Sexual Harassment Prevention for CNAs and HHAs

We hear a great deal about sexual harassment both in the media and in workplace training. What is harassment? According to the U.S. Equal Employment Opportunity Commission, harassment is “unwelcome conduct that is based on race, color, religion, and sex (including sexual orientation, gender identity or pregnancy) . . .” (EEOC, 2023a). What is sexual harassment, and how is it defined?  Some terms used to describe sexual harassment include, ‘unwelcome sexual advances and ‘request for sexual favors.’ A full definition of sexual harassment is unwelcome attention or conduct of a sexual type. It can include verbal comments, gestures, looks, jokes, remarks about a person’s body, and questions about a person's sexual activity (NASEM, 2018). Although sexual harassment can happen in many situations, we will be looking at sexual harassment in the workplace.

Sexual harassment includes many types of unwanted and upsetting behaviors. These include:

• Ongoing pressure for sexual favors.
• Uninvited touching, leaning over, getting into someone’s personal space, or pinching.
• Unwelcome sexual looks or movements.
• Unwanted attempts at making contacts, such as letters, emails, contacts on other forms of social media, and telephone calls.
• Sending materials with sexual content.
• Unwelcome sexual banter, jokes, comments, or questions.
• Shifting a work discussion to sexual subjects.
• Making sexual remarks about what someone is wearing, their body shape, or their looks.
• Making kissing and lip-smacking noises.
• Spending unneeded time with an employee.
• Touching someone’s body, clothing, or hair.
• Lying or spreading rumors about someone’s personal sex life (UN, 2023). 

From the list above, we can see that sexual harassment can happen in many ways. It can be visual behavior, spoken conduct, and physical contact.The term ‘quid pro quo’ means “this for that”. In the area of sexual harassment at work, it means a demand for sexual favors in return for employment, a good performance review, a pay raise, etc. The person doing this type of harassment has power and control and is usually the supervisor or manager. Other benefits that may be offered in return for sexual favors include improved workspace, such as getting a personal or bigger cubicle, better shifts, and the possibility of travel opportunities. On the downside, the employee is told that if they don’t give in to these demands, they risk being fired or demoted to a lower-paying job or working unsatisfactory shifts (UpCounsel, 2020).

Sexual harassment isn’t just nasty, bad conduct; it is against the law. The United States Equal Employment Opportunity Commission (EEOC) enforces Title VII of the 1964 Civil Rights Act. It bans discrimination based on a person’s sex, which includes their sexual orientation and their gender identity. Sexual harassment and assault in the workplace is a type of sex discrimination that goes against Title VII (EEOC, 2023b).

There are also state laws that protect employees from workplace harassment, including sexual harassment. Now, 50 states, including the District of Columbia and Puerto Rico, outlaw “sex” discrimination. Twelve of these states include sexual harassment under the protection against workplace discrimination based on sex. Thirty-nine other states, including D.C. and Puerto Rico, clearly say that ‘sexual harassment’ is not allowed in the workplace (NCSL, 2021).

States that now have sexual harassment training laws include:

• California. The law in California says that all employers who have more than five employees must give training to their supervisory staff and workers on how to stop sexual harassment and abusive behavior. Supervisors must get two hours of training every two years, and regular employees an hour of training every two years. The training must include real-world examples of harassment based on gender identity, gender expression, and sexual orientation.
• Connecticut. In Connecticut, all employers with more than three workers must provide anti-harassment training to new employees within six months of starting employment.
• Delaware. Employers must give each new and current employee the Department of Labor Sexual Harassment Notice. This notice explains what sexual harassment is and gives several examples. It provides instructions on filing a sexual harassment complaint with the Department of Labor and warns against punishing employees who file a complaint.
• Illinois. Every employer working in this state must provide sexual harassment prevention training to their employees every year. Chicago has its laws banning sexual harassment in the workplace. Chicago requires an hour of sexual harassment prevention training each year, along with an hour of bystander prevention training, also done each year. Supervisors must do an extra hour of harassment prevention training. There must also be a written notice posted about sexual harassment, explaining how to report it and what help is available to workers.
• Maine. In this state, employers who have 15 or more workers must provide sexual harassment prevention training. All new employees must receive this training, as well as those who have recently been promoted to supervisory or managerial positions.
• New York. All employers with 15 or more employees must provide sexual harassment prevention training every year. A notice explaining what sexual harassment must be posted in the workplace, and a fact sheet about sexual harassment must be given to every new employee. (Grace, 2022).

