The Royal College of Psychiatrists has issued a public apology for decades of mismanagement and misdiagnosis in supporting adult survivors of child sex abuse, citing systemic failures in NHS mental health services. The college calls for trauma-informed care training, longer therapy sessions, and improved access to specialist support, as personal stories reveal how delayed disclosures and inadequate treatment exacerbate trauma.
Apology and Calls for Reform
The Royal College of Psychiatrists has publicly apologized for decades of mismanagement and misdiagnosis in treating adult survivors of child sex abuse, acknowledging that mental health services have often failed to provide appropriate care. The apology follows a working group review involving experts, doctors, and abuse survivors, including Caroline, who shared her experience of being dismissed by a psychiatrist despite years of unresolved trauma. The group was set up after mental health services have seen a rise in people coming forward seeking help in the last decade or so, following high-profile abuse scandals involving schools, children’s homes and religious institutions, as well as the Jimmy Savile crimes.
NHS failing child sex abuse victims, say psychiatrists
The college is urging mandatory trauma-informed care training for all mental health staff, national guidance on recognizing historical abuse disclosures, and an overhaul of services to ensure long-term support. Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood, said that for too many adult survivors, mental health services have not felt like a route to safety or recovery. They have been another place where the impact of trauma was missed or where the offered treatment was inappropriate.
Personal Stories Highlight Systemic Failures
Caroline Thompson, 65, described how years of nightmares and mental exhaustion led her to seek help in her mid-50s. A psychiatrist dismissed her symptoms as unrelated to childhood abuse, diagnosing her with anxiety and prescribing antipsychotic drugs. She said that it was astonishing to her that it was not understood that traumatic memories are buried in order for you to survive. After private therapy, she gradually recovered, but the initial neglect left her. She said that they are lucky if they get eight sessions of therapy, when it could take eight sessions for a person just to disclose the abuse, according to Dr. Lade Smith, and immediate past president of the college.
Dr. Smith, who called for better training and investment, criticized the NHS’s fragmented system, which prioritizes short-term care over long-term support. She said that services are so fragmented. The system is set up to provide short, discreet episodes of care. Psychiatrists do not get the time to build up a relationship with patients so they can be properly supported. She added that these are just the people who get support – many don’t even get seen by mental health services because services are so stretched.
NHS failing child sex abuse victims in adulthood, say
NHS Response and Current Support Options
A spokesman for NHS England emphasized that victims can access 24/7 support through sexual assault referral centers and counseling services, with information available on the NHS website. He said that people who have suffered historic child sexual abuse may not have spoken about it for years, so it’s vital they know they can access specialist, trauma-informed support through the NHS. He also said steps were being taken to better support children and young people, with additional training provided to mental health support teams in schools and colleges.
Estimates suggest nearly one in 10 adults in England and Wales were abused in childhood. Such trauma increases the risk of mental health problems, including alcohol and drug misuse, eating disorders, self-harm, complex PTSD, anxiety, and depression. Around two-thirds of those abused as children have not disclosed it to services by the time they reach adulthood. One in five never disclose, and many of those that do take decades to speak out.
The college’s report details how treatment has sometimes been inappropriate, while people have been re-traumatized by the experience of repeated assessments and history-taking and not always being believed. Dr. Smith told the BBC it was clear people were not getting the support they needed, and that this was not just a failing of psychiatrists, but the whole mental health system. She said that the system is set up to provide short, discreet episodes of care. Psychiatrists do not get the time to build up a relationship with patients so they can be properly supported.
Parliamentary Apology to victims and survivors of child sexual
Caroline Thompson, who was psychologically and sexually abused as a child, raised a family and had a successful career as a specialist ear, nose and throat doctor. It was not until she started experiencing terrifying nightmares, aged 55, that left her unable to function due to mental exhaustion and lack of sleep, that she realized she needed help and was referred to mental health services. A psychiatrist she saw said her symptoms were unlikely to be due to the abuse because of the delay in presentation.
The college’s recommendations include developing specialist training materials for psychiatrists and advocating for policy changes to ensure survivors receive adequate, sustained care.
If you’ve been affected by the issues in this story, you can find information, advice and support from the BBC’s Action Line. Anyone feeling emotionally distressed or suicidal can call Samaritans for free on 116 123 or visit samaritans.org in the UK.
