Online sexual exploitation and image-based abuse — formative SAQs

SAQ 1 (10 marks)

A 15-year-old boy is brought to the emergency department at midnight after taking an overdose of paracetamol. He is medically stable. In a private moment he tells you that a "girl" he met on a gaming platform sent him a sexual video, he sent one back, and was then told to transfer money or the video would be sent to all his contacts. He has not told his parents. He is terrified and believes there is no way out. ^{[3] [2]}

1. Give your immediate assessment and safety actions, and the further steps you would arrange before he leaves the department. (4) ^{[2] [3]}
2. Outline how you would take the history and preserve the digital evidence without destroying it. (3) ^{[1] [6]}
3. Describe your mandatory-reporting and online-safety reporting duties, and how you would communicate with the family. (3) ^{[4] [6]}

Model answer — SAQ 1

(1) Immediate assessment and safety (4). Acute safety comes before everything else: perform a structured suicide-risk assessment (ideation, intent, plan, means, protective factors), because financial sextortion carries a high acute-suicide risk — the young man perceives no exit that does not involve humiliation. If he is acutely suicidal he cannot be discharged without a safety plan and supervision; remove access to means and ensure a safe, supervised environment. Assess the perpetrator's current access — whether the offender has his location, is actively demanding payment, or has already distributed the image — because a live threat is a safeguarding emergency that may need police involvement in real time. Inform your consultant and the child-protection team from the first minute, and arrange a formal mental-health assessment to determine disposition. ^{[2] [3]}

(2) History and evidence preservation (3). Take a careful, non-leading history using a HEADSS framework adapted to include online life — who he talks to, which platforms, whether he has met the contact, what was shared, and the nature of the threats and any financial demands. Record his exact words in quotation marks and note dates, platforms, usernames and payment methods; do not conduct a forensic interview, which is for the specialist and the authority, but capture what arises faithfully and contemporaneously. On evidence: advise him (and his parent, where appropriate) to keep the device, screenshot the threats, and record usernames and URLs — and critically, do not delete or wipe the device, and do not view, download, or forward the image yourself, because doing so can constitute further distribution and destroy the forensic material. Frame keeping the phone safe as part of the plan, not a punishment. ^{[1] [6]}

(3) Reporting and family communication (3). Two reports in parallel, not in sequence: notify the statutory child-protection authority on the basis of a reasonable belief of harm (not proof), and report to the designated online-safety or cybertipline body for image removal and offender identification (the eSafety Commissioner in Australia, the Revenge Porn Helpline in the UK, the NCMEC CyberTipline in the US, Cybertip.ca in Canada). Share relevant clinical information with the authority — statutory reporting protections generally override common-law confidentiality for the purpose of protecting a child — and document what you shared and why; do not transmit the image itself. To the family, be honest and non-blame: explain that their son is the victim of a crime, that images will be pursued for removal, and that punishing or confiscating his autonomy in anger can worsen the harm; a supportive family response gives the best chance of recovery. ^{[4] [6]}