Senior psychiatrists have told the BBC that the National Health Service is failing adult survivors of childhood sexual abuse who seek mental health treatment. The Royal College of Psychiatrists has released a formal apology addressing what it characterizes as systematic failures spanning multiple decades in the UK’s approach to this vulnerable population.
According to the college’s report, mental health professionals have concentrated excessively on symptom management while neglecting to investigate how past traumatic experiences continue to affect patients in adulthood. The college acknowledged that some survivors have experienced additional harm through their interactions with the mental health system. Issues identified include inappropriate treatment approaches, re-traumatization caused by repeated assessments and histories, and instances where patients were not believed when disclosing their experiences.
Dr. Lade Smith, immediate past president of the Royal College of Psychiatrists, emphasized that the systemic problems extend beyond individual psychiatrists to encompass the entire mental health infrastructure. She highlighted fragmentation within services and structural limitations that restrict the duration and continuity of care available to patients. Mental health staff typically have insufficient time to build therapeutic relationships, with patients often receiving only around eight therapy sessions when substantially more may be necessary for survivors to safely disclose abuse and begin healing.
The college’s report referenced research indicating that an estimated one in ten adults in England and Wales experienced childhood sexual abuse. Such trauma substantially elevates risks for various mental health conditions, including complex PTSD, depression, anxiety, eating disorders, self-harm, and substance misuse problems. A significant barrier to treatment involves disclosure rates: approximately two-thirds of abuse survivors have not reported their experiences to services by adulthood, with one in five never disclosing at all. Among those who do come forward, many wait decades before seeking help.
The Royal College of Psychiatrists is advocating for comprehensive reforms, including specialized training materials for psychiatrists, mandatory trauma-informed care training for all mental health staff, national guidance on handling historic abuse disclosures, and restructured services enabling long-term support. NHS England responded by noting that specialist services currently exist and are accessible around the clock through sexual assault referral centres and counselling services.
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