The three states with the most sexual harassment charges from the years 2018-2021 were Alabama, followed by Mississippi and Georgia. Other states with high numbers of sexual harassment charges included Kansas, Tennessee, Arkansas, Missouri, Nevada, the District of Columbia, and Louisiana (EEOC, 2023b). However, our figures do not tell the whole story; according to the EEOC, workplace harassment is underreported. In one study, 90% of people who said they had experienced harassment never reported it. However, after ‘# MeToo’ went viral in 2017, the EEOC received an increased number of sexual harassment charges over the next two years (EEOC, 2023b).

Most sexual harassment charges continue to be filed by women. Between 2018 and 2021, over 78% of sexual harassment charges were filed by women. Over 71% of sexual harassment charges filed along with race charges were done by African Americans. The figures from the EEOC also show that over 40% of sexual harassment charges were also linked at the same time to a charge of retaliation (EEOC, 2023b).

Several things can be done to prevent sexual harassment from happening at work. Employers are responsible for keeping the workplace free from sexual harassment. There should be a written policy that makes it clear that sexual harassment will not be allowed. The policy should have examples of the types of behavior that can be part of sexual harassment. Attention should be given to the language used in the policy; it should be easily understood and at the reading level that meets the requirements of the employees. The policy should be in more than one language to meet the needs of employees whose first language is not English (Gonzales, 2022).

The company or facility policy should let the employee know that they can and should report any incidents of wrongdoing the first or second time it happens. This gives the facility the chance to act and stop what is happening at the very beginning and lessens the bad effect it has on the employee who is experiencing the sexual harassment and their coworkers (Gonzales, 2022). It is not enough for the facility's policy to tell employees to report instances of sexual harassment to their immediate supervisor since this person may be the harasser. It is good practice for the employer to choose at least one person in authority who is outside an employee’s chain of command to be responsible for taking complaints of harassment. If the employees are part of a trade union, problems with sexual harassment can also be reported to the union representative (National Partnership for Women and Families (2019).

Providing sexual harassment training is important. The training should be fitted to the type of work setting and describe what sexual harassment is. It should also clearly tell any employee how they can report sexual harassment, provide extra resources for victims of sexual harassment, and describe the effects of sexual harassment on the victim. Sexual harassment training should be done with every new employee and included in every employee's annual mandatory training (Gonzales, 2022).

Studies have found that not all sexual harassment training programs are equal. Computer programs on sexual harassment, where an employee reads information and clicks through questions, are not as good as in-person training or a webinar where there is interaction between the person watching and the presenter. With interactive programs, information is presented in a meaningful way that gets the attention of the employee rather than something that just meets the requirement for sexual harassment training. It has been found that some bare-information training can do more harm than good by showing individuals how to stay just on the right side of the law and continue sexual harassment without being called out for what they are doing. These minimum training programs can also send the message that preventing sexual harassment isn’t that high up on the priority list for the employer or the company, even when that is not what is intended (Gonzales, 2022).

An employee's responsibility in preventing sexual harassment is to be aware of their conduct and how it might affect others. Will a coworker take what you are going to say as a compliment, or will they find it rude? If you are not sure, then don’t say it. The joke you heard when you were out for a night with friends might sound hilarious, but is it the type of joke that should be repeated in the workplace? If you are not sure, keep it to yourself. You may say, ‘It’s not my problem if someone is thin-skinned and doesn’t have a sense of humor.’ But if what you say offends a coworker, it is your problem, and the excuse that it was ‘only a joke’ is not a defense or that ‘everyone else found it funny.’ A sexual harassment complaint is not based on the number of people who make the complaint – it only takes one person to complain – and an employee could find themselves having to answer for their conduct.

An employee may have a coworker they can walk up to and put an arm around their shoulder, and they are both fine with that. However, employees should not take their friendship with one coworker or even a few and use that with everyone they work with, especially with a new employee. If a coworker lets you know by what they say or their body language that they are uncomfortable with what you are doing, stop that behavior immediately, apologize, don’t repeat it, and don’t talk about it with coworkers. Trying to get sympathy and support from coworkers may seem tempting, but it could be taken as harassment by the person offended by your actions.

