NHS fails adult child abuse survivors

The Royal College of Psychiatrists has issued a public apology for the NHS's decades of mismanagement and misdiagnosis of adults who were sexually abused as children. Senior doctors told the BBC that people seeking help for mental health problems in later life are being failed, with some experiencing worsened trauma.

Immediate past president of the college, Dr Lade Smith, said she was sorry that victims have too often suffered "avoidable harm when seeking help." A report from the college details how treatment has sometimes been inappropriate, with people re-traumatized by repeated assessments and not always being believed.

A System Under Strain

Dr Smith stated the failure is systemic, not just psychiatric. Services are fragmented and designed for short episodes of care, preventing psychiatrists from building necessary relationships. Patients are lucky to get eight therapy sessions, which may be the time needed just to disclose the abuse. Many people do not get seen by mental health services at all due to stretched resources.

Estimates suggest nearly one in 10 adults in England and Wales were sexually abused in childhood. This trauma increases risks for mental health problems including alcohol and drug misuse, eating disorders, self-harm, complex PTSD, anxiety, and depression. Around two-thirds have not disclosed the abuse to services by adulthood, with one in five never disclosing.

A Personal Account of Failure

Caroline Thompson, a 65-year-old former ear, nose and throat doctor, feels badly let down. She was abused as a child but did not seek help until terrifying nightmares began at age 55. A psychiatrist said her symptoms were unlikely linked to the abuse due to the delay and her successful career. She was diagnosed with anxiety, given anti-psychotic drugs, and discharged after a year of therapy still unable to function.

"I had to give up the job I loved," she said. Private therapy with a childhood trauma specialist helped her recover. She found it astonishing that the NHS did not understand traumatic memories can be buried for survival and surface years later.

Calls for Reform

The apology follows a working group review involving experts and survivors, including Caroline Thompson. The group was formed after a rise in people seeking help following high-profile abuse scandals. The college is calling for mandatory trauma-informed care training for all mental health staff and national guidance on responding to disclosures of historic abuse.

Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood, called the apology significant but said it must lead to meaningful change, as services have not felt like a route to safety for many survivors.

An NHS England spokesman said specialist, trauma-informed support is available 24/7 through sexual assault referral centres and counselling services. He added steps are being taken to better support young people, with additional training for mental health teams in schools and colleges.