The Royal College of Psychiatrists has released a report apologizing for what it characterizes as longstanding failures in how the National Health Service treats adults who experienced childhood sexual abuse and later seek mental health support. The college stated that such individuals have sometimes experienced inappropriate treatment and re-traumatization through the mental health system, in some cases worsening their original trauma.
According to the college, the core issue stems from mental health services focusing too narrowly on symptom management rather than addressing how past traumatic experiences continue to affect patients. Dr. Lade Smith, immediate past president of the college, emphasized that the problem extends beyond psychiatrists alone to encompass the entire mental health system. She pointed to fragmentation within services, with patients typically receiving only brief episodes of care. Many patients receive around eight therapy sessions, which the college noted may not be sufficient given that disclosure of abuse itself can require that many sessions. Additionally, many potential patients never access mental health services because available resources are stretched thin.
Statistics cited in the report indicate that nearly one in 10 adults in England and Wales experienced sexual abuse during childhood. Such trauma significantly elevates the risk of developing various mental health conditions, including complex PTSD, depression, anxiety, eating disorders, self-harm, and substance misuse. A substantial proportion of survivors delay disclosure, with around two-thirds not reporting abuse to services by adulthood and approximately one in five never disclosing at all.
The college has outlined several recommendations for improvement, including the development of specialist training materials for psychiatrists and mandatory trauma-informed care training for all mental health staff. The report also calls for national guidance on recognizing and responding to disclosures of historic abuse, along with a restructuring of services to provide long-term support rather than short-term interventions.
NHS England responded by noting that specialist services are available, including 24-hour access through sexual assault referral centres and counselling services, with additional training being provided to mental health support teams in schools and colleges. Meanwhile, organizations supporting survivors emphasized that the apology must translate into concrete action and meaningful systemic change.
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