surreptitiously. I was Deputy Director of Corporate Development and had a performance and research team. Because I also did my academic work on violence against women, I was beginning to try, I wanted to understand as deep as I possibly could, why this is such a difficult thing.

One of the things I understood, I began to pick up, and I was working with Catherine for we'd been working together for 15 years. She came to me as a postgraduate student initially, and now she's a professor, so life changes. And what I really wanted to know was where were the hooks, where were the ways of thinking differently?

And it was also, there was, Review after review, public review after review, saying the problem is training, the problem is individual officers, and actually, it was a corporate problem. When the, uh, eighth of the methodology of review that I had set up was published by the mayor's office in 2019, Katcher and I were already working on looking at much more detail of the form of the last of the seven.

Reviews that I had done, so we were looking at the data very closely and we, ourselves said we're going to have to do something very differently. So we set up a two page brief, if you're going to do it, if you were going to get in there and do something differently. Here are six areas, five areas, sorry, five areas you would look at.

We added a six because in those days there was no such thing as digital world. It didn't exist in the way that it does now. 

Katrin: Yeah, one of the sort of key principles that sort of underpins a lot of the work is what we typically see when there is a criminal justice response to sexual violence and in fact wider responses, probably also health responses is there is an over focus on the victim and survivor.

What was their role in it? Are they credible? And We argue that serves as a red herring that takes the attention away from where sexual violence begins with the perpetrator. So the whole model was built on police understanding sexual offending behavior and focusing on the perpetrators in their investigations, trying to evidence what they did to either create or extinguish.

Exploit a situation where they were able to carry out the sexual assault and lay the foundations for getting away with it because the vast majority of perpetrators do not face criminal justice consequences and most of them work from when they begin to think about Committing those acts to, to disguise it and get away with it.

So that's one of the key focuses. And I think this is also where it links back to the Pinnacle case in which you're so interested is one of the things she said about shame needs to change sides. Where should the focus be is it was her way of saying something that I think women have thought and said for a very long time is don't focus on us when it comes to prevention, focus on preventing.

Where the perpetration happens, don't responsibilize us for keeping ourselves safe by staying at home, by not going out at night, by not bearing clothing that might appear attractive to another person. Focus on those who perpetrate sexual violence Where the causes lie really, so that's probably the big shift in thinking.

Betsy: Yeah. And one of the approaches has also always been individualizing the officers as the problem. And we focused on the police, policing PLC as the problem. That they didn't actually enable the officers to have the right competence and confidence to do that work either because their, the way in which they framed their own learning and development was.

I wouldn't say faulty, I would say it was not sufficient. It also didn't pay an attention to the academic literature and research that had been conducted over the last 30 years. 

Gavin: Was it just something that come about over time, then, the way that the police approach these cases, or? 

Betsy: No, the thing is about policing is it's in a hermeneutically sealed profession.

Police teach others from the way they've done it before. And if that's the case, then indeed the way they've done it before is so steeped in mythology and victim blame and a misunderstanding of the context within which rape happens. The frame of it was largely around stranger rape, for example, which is 5 percent of the recorded rapes in the country.

So you had 5 percent wagging the 95 percent of the dog. Not understanding the links between known others and sexual violence meant that they could not conduct a very good investigation. What's interesting about the Pellico case, it's actually a really good police investigation. I think the police deserve an honor for that.

Because they are the ones, they were the ones who actually won, first convinced the victims of the upskirting to be involved in the case. That gave them leverage to seize the digital devices. The digital devices then enabled them to see what he was doing to his wife. That was not part of the case, initially.

That was totally serendipitous for that to be found. So that's a really good investigation. A kind of stellar investigation. If the police officer who responded initially to that and decided that actually it wasn't, obscuring wasn't very important, they weren't going to do anything about it, we would not know anything about the Pellicutt case.

We were trying what we were trying to do in Ceteria which by the way has had the result of tripling the charge rate. And three years is that, and there are much more to go the my sense is that number can go much higher than that if they enable enough resource to be able to do that work.

So what we looked at specifically, we got it down to six words. If you were a police officer, you need to be victim centered, suspect focused, and context led. And it's that context led that's really quite important as well, thinking about the suspect, thinking about making sure that the victim is, I would say, comfortable and supported in the, being able to tell what their story is, because that story is the way in which you think about the way sexual offending happens, because they're giving you clues about how to do the investigation of the suspect.