Most employees value their reputation and their employment. Being accused of sexual harassment is serious; it is an offense that breaks both State and Federal laws. An employee in this situation can face disciplinary action, including a written or verbal warning, suspension, or being fired (Impactly Inc, 2023).

First, victims of sexual harassment need to remember that they are not to blame for what is happening. Sexual harassment is unwanted attention, and unfortunately, most of the time, ignoring it will not make it go away; it often makes it worse. So, what can you do if you are being sexually harassed? Start building your support system by telling your family and friends about the harassment. Then, write it down. Get a journal, a simple notebook will work fine, and write down everything that happens with the person who is harassing you. Most of us think that we will remember everything, that some events are so awful there is no way we will forget them. But we do, or we end up getting important details mixed up.

Write down all the details of the harassment. Start by writing down the dates, times, and places where the harassment occurred. Rather than saying, ‘On the unit where I work,’ say, ‘at 2 pm at the nurse's station when I was documenting the patients' vital signs.’ Write down exactly what happened. Did the person step too close or try to touch your hair or body? What did they say? Did they make it impossible for you to get past them? Was there anyone else around who saw or heard what was happening? Keeping a good record of what took place will help ensure that it is not just your word against the person harassing you. You don’t want a situation where you say that some unwanted conduct happened on such and such a day, because that is how you remember it, only to have the harasser, prove that they were not working that day. A written record stops this from happening. Also, keep anything that the person harassing you sends to you, such as emails, notes, voicemails, or pictures(Legal Aid at Work, 2023).

Tell caring coworkers about what is happening. You could discover that others are having the same struggles as you but don’t know what to do about it. If others are suffering sexual harassment, it is worthwhile to put together a joint complaint. This makes it more serious and lets management know it affects more than one employee and could become more widespread. Also, ask your coworkers to be alert to what is happening. If they hear or see anything that is unwelcome sexual conduct, ask them to please come forward. Having witnesses to what is going on helps to strengthen a complaint. But use caution when talking to coworkers. Know the people that you are talking to and can trust.

It is also important that you talk to the person who is harassing you about what they are doing. Make it plain to them that you do not welcome their conduct or want anything to do with it and want them to stop. It may be too much to stand before the harasser and tell them these things, but that is not a reason to let it go. Often, the person doing the sexual harassment counts on their victim being too embarrassed, shy, or afraid to do anything about it.

A way around this is to write them a letter instead and send it to them. This is a good move because it provides further documentation of the harassment. The letter should include as many facts as possible, including dates and a description of what happened. Let the harasser know how their actions are affecting you and your work. You are angry, afraid, embarrassed, constantly on edge, and dread coming to work. Say what you want to happen from now on. Things that can be said include, “I want our relationship to be strictly professional. I want to work with a different supervisor.” Think about this before writing it: Would you be happy changing to a different shift or a different unit, and is there a supervisor that you would feel more comfortable working with? You can also say, “I don’t want you to come close to me, to touch me, or try to touch me, or to make comments about my physical appearance or my body” (Legal Aid at Work, 2023).

Some people may find that writing a letter is too much for them. English may not be their first language, and they can feel awkward trying to find the right words to describe what happened or is happening. Others may be concerned that their level of English is not ‘good enough’ to tell their story. However, it is not about perfect English or stylish writing. Use everyday language, the words you know and are familiar with, to put your concerns in writing. No one will be looking at the quality of the writing but at the described concerns. Getting a friend or coworker to help write the letter or read it over once it's completed is also possible. The most important part is to keep a copy of the letter.

How a harasser reacts to having their behavior called out depends on them. One response is that they will try to make little of the incidents and laugh them off. They may say, ‘Come on, I was only joking. Everyone else knew it was a joke; why are you so thin-skinned.” Or “I thought we were better friends than this. I would never complain about anything you say to me.” These are examples of the harasser trying to put the blame back on the person who is the victim of sexual harassment, trying to make them feel guilty about standing up for themselves. But even if some of what the harasser said or did was intended as a joke, according to the law, harassment is how the person at the receiving end felt about it. If the victim felt harassed, then it was harassment, regardless of what the intent of the doer of the action was. As for using the excuse “we’re all friends here,” friends do not say or do anything that will hurt, humiliate, or abuse each other. No matter how the harasser responds, it should not stop the harassed person from moving forward with their complaint.

