Barriers faced by adults with intellectual disabilities who experience sexual assault: A systematic review and meta-synthesis

Background: Sexual violence is associated with significant morbidity and mortality. The incidence of sexual violence against adults with intellectual disability is significantly higher than in the general population. The aim of this systematic review and qualitative meta-synthesis was to explore the barriers faced by adults with intellectual disability in reporting sexual assault from the perspective of different stakeholders. Method: A systematic literature search was conducted to identify relevant studies. A hermeneutic interpretive approach was employed to review and assess the methodological quality of the studies. Findings were meta-synthesized and juxtaposed to identify themes, concepts and interpretations. Results: Thirteen studies were included. Three overarching themes emerged from an interpersonal, professional and social context, and within these domains, eight subthemes emerged as barriers to reporting sexual assault, including fear, communication, sexual knowledge and understanding, intellectual disability identification, lack of collaboration between service providers, presumption of capacity/credibility, lack of resources, myths and misconceptions. Conclusion: The research demonstrates that deficiencies in communication and collaboration among agencies, a lack of appropriate legislation and specific training needs and education programmes are significant barriers in the reporting of sexual assault by people with intellectual disability. These findings are not unique to adults with intellectual disability and have also been identified among people from the general population who experience sexual assault. However, adults with intellectual disability have additional barriers to overcome in order to access equal rights to healthcare, education and the legal system.