But the context gives you the clues. about also the surround song of where the sexual violence takes place. So, those three principles, in addition to thinking very much around procedural justice for victims, enabling them to be treated as fairly as possible. The conviction, the, sorry, the charge rate may only be somewhere hovering near 9 percent at the moment, currently.

That still means 90%, 90, over 90 percent of the recorded.

However, there of those where the victim doesn't want to be involved in the criminal justice system. In many ways, victims are altruistic. They report things hoping that the police will put it into their pot of understanding in order to prevent it from happening to somebody else. Kinds of things that are enabled by satiria is not just the change of an investigation.

But it's a change in the approach to thinking differently about sexual violence where victims have more choice, they have the choices. to do things. I had a conversation with an ISVA the other day and she said I still have to explain to the police why victims want to, withdraw their complaints.

I said, They don't withdraw their complaints. It's already in the record. They may not want to go through criminal justice process. What happened to them is already recorded. So they don't like tip exit out and erase it. That is information that's important in terms of the other kinds of work that policing ought to be doing.

In terms of thinking very differently about how you prevent rape and sexual assault. How do you make that explicit so that other systems, health being one of them, can mobilize in a way to be much more preventative and healing. Than they can. And at currently, 

Gavin: are there any ways you think that the health system could mobilize in the way you're talking about to be more friends too.

Betsy: One, it's your, their information and two is that it's, to me, sexual violence is a major cause of trauma. So trauma informed health, again, substance abuse, all kinds of abuses are walking into health, the health, bad health into the health service. And it's really important to, it's like, how do you get somebody to think that's, that there is much more going on here than is transparent to the interaction and to what that is being described to you in a health setting.

Katrin: And we mustn't forget also about children who are sexually violated and they are very unlikely to go to the police, but children may be in healthcare settings, so it's a way, healthcare reaches many more people than criminal justice does and if we're not just satisfied with the criminal justice response but we want to go further and we say we want to reduce sexual violence, the aim is to prevent it, it's a to get it down for less of it to happen and I cannot really think of a problem of crime, that's why we want to frame it, that's solved through criminal justice.

That has rarely proved to be the answer. So surely there has to be a response that tackles the root causes of sexual violence and before you ask me what they are, it's complicated. But most certainly health has an aspect. In it for discovery for prevention I think framing it as a problem of crime and justice hugely limits the levers that might be in view for us to think about preventing it.

Betsy: And health, the ones who are managing the sexual assault referral centers, and they are around the country. They are the places where some victims go to be examined and for evidence to be collected and to be recorded about what's happened to them. They also offer counseling and other kinds of support as well.

I do think that the links are really critical in terms of getting them as right as possible. Because, And we can, the important thing about Saturia is we're focused, we're trying to get the police service to focus, one, on repeat suspects. So if we're in a position where everybody needs to be every perpetrator needs to be prosecuted that's going to clog the system and we might not be able to do that.

But if you've got somebody who's repeatedly using sexual violence against a number of women or his own partner. Because a lot of repeat violence is, again, in a domestic setting. So the overlap between sexual violence and domestic violence is really important to note. So in policing, for example, you got a unit that's, that maybe thinks they're dealing with domestic violence on this side.

and sexual violence on that side. Trying to put those knowledges together in a way which is far more holistic in terms of the person who's in front of you who's been harmed and actually has somebody who is harmful out on the street or has power over children, then you need to try to challenge that behavior.

Katrin: And then one of the great unsayables is Healthcare settings often are a site of sexual violence and sexual assault as well. A few years ago, the British Medical Journal, together with the Guardian, a British newspaper, did a major investigation into sexual assaults within the National Health Service in the UK and found staggering levels of sexual violence from patients towards nurses and doctors, amongst nurses and doctors.

And also the other way around and that is something we feel very uncomfortable talking about is sexualized violence in healthcare and medical settings where people are there, where they're vulnerable, they might it's a setting where being unclosed and physical contact may feel very normalized and where you get a lot of vulnerable people swept into it and that's another example of the ways in which we allow sexual assault to continue because there are so many spaces we are unwilling to look at when it comes about to uncovering it, really.

Gavin: Is anything further being done on that front that you know about? What are some of the safeguarding procedures do you know in health settings? 

Katrin: There was little follow up to that study, and I know that the Guardian attempted to run another story, and there was another story, but there was very little follow up.

One of the things that did shock me at the time was one of the investigators, people in the investigation within the journalists mentioned to me the booklet which is used to talk about sexual violence in the workplace, and it was placed in the safer sex booklet. Which to a victim must come as a huge insult that's how it's framed.

