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A Mission resident who was brutally assaulted on Fair Oaks Street in the Mission District on Dec. 8 has begun to heal physically, but the emotional scars remain, a close friend said.

“Psychologically, it’s absolutely impossible to tell at this point how she’s recovering,” Arie Jongejan said.

Advocates for rape victims said the healing process can take years, and the ongoing criminal investigation and later judicial proceedings can both help the healing process and serve as a negative reminder of the trauma.

Earlier this month, 32-year-old Frederick Dozier was arrested and arraigned in connection with three sexual assaults that took place in the Mission District last year, including that of Jongejan’s friend. Those assaults have attracted much media attention, but recovery from sexual assault is a challenge that many women face. Police department statistics show that 127 rapes were reported citywide in San Francisco in 2011 compared to 140 in 2010, but more than 60 percent of rapes go unreported, according to the FBI.

New York Times health columnist Jane Brody began a recent series on rape: “Nearly every woman I know can recall one or more instances in which she was sexually assaulted, harassed, threatened, inappropriately touched or even raped. Yet few told anyone about it at the time, or reported it to the police.” Brody went on to acknowledge three instances in which men acted toward her in inappropriate ways.

The call to a hotline is often the first step in dealing with rape or sexual aggression. Locally, SF Women Against Rape (WAR), 3543 18th St., and the Trauma Recovery Center, 727 Mariposa St., provide 24-hour hotlines for victims who do not want to visit a hospital or are suffering from past assaults. They are the only free counseling centers in San Francisco that are specifically for victims of rape.

Most people who call the 24-hour crisis line have not reported the assault, said Janelle White, SF WAR’s executive director. They call because they’re suffering; they may be having nightmares or flashbacks or suffering from post-traumatic stress disorder or depression. Sometimes that leads to counseling.

White said the healing has to start somewhere, and the most important thing to do is to talk to somebody about what happened. If not, she said, “it does just eat away at you.”

Jon Dean Green of the Trauma Recovery Center urges victims in San Francisco to call 911 immediately after the assault and have the police transport them to San Francisco General Hospital for examination.

Seeking medical attention is important to prevent pregnancy and to treat and prevent sexually transmitted diseases, including HIV. To be effective, it’s important to be treated within 72 hours.

Any hospital can treat victims, but SF General is the only one in San Francisco where forensic evidence can be collected. Police and prosecutors said DNA evidence helped lead to Dozier’s arrest.

If the victim is not sure about filing a police report, the hospital will hold the evidence for up to 90 days.

At the hospital, the patient will be set up with a social worker from the Trauma Recovery Center or an advocate from SF WAR to discuss next steps toward psychological and emotional healing. “A lot of times, what people want is a friendly, nonjudgmental ear,” Green said. “Some are angry or upset with themselves,” and they need to be told that what they are feeling is normal.

SF WAR offers both one-on-one and group peer counseling, and the Trauma Recovery Center, employing psychologists and psychiatrists, provides 16 sessions of free trauma-focused therapy.

While White says there is no official waiting list for individual counseling at SF WAR, there is for group counseling.

SF WAR has the capacity to run three group counseling cycles per year, according to Lisa Thomas-Adeyemo, the organization’s director of counseling. The groups run anywhere from 8 to 12 weeks and are closed, meaning that people must be placed in them by Thomas-Adeyemo. People on the waiting list are called as a new group is being formed.

Thomas-Adeyemo completes assessments to decide if an individual is a good fit for the group — for example, in terms of race and age. “We have a real commitment to our groups being accessible and safe,” she said.

When the Fair Oaks assault victim went to the Trauma Recovery Center for an initial visit in early December, she was told that it would take a month to receive follow-up counseling, according to Jongejan. Eventually they found an opening earlier in January.

Green wasn’t sure why Jongejan’s friend had such a long wait, because that’s not usually the case. It may have been a result of lighter staffing during the holidays, he said.

Usually, Green said, the intake session takes place less than two weeks from the time the victim calls, with a follow-up visit the following week.

At SF WAR, the intake appointment happens within a week. According to Thomas-Adeyemo, the first of the 10 peer counseling sessions offered to victims “may take one to three weeks.” Timing depends, she said, on volunteer availability, level of demand and finding a good counselor to pair with the client.

While some people who decide they want counseling may want to begin immediately, others don’t mind waiting a week or more. “Every survivor is different in terms of how they’re going to experience [treatment centers]; some want to jump in, and some want to ease into it,” White said.

Though funding plays a role in the wait times for counseling, if SF WAR got an infusion of money, White says they would be very strategic in how it was spent. The resources might be better spent on prevention than making sure people have same-day counseling, she said.

They do not want to “bring people in, help them heal and then send them back out” into a world where they will be raped again, White said.

Shame and self-blame are big barriers to victims’ reporting of sexual assaults to the police. The crimes are difficult for people to talk about because of their sexual nature.

“To talk about even consensual sex in our culture is difficult. Think about trying to talk about something that is not consensual,” White said.

Jongejan understands how important it is for victims to have a case manager who can coordinate services and keep them informed and getting what they need.

His friend has been in touch with the district attorney’s Victim Services Division, which provides case workers to help victims navigate the criminal justice system, find resources and complete the paperwork required to be reimbursed for relocation, lost wages, medical treatment, counseling and other needs.

Jongejan’s sense, however, is that the advocates don’t have enough time. “If she needs something specific, she can call them,” he said, but it’s not enough attention.

Last year alone the division served more than 5,000 victims, a number that’s remained stable for the last few years, according to Stephanie Ong, its director of communications.

Caseworkers are assigned to the victims in every police report. These advocates are then required to contact the victim within 24 hours.

Although some victims miss a lot of work, Jongejan said that his friend returned to her job in late December, perhaps wanting some normalcy. Still, he says, “I think it’s a very real possibility that at some point down the road she could have to take time off work for the healing process.”

Her boss told her that she can take time off with no advance notice, if she needs to. “He’s been very supportive,” Jongejan said.

His friend, he said, seems to be doing better each day, but Jongejan knows her psychological recovery will be a long, difficult process. And it isn’t linear; there will be triggers that cause setbacks.

White agreed, noting that healing can be a lifelong process.

“I don’t know what fully recovering means. I think it’s more of a process,” she said. “And the sooner you start acknowledging that there has been a trauma and that you want to heal — to do something to feel better — that’s a huge step.”

“I do think healing is possible, because I am a survivor,” she said.

Trauma Recovery Center
2727 Mariposa Street, Suite 100

SF Women Against Rape
3543 18th St., Suite 7

District Attorney’s Victim Services Division
850 Bryant St., Room 322
Drop-in office hours in the Mission: Tuesdays, 10 a.m.-1 p.m. at Mujeres Unidas, 3543 18th St., Suite 3