Senior psychiatrists have told the BBC that the National Health Service is failing adults who experienced childhood sexual abuse and later seek mental health treatment. The Royal College of Psychiatrists has issued a formal apology, acknowledging that such patients have faced misdiagnosis, inappropriate treatment, and re-traumatization during their care within the system.
A working group established by the college, which included abuse survivors and leading consultant psychiatrists, conducted a review of NHS care practices. The group identified systemic problems, including mental health staff focusing primarily on symptom management without adequately exploring how past traumatic experiences continue affecting patients. The college noted that treatment has sometimes been inappropriate, with patients subjected to repeated assessments and history-taking that has worsened their conditions.
Dr. Lade Smith, immediate past president of the college, emphasized that the failures extend beyond individual psychiatrists to affect the entire mental health system. She highlighted that services are fragmented and structured to provide short, discrete episodes of care, making it difficult for psychiatrists to build relationships with patients. She noted that patients often receive limited therapy sessions—sometimes as few as eight—when significantly more time may be needed for disclosure and healing.
Research indicates that nearly one in 10 adults in England and Wales experienced childhood sexual abuse, which significantly increases the risk of mental health problems including complex PTSD, depression, anxiety, substance misuse, and eating disorders. However, disclosure rates remain low, with around two-thirds of those abused as children never disclosing to services by adulthood, and one in five never disclosing at all.
The college is calling for mandatory trauma-informed care training for all mental health staff, development of specialist training materials for psychiatrists, and national guidance on recognizing and responding to disclosures of historic child sexual abuse. NHS England responded by highlighting available specialist services and recent initiatives to provide additional training to mental health support teams in schools and colleges.
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