Another problem someone can face is what to do if the person harassing is a patient. One of the steps the employee can take is to set boundaries with the patient. Let them know that you do not want them making sexual comments to you or asking questions about your personal life. Also, tell them that touching you is not allowed. This can be said in a kind but firm manner. However, this may not work if the patient is mentally ill or has a disorder that causes them to be confused and not know where they are or who they are talking to. Sometimes, a patient will confuse a staff member for their spouse and think they are having an intimate moment or conversation with someone close to them. In these cases, the supervisor or manager may need to get the social worker or other therapists involved to work with the patient on this problem (Androus, 2023).

Sexual harassment by patients, whether in an acute care hospital, assisted living, or a nursing home, should not be viewed as ‘part of the job.’ It is not part of anyone’s job description that they have to be able to handle incidents of sexual harassment from a patient on their own. An employee may fear that if they are not able to deal with sexual harassment from a patient independently, they may be seen by their coworkers and supervisors as ‘not fit for the job.’ Unlike a regular hospital stay, patients in long-term care facilities such as nursing homes can be there for months or even years. They may be cared for by the same assistant for long periods, which can change the patient and caregiver relationship. However, like all other types of sexual harassment, this too is the responsibility of the facility to deal with, not the employee on their own (Pennington, 2022).

Sometimes, when dealing with older patients, they may not know that their actions and statements can be taken as sexual harassment. What a patient may have got away with saying to a caretaker 20 or 30 years ago is not okay in today’s world. This does not mean that their behavior should be excused or ignored; it should be pointed out that these actions or comments are no longer allowed. If the caretaker feels uncomfortable having this conversation with the patient, they should ask the supervisor or social worker to discuss this problem with the patient. Often, in these cases, the patient will feel embarrassed by what they have done and apologize for offending. They may want to talk about how they grew up and the culture in those days. Information sharing can lead to a better working relationship between the patient and the caregiver (Fenwick, 2021).

The facility should not shy away from dealing with these types of sexual harassment because they don’t have a policy in place to deal with them. Any facility that has older or confused patients should realize that sexual harassment of the staff by a patient could occur, and they should have a written policy in place that speaks to it. Some steps can be taken to address the complaint when it does happen (Fenwick, 2021).

An employee experiencing sexual harassment should also reach out to their supervisor - if that is not the person who is doing the harassment. If their supervisor harasses them, they must talk to the manager or go directly to the human resources department. The employee can go to their union representative if a union exists in the facility. This person should be able to help and guide the employee in getting their complaint to the attention of the right person in the organization. Ask the human resources department if the facility has a sexual harassment policy; if there is one, get a copy. Follow the employer's complaint procedure. Once the facility management and the human resources department are made aware of the complaint, they should assist the employee in bringing forward their complaint (Legal Aid at Work, 2023).

According to the United States Equal Employment Opportunity Commission (EEOC), most harassment victims do not formally complain. Only around 6% to 13% report what is happening. That means that most sexual harassment in the workplace goes unnoticed, and no action is taken (Foley, 2020).

Why would an employee put up with a bad, abusive work situation and not report it? There can be several reasons for this. There is a social stigma around sexual harassment that can make an employee feel that they will be unfairly judged by their coworkers or even disliked or snubbed at work if they make a complaint. For many employees, this can be seen to be nearly as bad or worse than the sexual harassment that they are putting up with.

Fear that their complaint will not be believed or taken seriously. This can be especially troubling for an employee if the sexual harasser is their supervisor or a coworker that everyone else seems to like and get on with.

Fear of retaliation, either work-related or on a social level. The biggest work concern is, ‘What if I get sacked for complaining?’ Often, the harasser will either hint at this or say, ‘Do you know what happened to the last person who tried to complain? You got their job.’ The person who is suffering sexual harassment may not know the truth of this, but they are too afraid to call the harasser's bluff. Employees often feel that supervisors and those who are ‘higher up’ are untouchable and can get away with almost anything. But this is not true, and every employee should know it is false. Companies and facilities are held accountable for the actions of their employees, regardless of their position.

On a social level, employees are afraid that if they complain about sexual harassment, they will be seen as troublemakers. They fear losing friends, being talked about, or being blamed for the actions of the harasser and having brought this on themselves.

