Edited by Sokhna Fall
Cover image. AI generated
A woman walks into a police station to report a sexual assault. She has already done the hardest part: deciding to speak. What she does not expect is that the process of seeking help will become part of the trauma itself. An officer asks what she was wearing. Why she did not leave earlier. Weeks later, she repeats the same story to doctors, investigators, social workers, and eventually in court.
The assault happened once.
The retelling happens many times.
This experience has a name: secondary victimization. It describes the harm people suffer not from the original event, but from the way institutions respond to it.
When Help Doesn’t Feel Like Help
We turn to institutions – police, hospitals, welfare offices, universities – when we need support the most. These are moments of vulnerability: reporting a crime, asking for medical care, applying for assistance, seeking refuge.
The question is: what happens when the system meant to help ends up making things worse? Many people describe feeling judged, doubted, or simply processed, even when no one is openly hostile. Research shows that negative reactions from professionals can intensify trauma, increase depression and anxiety, and discourage people from continuing with legal or medical procedures. And that can hurt, too.
It’s Not (Just) About Individuals
It is easy to blame single actors: the insensitive officer, the distracted doctor, the bureaucratic clerk. However, the issue often runs deeper.
People working in public services are under pressure: high caseloads, staff shortages, strict performance targets, fear of complaints and lawsuits. To cope, they lean on routines and protocols – filling forms, ticking boxes, moving cases forward. This dynamic reflects what Lipsky called street-level bureaucracy: everyday decisions made under constraint, where small shortcuts become normal practice.
From their perspective, they are doing their job. From the other side of the desk, it can feel like nobody is really listening. The result is a gap between how help is delivered and how it is experienced.
When Procedures Become a Burden
Even simple processes can become overwhelming in difficult moments. Think about it:
- repeating the same story over and over
- filling out complex forms in a second or third language
- waiting weeks or months with no clear information
- collecting documents that are hard or painful to obtain
These steps may seem routine, but they carry a cost – especially for those already dealing with trauma, stress, or uncertainty. Herd and Moynihan describe these hidden costs as administrative burden: the effort needed to understand rules, comply with requirements, and endure the psychological weight of asking the state for help.
Over time, the system itself can become a source of anxiety.
The journey through institutions can look very different depending on how procedures are designed. The infographic below sketches this contrast.
The Cost of Feeling Unseen
One of the most damaging effects is the loss of trust.
When people feel ignored, doubted, or treated without dignity, they may start to withdraw. Some stop seeking help altogether. Others disengage from legal or medical processes, even when they urgently need them. This dynamic aligns with what scholars call institutional betrayal: harm that occurs when institutions fail to prevent, respond to, or acknowledge wrongdoing within their own sphere.
Trust in institutions is not built only on outcomes – convictions, diagnoses, benefits granted. It also depends on something more basic: being heard, respected, and taken seriously. When that is missing, the damage goes beyond a single case and begins to erode the legitimacy of the institution itself.
A Quiet, Accumulating Harm
This kind of harm rarely comes from a single dramatic moment. It builds up.
An interview that feels more like an interrogation than a conversation. A delay with no explanation. Another form, another queue, another anonymous letter addressed “Dear Sir/Madam”. Each step may be defensible on paper. Taken together, they can leave people exhausted, ashamed, and disillusioned. Recent work suggests that repeated, stressful interactions with systems – from immigration to welfare to justice – can create cumulative forms of trauma.
The result is a quiet, slow-burning harm that is hard to see from inside the institution, but very clear from the outside.
Why This Matters Today
Public debates are increasingly shifting from what institutions deliver to how they treat people along the way. From the handling of sexual violence cases, to refugees navigating asylum procedures, to patients trying to access mental health services across Europe, a common question is emerging: does the system feel safe enough to approach when you are already hurting?
For many, the answer is still no. People most affected by violence, discrimination, and poverty are often those who face the steepest administrative burdens and the least responsive institutions. This is not a side issue. It shapes who can realistically exercise their rights and who quietly disappears from the process.
Can Things Change?
Institutions are essential. The goal is not to dismantle them, but to rethink how they work. In recent years, there has been growing attention to more human-centred, trauma-informed approaches in justice, healthcare and social services. These approaches start from a simple recognition: many people who encounter institutions carry histories of trauma, and the system should be designed not to add to that load.
Trauma-informed and victim-sensitive practices include:
- reducing the need to repeat painful experiences
- coordinating services so that information follows the person, not the other way around
- using clear, predictable communication about what will happen next
- offering safe spaces, support persons, and realistic choices during procedures
- training staff not only in law and protocol, but also in the basics of trauma and its effects.
Alongside this, Freyd and colleagues speak of institutional courage: the commitment to face problems openly, protect those who report harm, collect honest data about institutional failures, and put people’s safety above reputational comfort. Small shifts in how people are treated – a different question, an extra explanation, a visible willingness to take responsibility – can make a disproportionate difference.
A Simple but Uncomfortable Question
When people ask for help, they are often at their most vulnerable. In that moment, what matters is not just receiving a response, but how that response is experienced.Because what is meant to offer care can, within institutional settings, fail to acknowledge the person standing in front of it. And that raises a simple, uncomfortable question: are institutions supporting people, or just processing them?