Sexual assault survivors in rural Ohio may have to travel hours to get a forensic exam.

During National Forensic Nurses Week, Ohio advocates say they're working to expand access to these trained professionals who can offer trauma-informed care.

Tammy Robertson, statewide director of forensic nursing for the Ohio Alliance to End Sexual Violence, said beyond a medical exam, forensic nurses can provide courtroom testimony, and assist patients in ways other health care professionals typically do not. She wants survivors of sexual assault, elder abuse, domestic violence, child abuse or human trafficking to know some hospitals have forensic nurses on staff.

"And, at least if the hospitals are unaware of that program, or doesn't have a program, they can potentially reach out to a surrounding hospital and get that patient services," Robertson advised.

Robertson added advocates are working to educate community partners, including law enforcement, prosecutors, child protective services and others about the resources forensic nurses provide.

If you or someone you know is experiencing a crisis or needs help, call the Ohio Sexual Violence Helpline at 844-644-6435, 24 hours a day, seven days week.

Robertson pointed out the holistic approach to care and support forensic nurses offer has been shown to improve survivor outcomes.

"There is, statistically, shown that there is a better healing outcome for those patients who receive care from a forensic nurse," Robertson noted.

Nationwide, between 17% and 20% of hospitals have a sexual assault examiner or forensic nurse available, according to the Rape, Abuse and Incest National Network and the International Association of Forensic Nurses.

More than 60% of sexual assaults are never reported to police, due to concerns like fear of retaliation or negative social interactions. But Nebraska advocates say there are resources to help with confidentiality issues.

These reminders come amid heightened concerns about threating behavior women experience online.

Katie Welsh is the vice president of programs for Omaha's Women's Center for Advancement - which works with survivors of domestic violence, sexual assault, human trafficking and stalking.

She said advocacy groups and law enforcement are learning more about the overlap between online harassment and physical abuse.

"It's kind of a new frontier in many ways," said Welsh. "While it may start where the victim and abuser are geographically separated and are communicating online, that it often leads to them meeting up so that the abuser can assert power and control."

Welsh said in its worst form, this can include sexual violence.

No matter the situation, she said anyone targeted can call the Women's Center's 24/7 crisis hotline (402-345-7273) where a confidential advocate works with the survivor ready to report what happened.

The Women's Fund of Omaha also stresses that reporting can happen anonymously, and the website sexualassaulthelp.org is another resource.

The website notes the survivor isn't required to provide any identifying information to law enforcement.

In other situations, Welsh acknowledged the challenges that sometimes come up when a survivor reports an assault or harassing behavior, and is bombarded with threatening online messages afterwards.

"Those online interactions are hard to shut off, you know," said Welsh. "They can from a lot of different sources - email, social media."

She said taking down social media profiles and changing email addresses might help ward off online harassment.

Welsh added that taking screenshots of online threats and daily notes about interactions can help when reporting them to authorities.

Sexual violence remains a significant concern in Ohio, and specialized teams, such as Sexual Assault Response Teams and Coordinated Community Response Teams, are designed to provide critical support to survivors. Now, a new study aims to assess the effectiveness of these teams and identify gaps in service.

Nicole Kass Colvin, director of coordinated community responses with the Ohio Alliance to End Sexual Violence said this research is essential.

"We are really hoping to get some information on what teams exist and what we can do to make our teams really effective across the state of Ohio. It takes all of us to end sexual violence," she explained.

While the teams aim to provide holistic support, there is limited Ohio-specific data on their effectiveness. The survey tied to this research seeks to gather information about how these teams are structured and where they could improve. Some question whether this approach alone can address all the challenges faced by survivors without more resources.

Anna Ressler, assistant professor at Miami University is leading the research, and explained that while the teams are known to be valuable, the details of how they operate effectively are still unclear.

"There's a lot of research that shows that these teams are necessary. But we don't know what constitutes an effective team," she said.

The study's results are expected to inform improvements in services for survivors across Ohio. Those involved in these response teams, or those interested in starting one, are encouraged to participate in the survey, contributing to this important research and Ohio's ongoing efforts to address sexual violence.

In Ohio, the effects of domestic violence continue to devastate families.

The Ohio Domestic Violence Network released its ninth annual fatality report, which revealed 114 people, including 15 children, lost their lives to domestic violence in the past year, including incidents where victims were shot, strangled or beaten, often while trying to leave their abuser.

Lisa DeGeeter, senior director of policy and prevention for the Ohio Domestic Violence Network, said many victims were seeking help.

"We continue to see victims, particularly parents, reach out for help to protect themselves and their children and not receive what is needed to save their lives," DeGeeter explained. "The victims were leaving, they were reporting, filing charges, requesting protection orders but it wasn't enough to stop the violence."

Despite protective measures, 72% of cases involved victims who had prior interaction with the justice system. Critics argued current resources and interventions are insufficient to prevent violence escalation, fueling debates about Ohio's legal framework for protecting survivors.

Advocates said Ohio's younger population is also deeply affected. The report showed 79 children lost a parent to domestic violence, with at least 33 children present during the fatal incidents.

Maria York, policy director for the Ohio Domestic Violence Network, highlighted the profound effects on children who not only lose their caregiver but also a sense of security and normalcy.

"We don't want this to be the new normal," York urged. "After COVID, we had 131 fatalities, it seems like this is the new normal of just having these triple-digit homicides with domestic violence."

The report showed domestic violence fatalities have not returned to pre-pandemic levels and more than two-thirds of the cases involve firearms. York called on law enforcement, policymakers and community leaders to collaborate to address the issue.