An employee may not trust their facility’s grievance process. Will what they say be kept confidential, or will it be leaked and become public knowledge? This type of concern is not a failure on the part of the employee but on the part of the facility. Facility policies about keeping employee information confidential should be very clear. Information is only shared with those who need to know.

A big fear is, what if I make a complaint, and even though there is an investigation, nothing much changes? The harasser is still there in the same position. This can cause the employee to feel more discouraged and depressed.

An employee who has a good work record can be worried that if they complain about sexual harassment, they will be blacklisted by their employee. They will be passed over for better work schedules or getting the time off that they requested. If they leave, they will not get a good reference.

An employee may feel helpless because of their work status. If they are not an American citizen and are in the United States on a temporary or work visa, they may be afraid that if they make a complaint about sexual harassment, they will be deported (Foley, 2020).

An employee may give in to the harasser's demands initially but later regret this decision and want to end all contact with this individual. In these cases, the harasser may tell the victim that since they were willing to do what was asked of them, they now have no case for sexual harassment and are stuck in an abusive relationship. However, this is not true. Even if the employee agrees to the demands of the harasser, this can still be judged as sexual harassment if the actions of the harasser were “unwelcomed” (WomensLaw.org, 2023).

Immigrant workers can face many obstacles, such as reduced skills in the English language, lack of knowledge of the laws in the United States, and what protections they have as employees. Often, a harasser will use this against an employee, threatening to take their work permit away if they don’t agree with the harasser's demands. For many immigrant workers, there is also a cultural barrier; matters related to sex are not discussed openly, and they can be deeply ashamed that they are the victims of sexual harassment. This shame can stop them from talking to their families and friends about what is happening. Sometimes, they may not have family in this country and no close friends that they can turn to. Depending on the situation they experienced in their home country, many immigrants are extremely afraid of people in authority. They can have this same fear of the managers and supervisors in their workplace and will put up with bad treatment and harassment rather than speaking up (Tahirih Justice Center, 2023).

Whistleblower laws protect against punishing a person who reports wrongdoing at their workplace. The term whistleblower refers to an employee who reports an abuse of the law by their employer. This includes reports of witnessing incidents of sexual harassment against a coworker, either by another employee or by a supervisor. The federal government has laws that protect the person making the report. The law states that an employee cannot be fired or treated unfairly because of the complaint that they have made (U.S. Department of Labor, 2023).

Two conditions must be met to be covered by whistleblower protection. Firstly, the person making the complaint must have a ‘good-faith belief’ that the law is being broken. A good-faith belief means that the employee honestly believes something wrong is happening. Secondly, the employee must complain to their employer or the proper federal agency. It is important to remember that even if an investigation finds no wrongdoing, the employee making the complaint is still protected under whistleblower laws (FindLaw, 2022).

It is hard to see sexual harassment happening to a coworker. Do you stand by and let it happen? After all, isn’t it management’s responsibility to stop these things from happening? But what if management doesn’t know about it, and no one else is doing anything? As a witness, you can do a lot to help and support the person who is a victim of sexual harassment. The following actions can be used when you see someone being sexually harassed. They are known as the ‘Five D’s and were developed by the organization ‘Right To Be.’

