Decision-making processes in help-seeking following sexual violence: A qualitative study

INTRODUCTION: Sexual violence remains widely underreported, often described as the “tip of the iceberg,” due to survivors’ fear, stigma, and uncertainty about seeking help. Although reporting rates in Indonesia have increased, the processes through which survivors decide to seek support remain insufficiently understood. This study aimed to explore the decision-making experiences of survivors of sexual violence in seeking help.
METHODS: A qualitative descriptive design was employed using purposive sampling. Participants were survivors of sexual violence who had sought help and had been screened for post-traumatic stress disorder (PTSD). Data were collected through in-depth interviews and analyzed using thematic analysis.
RESULTS: Seven interrelated themes emerged, including the chronological context of sexual violence experiences, survivors’ initial ignorance of sexual violence, multidimensional life changes following trauma, self-denial after sexual violence, decision-making processes driven by the refusal to fall into depression, the role of support from trusted individuals, and survivors’ experiences after seeking help.
DISCUSSION AND CONCLUSION: This study highlights the complexity of survivors’ help-seeking decision-making and underscores the importance of trauma-informed and culturally sensitive mental health nursing care. Strengthening community education on sexual violence, supporting families in responding appropriately to disclosure, and developing targeted nursing interventions may facilitate survivors’ recovery and engagement with professional services. Future research should further examine factors influencing help-seeking and evaluate the effectiveness of nursing interventions for survivors experiencing PTSD.

Keywords: Decision-making, mental health nursing, seeking help, sexual violence survivors