Supporting Adult Survivors of non-recent sexual abuse: Needs and Provision
The need for specific support for adult survivors of historic / Non recent childhood abuse is neither well understood or provided for.
The belief within the groups that commission both physical and mental health services is that the existing generic services are adequate.
Needs and Provision.
One of the big issues, at least in my limited experience, is that dealing with the fallout from childhood sexual abuse isn’t easy. It requires a lot of support and professional help.
That support is increasing being put in place for children, as it should be. But in many cases the abuse is not disclosed at the time and often not coming to the surface until the victim is an adult, often years or decades later.
The support that an adult victim will need is officers going be different for each and every one but there will I feel be some commonalities that need to be provided for.
I would suggest that the support falls into two general categories, Mental Health issues and trauma related problems.
The mental health issues will generally be things, such as anxiety disorders and depression and will impact the day to day life of the victim. These problems can in large part be helped using existing Mental Health interventions such as Talking Therapies, CBT, Group work and medication such as Antidepressants.
However, these symptoms are ‘surface’ expressions of a deeper more fundamental wound caused by the abuse and the grooming and subsequent controlling behaviour to keep the victim quiet.
This is very similar in nature to the mental health issues, grouped under the umbrella of PTSD, that solders suffer from dur to battlefield trauma. Indeed, it is very much the same a deep seated emotional trauma surfaces, sometimes many years later, and causes these surface symptoms.
It is, in my opinion, the underlying emotional trauma that needs addressing in adult survivors if they are to successfully deal with the surface mental health issues as well as forge a future that can approximate the sort of life experienced by people that have not suffered in the same way. Note I say approximate as I don’t think there can ever be a full ‘recovery’ the damage has been done and simply cant be fully undone!
For the deeper trauma, related problems, a more context focused approach is needed. At the very least services need to be provided both focused on the experiences and needs of adult survivors and delivered by professionals who have training and experience of working with adult survivors of childhood sexual abuse.
My personal experience in trying to access such support services led me to believe that there were few, or no, such focused services available in the south west of the UK. The general feeling seemed to be that the generic mental health services provided health care system were enough and that if more focused help were needed this would have to be sourced privately.
I decided to test this impression by asking the service providers what services they had in place for adult survivors and what they planned to commission.
My first port of call was the local Clinical Commissioning Group who are responsible for identifying the health care needs and commissioning their provision.
Their website says of their role
Somerset Clinical Commissioning Group, or CCG, is responsible for planning and buying healthcare services for 544,000 people across Somerset. We are a statutory body, established under the Health and Social Care Act 2012.
Using a freedom of Information Request (FoI) I asked:
“I am interested in understanding the current and planned provision for supporting adults who were subject to sexual abuse as children.
Specifically I would like to know what funding and services you have in place to support these survivors overall and what funding and services you have in place for women and men specific requirements.
Additionally I would like to know what the above information that you are planning to introduce in the next two year”
The response was not encouraging!
“Somerset CCG does not commission any specific services for survivors of Historic Child Abuse”
“Somerset CCG has no plans to commission a specialist service for adult survivors of child sexual abuse in the next 2 years”
They subsequently suggested that the local authority, Somerset County Council, were planning to provide some specific targeted support to children who had suffered child abuse and suggested they may have similar plans for adult support, so I sent the same FoI request to them, and to the neighbouring authority North Somerset County Council.
The response was very similar to that to the CCG and equally as depressing!
“Somerset County Council does not commission services supporting adults who were subject to sexual abuse as children. “
And suggested I contact the local police force
“I would suggest you contact the Avon & Somerset Police & Crime Commissioners Office“
While I have to say I don’t quite understand why the criminal just system should be providing health care I followed up the suggestion with the same questions sent to the Police & Crime Commissioner for Avon & Somerset.
The response? Surprisingly they do provide ‘grants’ to charities who work in the sphere
PCC grants and contracts for victim services are listed on the PCC’s website
- Lighthouse Victim Care (victims of sexual violence and abuse receive support by virtue of being a priority victim under the Victims Code of Practice)
- Sexual Assault Referral Centre (NHS England is the lead commissioner)
- Independent Sexual Violence Advisors
- The Greenhouse service
- Southmead Project Service
- West of England CSE Service
But obviously, these are focused on victims currently going through the criminal justice system, and naturally focused on the needs of the system rather than the total needs of the victim.
Natural I feel that the belief that adult survivors of childhood sexual abuse can be successfully supported by the provision of generic mental health support with some additional add on services based round the criminal justice system is inadequate and leave the adult survivor not only suffering needlessly but vulnerable to further exploitation as well as reducing the chance of the adult disclosing and thereby providing that input into the child protection system, criminal justice system that prevention of future abuse relies.