• Distraction- Distraction is a good way to intervene. The goal is to stop what is happening by interrupting it. The best way to put this in practice is to ignore the person who is doing the harassment and talk directly to the person who is being harassed. Don’t talk about the harassment you see happening, but talk about something completely different. An example could be, “Did you hear that we’re getting supplies from a different vendor? Do you think they will be as good as the old one?”
  • Another distraction is to ‘accidentally’ drop or spill something. Just be careful with spills so you don’t damage equipment or paperwork. One example would be to drop the change in your purse or wallet and make a fuss complaining about that.
  • Another choice is to ‘get in the way.’ Keep doing what you are doing, but get in between the person doing the harassment and the victim. You don’t have to say anything or acknowledge them. Act as if you are in your own space getting on with things.
  • The important benefit of distraction is that you are not openly intervening in the harassment, but you are making it harder for it to happen.
• Delegate- This is when you ask someone else for help intervening in harassment. Look for someone who you believe will be comfortable helping. Tell them exactly what you see happening and ask if they can help. An example of how this can be done in the workplace is to say to the person you want to assist you, ‘I think Paul is making the new person seriously uncomfortable. Can you help by standing between them or getting Paul’s attention so I can get the new employee away from there?’
• Document- You record or take notes of the harassment. But there are important precautions to take with this.
  • First of all, is there someone else who is trying to help the person who is being harassed? If not, try to place one of the other Five D’s discussed here. Keep in mind that recording someone being harassed while they are completely on their own without help can add further trauma for them. Secondly, make sure that you are in a safe situation.
  • You must always ask the person being harassed what they want you to do with the recording or the notes you have taken. Never post it online or use it in any way without their permission. When the incident occurs, they may be too upset to say what they want done. Don’t demand a full answer at that time; just let them know that you have this evidence of what happened, reassure them that you will keep it safe and private, and give them some time to think about it. Also, ask if they want you to give them what you wrote about the incident.
• Delay- Most of the time, bystanders are not clued in that sexual harassment is going to happen to a coworker. Often, it comes out of nowhere, with no warning, unless the harasser has an established pattern of how they act. Caught off guard or doing something that they cannot leave, a witness to sexual harassment may not be able to intervene at the moment. But that doesn’t mean that witnesses should ignore what happened and let it pass. As a bystander, you can help to decrease the trauma the victim of harassment suffered by talking with them after the incident occurred. Make your approach gentle so they don’t feel confronted or frightened, especially if they are someone you don’t know very well. Tell them you witnessed the incident and what happened was wrong. Ask them how they are feeling and if there is anything you can do to help them. Let them know you will help them report the incident if they want to. Victims of harassment often feel alone, and offering them your strength to make them feel stronger can help them find a way out of a very bad situation.
• Direct- Call out what is happening at the moment. It takes courage to do this and should also be used cautiously. Before saying anything, ask yourself if the situation will improve or worsen. Will it make the harasser stop their actions, or will they change course and start harassing you instead? Look at your relationship with the harasser. Are you an older or more senior team member that coworkers generally listen to? And do you believe that the person who is being harassed wants a bystander to speak up? If you have doubts about the answer to these questions, it may be better to use a different intervention. If you do decide that direct intervention is the best way to go, here are some important points to remember:
  • Keep it short and to the point. Examples of what you can say are, “This is inappropriate. It is disrespectful. Stop this now. Please leave them alone.”
  • Don’t get into anyone’s personal space. Position yourself as close to the victim as possible. Keep your body language non-threatening and your voice firm and clear.
  • Instead of speaking to the harasser, ask the victim, “Are you okay? Do you want me to call someone?”
  • You may feel angry and upset by what you see happening, but don’t let that tempt you into telling the harasser exactly what you think of them. Stay away from an argument; your goal is to help the victim, not to get into it with the person harassing them (Right To Be, 2022).

It is important to know that as a bystander, you are not helpless; there is something you can do. Supporting a coworker who is being sexually harassed makes for a better workplace for everyone. Every employee can do their part in supporting fairness and respect in their workplace. The best way to deal with harassment is to stop it from happening in the first place. Some actions that every employee can take to make sure that sexual harassment does not happen where they work include:

• First, consider your thoughts about gender, sex, race, and where people come from. Are those thoughts and beliefs fair and balanced, and how do they affect how you treat the people you work with?
• Talk to your coworkers, supervisors, and managers about ways to increase workplace diversity and inclusion.
• If they are not already happening, ask that your workplace begin staff training on diversity, inclusion, sexual harassment, and what bystanders can do to help.
• Get to know and befriend people at work who, for whatever reason, may be seen as being a minority. Do what you can to ensure they are heard and treated with respect (National Partnership for Women & Families, 2019).

The law makes it clear that employees who report sexual harassment cannot be punished by their employer for doing so. Some of the ways retaliation can be done include:

• Giving an employee a performance evaluation lower than they deserve.
• Making it more difficult for employees at work, for example, moving them to a shift that is hard for them because of their home responsibilities. The employee could also be moved to a position they don’t want.
• Questioning an employee’s immigration status.
• Putting the employee and their work under increased scrutiny, more than what is done with other employees.
• Firing an employee (EEOC, 2023)

However, employees need to know that they can still be disciplined or fired for work problems that have nothing to do with their report of sexual harassment (Worker.gov, 2023).

