LONDON — People sexually abused as children and later seeking help for mental health problems are being failed by the NHS, senior psychiatrists have said, with the Royal College of Psychiatrists issuing a public apology for what it describes as decades of mismanagement and misdiagnosis.
The college says some survivors have been made worse by treatment that focused on symptoms rather than past trauma. It says repeated assessments, detailed history-taking and not always being believed have re-traumatised patients instead of helping them recover.
Dr Lade Smith, the college’s immediate past president, said she was sorry that victims had too often suffered avoidable harm when they reached out for support. The apology appears in a report given to the BBC.
College says fragmented services leave survivors without the time and continuity they need
The report says the problem is not limited to individual psychiatrists, but reflects the wider mental health system. Dr Smith said services are too fragmented and built around short, separate episodes of care, leaving clinicians little time to form a relationship with patients.
She said some people are offered only eight sessions of therapy, even though it may take that long simply to disclose abuse. Many others, she added, never reach services at all because mental health provision is so stretched.
The college says support is improving, but argues that better training and more investment are needed. NHS bosses have said changes are already being introduced, although the college wants a more consistent approach across services in England and Wales.
Case of Caroline Thompson shows how abuse can be missed years later
Caroline Thompson, 65, says she feels badly let down by the NHS after being psychologically and sexually abused as a child. She later raised a family and built a career as a specialist ear, nose and throat doctor before seeking help in her 50s.
At 55, she developed terrifying nightmares that left her mentally exhausted and unable to function. When she was referred to mental health services, the psychiatrist she saw said the symptoms were unlikely to be linked to childhood abuse because of the delay in disclosure and because she had managed to have a family and successful career.
She was diagnosed with anxiety and given antipsychotic drugs. After about a year of therapy she was discharged, but says she still could not understand what was happening and had to give up the job she loved. Private trauma-focused therapy eventually helped her improve over the following years.
Specialist training and national guidance are among the changes being urged
The apology follows a review by a working group of experts, doctors and abuse survivors set up by the college. It was chaired by consultant psychiatrists Jo Stubley and Maria Podlejska-Eyres and included Caroline Thompson.
The group was formed after more survivors came forward in the past decade, following high-profile abuse scandals involving schools, children’s homes and religious institutions, as well as the crimes of Jimmy Savile. The college is now promising specialist training materials for psychiatrists.
It also wants mandatory trauma-informed training for all mental health staff, national guidance on recognising and responding to historic child sexual abuse disclosures, and an overhaul of services so survivors can get longer-term support. Gabrielle Shaw of the National Association for People Abused in Childhood called the apology significant and welcome, but said it must lead to meaningful change.
NHS England says specialist support is available round the clock
An NHS England spokesman said specialist services are available and pointed to sexual assault referral centres and counselling services that can be accessed 24 hours a day, seven days a week, with information on the NHS website.
He said people who have lived through historic child sexual abuse may not have spoken about it for years, so it is vital they know they can access specialist, trauma-informed help through the NHS. He also said extra training is being given to mental health support teams in schools and colleges to better support children and young people.
Estimates suggest nearly one in 10 adults in England and Wales were sexually abused in childhood. The college says that trauma can increase the risk of alcohol and drug misuse, eating disorders, self-harm, complex PTSD, anxiety and depression, and that many survivors do not disclose abuse until decades later, if at all.
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