It's not violence. No, this is sex and you weren't safe in how you were having sex here. I think it's, there is still a huge taboo and if healthcare settings and providers aren't willing to look at it in their own area. I'd have little hope for them to look at it for the patients and wider populations they deal with.

And that's just an example from the UK, which I know well. But no doubt globally we see these issues in a lot of different countries and contexts. 

Betsy: Yeah, so what we did with Ceteria and the police services we basically enable them to see what sexual violence means. through the eyes and lived experience of victims.

We took their own data on repeat perpetrators and said, in your own records, 25 percent of the perpetrators that are named are the same guys. And that, I think, that definitely shocked them, at least 25%. And because most of sexual violence is committed between known others, they can generally give them the perpetrator's birthday and including where they live.

Then we said, you really need to change the whole way you approach your learning and development. You need to think very differently about that. The whole course was rewritten, and that's changed. You need to also think very differently about your front line and how they do victims. I've just heard today 50, 000 police officers have been re socialized on the front line course.

So That's a major hit. We have suggested ways they think very differently about the use of their own data. Crime reports are actually rich sources of information. As social scientists, of people who are used to looking at and understanding data in a different kind of way, we were encouraged in the police service to say, you're sitting on a gold mine.

You need to use that because that can proactively enable you to think very differently about do you have the capability and capacity to deal with what's being reported to you. And also you begin to see the shifts. So what's happening now is an increase in peer on peer young people. Surprisingly, not surprisingly, kids are carrying porn in their hands because they all have digital devices and these things.

The sexual techniques that they're using are actually beginning to show up as rape. If you have a young kid, he says actually all I'm doing is what the, what I'm seeing on the screen. One, it's a confession, but two, it's actually rape. And then the last thing they did was actually Suggesting the police service they need to really ramp up their own digital forensic capability because so much of this stuff is actually the evidence of which is on these digital devices.

These are all, this is a new problem, it's only ten years old. With that kind of approach, it's we've put six stakes in the ground and said they're all tethered to each other. How you, a police force, are you able to meet the Satyria challenge, basically. And can you get better in these six areas?

And that itself has led to a tripling of charge, charges, a whole different way of working, an appreciation of the officers who understood that they were all being stressed out because they didn't have the confidence and capability to do what they were doing. We're giving them more tools, different ways to think about it, and we haven't changed any laws.

Gavin: A lot of what we've been talking about is the unravelling of stigma and how that affects victims, but also the institutions interacting with the victims. I'd be interested to ask how you think stigma and issues surrounding stigma have changed in the time since you've been working in the area, if told.

Betsy: I don't think they've changed yet, except for the kind of thing, to me it would be a feminist ethos, it's not your fault, you are not to blame. But yet we know that one of the major reasons why things don't get reported is because people internalize the shame and the blame. And they feel stigmatized.

What did I do? Will people think differently about me if I report this? I can't let my family know. And indeed in some cultural settings, you have violated the community rules. 

Katrin: In movements like the Me Too movement, after Harvey Weinstein, and we've had them in different places. Japan had its own Me Too movement in a different context, now France has it.

What they do is, they do change the conversation, and we've seen after each one of those in these national contexts, then there is more reporting, and the stigma slightly shifts in that the willingness to talk about it is there. The problem then is if the systems don't change to come in behind that to enable victims and survivors to do something with that willingness to report.

So if there are no systems of support that provide medical, psychological support, criminal justice routes, if that's what the victim survivor wishes to pursue, then we are leaving. Victim survivors in a difficult position of now, in addition to the shame and the guilt, the willingness to overcome it might then also be the guilt to not be able to take it forward.

The raising awareness, lifting the shame and the guilt is a nice first step, but on its own isn't going to change the situation unless We, as a society, are willing to set up the systems to come in behind that and allow a victim and survivor to move forward with their lives after disclosing.

Betsy: Many of our public services are dysfunctional. They're not working in a way that supports people. And when you're talking about somebody that's highly vulnerable, as well as and one of the things we know is this, is that, that sexual intrusion leads to lots of mental health issues. Not for everybody.

What it actually does is something about it just reaches into the core of victims beings and we assume that everybody can just rise above it and then put their, problem, to, to any public service, a health service, a police service, and hope that, that problem gets dealt with in a way that is, understands what it's, what, how you've responded to it.