Being a victim of sexual harassment at work can be hard on an employee, especially if there are repeated incidents. How each of us responds to trauma is not a choice that we make; it is an unconscious survival reaction that happens deep inside our brains. It can be the cause of long-term health conditions that disrupt the person's life, such as depression, difficulty sleeping, chronic pain, and gastric problems. Some of the bad effects of being a victim of sexual harassment can cause problems in all parts of the person’s life. These include,

Emotional Effects:

• Anger and irritation. Being defensive and getting into arguments easily.
• Fear, dread going to work. I am always nervous, uneasy, and unable to relax, especially at work.
• Humiliation, feeling embarrassed, ashamed, and losing self-worth and dignity.
• Guilt and self-blame. Feeling that they are responsible for what is happening. Developing an unhealthy way of thinking about the abuse they have suffered.  Thinking, ‘Maybe I deserved it. It's my fault; I did something to make it happen.’
• Betrayal, especially if the harasser is someone that an employee should normally be able to trust, such as a supervisor or manager.
• Feelings of being abused and harmed.
• Powerlessness and loss of control. They feel helpless and see no way to change or improve their situation (ARO, 2023)

The effects that sexual harassment can have on the mental health of an employee include:

• Anxiety, worrying that something bad is going to happen.
• Depression, feelings of sadness and hopelessness that don’t go away.
• Staying away from situations, places, and people who are close to the harasser or where the harassment is likely to take place or has taken place.
• Feeling emotionally numb, finding no joy or happiness in anything that they do.
• Isolating themselves from family and friends.
• Post Traumatic Stress Disorder (PTSD).
• Problems with concentration.
• Lack of motivation.
• Substance abuse.
• Suicidal ideation (ARO, 2023).

Sexual harassment can cause physical side effects due to the stress of what is happening. These physical symptoms include:

• Headaches or migraines.
• Night terrors, nightmares, or problems with sleeping.
• Changes in the person’s weight. They may lose weight because they are too upset to eat, or they may gain weight because of overeating junk food and ‘comfort foods.’
• Having no energy, feeling tired all the time.
• Problems with intimacy and sexual activity.
• Skin conditions include rashes or ‘breaking out in hives.’
• Panic attacks.
• Development of phobias (UpCounsel, 2020). A phobia develops when a person has too much fear of certain places, situations, or things. People with phobias have a strong feeling of dread or panic when they are faced with the source of their fear. The effect of a phobia can run from annoying to severely restricting. Someone with a phobia often knows that their fear is not sensible, but they are not able to get rid of it (Legg, 2019).

Sexual harassment can also have negative effects on the person’s work. They may often be absent from work. They may feel they have no option but to leave a job they enjoy. The stress from sexual harassment can cause decreased interest in how they are doing their job. This, in turn, can lead to poor job performance evaluations. A manager and human resources department should stop and take a second look at the poor job performance of an employee who had a good job record up to that time. This should be a red flag for those in charge that issues must be looked at closer to see what is causing them (UpCounsel, 2020).

Some general advice for victims of sexual harassment includes taking care of yourself. In difficult times, self-care becomes even more important. Get enough rest, do not skip meals, eat nutritious foods, do not overeat junk foods, or consume too many ‘comfort’ foods. Take time to do what you enjoy and help you relax, such as going for a walk or the gym. Staying as close as possible to your normal routine helps you to deal with stress (Bettencourt, 2023).

Many victims of stressful events, including sexual harassment, try to cope by making little of what happened. They can tell themselves things such as, ‘It wasn’t all that bad. People have gone through worse. It's over now.’ But this doesn’t always work. We often don’t know how badly we have been affected by a situation until ‘the dust has settled,’ and weeks and months later, we still suffer the effect of it, even if we try to tell ourselves that we are not.

Two of the most serious effects of suffering a trauma such as sexual harassment are panic attacks and post-traumatic stress disorder, known as PTSD.

A panic attack is a sudden feeling of fear that also has a strong physical response. During a panic attack, the person can sweat a lot, have problems with breathing, and feel that their heart is racing. They can also have chest pain, trembling, chills, nausea, and a feeling that they are out of control. For someone going through a panic attack, they can often feel like they are having a heart attack. Symptoms are generally at their strongest within 10 minutes after a panic attack begins and then stop soon after. It is a very frightening situation to be in. However, a panic attack is not dangerous or harmful to health, but it can cause problems with a person’s quality of life. Anyone having symptoms of panic attacks should see their doctor to make sure there is no physical cause for what is happening. With treatment, most people who suffer from panic attacks get better (Cleveland Clinic, 2023).

