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NHS pledges comprehensive mental health support for survivors of sexual assaults and abuse

Yesterday, the NHS and a number of news outlets reported on health minister Jackie Doyle-Price’s recent visit to the Havens, one of the NHS’s leading treatment and support centres for survivors of sexual abuse and assault. 

Woman during a psychotherapy session
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Alison Millar (pictured) is partner and head of the abuse team at Leigh Day. Rose joined Leigh Day in September 2017 as a paralegal she works with Alison and the rest of the Leigh Day abuse team on legal action on behalf of survivors brought against individuals including teachers, carers and sports coaches as well as the institutions in which the abuse took place.
This centre is a model of the new services which are to be rolled out across the country next year as part of the NHS’s five year plan, published in April this year.

The “Strategic direction for sexual assault and abuse services” report sets out how the NHS intends to deliver “lifelong care for victims and survivors”, with a plan for implementing the necessary changes over the next five years. This strategy is backed by an investment commitment of £4m per year until 2020/21.

The strategy was developed in consultation with survivors of sexual assault and abuse, as well as with government and relevant charity organisations. It sets out six key priorities for improving NHS services for survivors:
  1. Strengthening the approach to prevention.
  2. Promoting safeguarding and the safety, protection and welfare of victims and survivors.
  3. Involving victims and survivors in the development and improvement of services.
  4. Introducing consistent quality standards.
  5. Driving collaboration and reducing fragmentation.
  6. Ensuring an appropriately trained workforce.

During the course of our work pursuing claims on behalf of survivors of sexual abuse, a frequent issue raised by clients is the lack of appropriate support they have received from the NHS. A typical scenario may involve a client who has survived sexual abuse as child seeking support from their local GP, or presenting to their GP with significant mental health problems which their GP is often aware are a result of their childhood abuse. The support offered by the NHS appears to generally be inconsistent, and at best generally offers limited services with finite amounts of support. This can often lead to survivors opening up for the first time about their experiences to a mental health professional, only to find that their limited number of NHS provided sessions are cut short, or that a change in circumstance can lead to a total change in their NHS support provision. 

This can lead to survivors, many of whom struggle to engage with authorities, to give up and disengage with support services, and can lead to significant secondary traumatisation. Obtaining compensation for necessary therapeutic intervention following a lack of support from the NHS is often a key motivation for survivors approaching us to pursue a civil claim. A typical claim on behalf of a survivor of abuse frequently involves obtaining evidence from a specialist psychiatric expert, who is often called on to comment on specific mental health treatment requirements, which are seldom available on the NHS. For those who do not wish to or are unable to pursue a compensation claim, avenues for support are even more limited – a number of specialist charities offer such support, but are often overstretched due to demand.

Based on our own observations of survivors’ care needs, we would emphasise the need for the services outlined in the Strategy to be provided on a truly comprehensive basis. Although we welcome the commitment for CCGs to provide mental health services which understand the specific needs of victims and survivors of abuse, the needs of survivors identified by our psychiatric experts are complex and often extend beyond counselling. We hope to see future provision under this strategy for a broad and comprehensive range of ongoing psychiatric treatment linking to other specialist support and welfare services that may be needed to address the ongoing effects of childhood trauma including, but not limited to, housing, benefits and employment advice and specialist drug and alcohol services.

Given the current crisis in NHS funding, and the lack of resources provided to mental health services in other areas of health service provision, it is concerning that funding for these services is only guaranteed up to 2020/21. The effect on an individual survivor’s trust in authority and on their own mental health of services suddenly coming to an end can be calamitous, and we would hope that the NHS takes seriously the resource implications of a ‘”lifelong” commitment to support for survivors of sexual assault and abuse.

We note that “specialist voluntary sector services” and the “third sector” will be involved in the provision of aspects the Strategy, along with NHS England, CCGs, Police and Crime Commissioners, Local Authorities, the MoJ and the Home Office. We would note from our own experience that such specialist charities are often under-resourced and overstretched, and hope that the funding commitments to this Strategy are sufficient to avoid further burden being placed on these valuable organisations.

Overall, we welcome this commitment from the NHS to provide a comprehensive and lifelong support service for survivors of sexual assault and abuse. We welcome the Strategy’s recognition that initial failures by NHS staff to appropriately respond and empathise with survivors can have a profoundly negative impact on diagnosis, recovery and trust. Commitments to training staff, safeguarding service users, collaboration between services, consistent quality standards, prevention and consulting survivors in the development of these services are all much needed improvements to the current NHS provision.

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