And that's, that is, that's just not happening. And even with, we've, we, when we might have, the problem is we've done, with Soteria is I think we've done a really good job revamping the police perspective. But that's only in the beginning, so if you want to be involved in criminal justice, there's this other bit, courts and juries and everything else, that is dysfunctional at the moment.

Gavin: Are there any basic steps that systems could take to, to improve in the support of victims? 

Betsy: It is this kind of notion of being much more holistic, and this is, we have been continually trying to fight against the staccato of public services, or the silos of public services. And if they're not, if they're not coming together in this, in a more seamless and supportive way, then If you get jarred all the time, no wonder.

That's one of the reasons why people decide they just can't. It's actually better for their mental health. to just deal with what happened on the room. 

Katrin: Yeah, so that's a sense of being trauma informed or trauma responsive, so not just knowing about it, but being able to adapt how you interact with a victim survivor, or just being aware that the person you are dealing with may have experienced sexual violence is a first step to ensure there is appropriate interaction.

For example, if somebody experienced sexual violence, that might change how they can interact with authority or in a medical setting. And if you are not conscious of that, and you're not offering spaces or for people to be met on their level, so for example, A woman might not be comfortable to be examined by a male doctor, and those are the sort of easy ones we can think of, but there is much more to that.

Sometimes people who've experienced sexual violence, there is, it's even more important that no steps are taken around their body, that where there isn't clear consent, clear boundaries. People won't necessarily say, so reading that, that's a very good first step. The second one is integration. So in London, we have an Excellent example, and we have it in many Nordic countries, called the Barnahus approach, and then it's called the Lighthouse, where there is a integrated support between the health service, social services counselling support, and if desired police response.

That means a victim and survivor isn't. going from pillar to post with uncoordinated responses. So there is a lot there that could be done to just make that a little bit better. 

Betsy: And to have that offer as a standard offer as opposed to the small number of people that end up going through that particular approach.

Gavin: I suppose the more emphasis you put on victims to go from pillar to post, like you were saying, that the fewer of them actually go through with it. I wanted to finish up by asking what you are both working on currently and what you hope to see over the next few years in the field of this research.

Katrin: Operation Ceteria, which Betsy has explained lots about improving how police respond to sexual violence. I'm very interested to see what I'm working on, what happens when those cases enter the court. room, and also further down the line, the process doesn't end at trial. In fact, if there is a conviction, there will be prison, probation, parole.

And if there's no conviction, both the victim survivor and the perpetrator go on to live lives. It's not like in a movie where the end is the trial, it's to see the after, what happens after. So it's much more end to end perspective. 

Betsy: And I'm interested in bringing this approach into a much wider understanding of public protection so that other issues such as stalking, harassment, domestic violence child sexual exploitation.

Those are still siloed in policing. They're treated very differently. And if you have a core understanding of this is actually an approach that's useful across the board and that it enables both the police officers to feel better about how they work and what they do and their interaction with victims during an investigation as well as better outcomes.

as well. So that is a just beginning a conversation at the moment. I know the police service is just about to establish a public protection unit inside the College of Policing. But to me, there needs to be quite a lot of understanding of how would you change? How would police service really change its whole learning and development to be able to align with that?

So there are a number of things like, do they have the appropriate skills to interview across the board? What does that mean in terms of the way we would approach that very differently? So we were the outside ghosts of Christmas past or whatever we were the outside eyes that enabled a service, a police service to see something differently about the way they worked.

And I think that was The most successful part of our interaction in Satyria, that we were those fresh eyes. Because we, after 13 years working in police service, I can tell you I do know them very well. But you needed to know them from the inside in order to get them to work differently. I would hope that there will be, Catrin's work in terms of thinking about courts and the judiciary being able to work very differently.

Because we need to bring in that perspective of if you brought in lived experience and you were trying to and also trying to uphold justice, and we are talking about fair trials and we are not, we're not violating any of the civil rights of either the offenders as well as the victims, but what would it look like?

How could we, and we now know that it can be done. So to me, my impatience is I know that when you understand something differently, you do it differently. That's the former academic in me because that means that once you understand it, then you try to do it differently. 

Gavin: I think that's probably a good note to end on.

Professors, thank you. Professor, thank you so much for joining me on the podcast. I'm really glad we could have this conversation in such a huge, all pervasive topic with so many implications for health, and I'm I'm glad that we could Have a discussion on the scratch the surface of it today. So thank you both very much.

Betsy: Thank you. Thank you for having us

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