Post-Traumatic Stress Disorder (PTSD) is a condition that can happen after someone has been through or witnessed a frightening, distressing, or unsafe event. We usually think of people having PTSD when they have been caught up in war, or a natural disaster such as an earthquake, or being involved in a bad accident. Still, it can happen too after an abusive situation. Even though the abuse and harassment may have stopped, the victim still feels afraid and anxious. PTSD can begin soon after the incidents have stopped or may start months later. To be diagnosed with PTSD, the symptoms must continue for more than a month and must be serious enough to cause problems with school, work, or dealings with others (SAMHSA, 2023). Symptoms of PTSD include:

• Flashbacks, where the person feels that the incidents are happening over again. Reliving the abuse.
• Problems with sleeping or having nightmares.
• Feeling alone or separated from others.
• Losing interest in doing anything, such as fun activities or hobbies.
• Feeling anxious, guilty, or sad.
• Having frightening thoughts.
• Problems with concentrating.
• Suffering from physical pain such as headaches or stomach pain.
• Stopping memories, thoughts, or emotions closely related to traumatic events.
• Problems with remembering things.
• Harmful beliefs about oneself or other people.
• Having a bad temper or being touchy.
• Feeling very watchful.
• Easily startled.

Anyone who has been a victim of sexual harassment and is having any of these signs and symptoms should see a doctor who has experience with diagnosing and treating PTSD, such as a psychiatrist or psychologist. Treatments and therapies available can help (SAMHSA, 2023).

It is never an easy thing to know what to say in any difficult situation. It can be hard for someone to talk about being sexually harassed, but it can be just as hard for the person who is listening to their story. Some of the best practical advice is not to worry about what you will say; firstly, pay attention to what the other person is saying. Listening with care and understanding is the most important thing we can do. Some other things to keep in mind are:

• It is up to the person telling their story about sexual harassment to decide how much they want to share or not. They may start talking about what happened or is happening, and when they hear themselves putting it in words, they suddenly get cold feet and want to stop. It is not the listener's fault that the person no longer wants to discuss it. The best way to respond is to let them know they can tell you as much or as little as they want. Let them know that you understand how hard this is to talk about, and if they want to talk more at another time, you will be there to listen.
• Recognize their pain without supposing how they feel. We cannot truly say how someone is feeling in any situation. We think we know how we would feel, but we cannot suppose that is how the person telling their story feels. We should avoid what we might see as helpful things to say, such as, “It wasn’t all that bad,” or “What a horrible, awful thing to happen. I couldn’t handle something like that.” The best thing to say is to ask them, “What was it like for you?”  You can, of course, show your feelings of anger and sadness that this has happened. It confirms for the victim that what happened is wrong, that you are listening, and that you care about them.  What you don’t want to do is to make the conversation about your feelings but keep it fixed on the person telling the story. Tell them you are there for them and ask how to help them.
• Don’t ask too many questions. Listening to someone tell you their story about sexual harassment; you are anxious to understand exactly what happened and all the details so that the picture is clear in your mind. This can lead to asking a lot of questions. But even with the best intentions in the world, questions such as, “Why did you take so long to complain about it,” can be off-putting. Asking questions can cause the victim to stop talking. They may think you are judging or blaming them for what happened.  You can certainly have questions about what you are hearing, but you don’t need to ask them.
• Offer to assist the person in finding help. Some people will already have help, family that they can rely on, counselors, and doctors that they are in contact with. But others may not have this kind of help. It is important to ask if they have support. You can tell them you don’t know what help is out there, but you are willing to help them search for what they need.
• Self-care. Hearing someone’s story about sexual harassment can have a deep effect. You must look at your own feelings and practice self-care. Sometimes, you may need to talk to someone you trust or a healthcare professional. It is necessary to remember that the victim’s story is not yours to retell to others. After hearing their story, you need to focus on sharing your feelings, emotions, and thoughts. This time, the conversation is about you (Vanderbilt University, 2023).

Sexual harassment in the workplace is not a joke or something to be taken lightly. Those who do it are breaking the law. Those who are the victims of sexual harassment need to know that they do not have to put up with it and that there is a solution. In our places of employment, we all have a responsibility to ensure it is the best workplace. Those who are victims of sexual harassment should be encouraged to report what has happened and to get the help they need to recover from this trauma. Preventing sexual harassment is everyone’s business.

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