The Royal College of Psychiatrists has released a formal apology regarding how the NHS has handled mental health care for adults who experienced childhood sexual abuse. According to senior doctors at the college, these patients have frequently received inadequate treatment, with some experiencing worsening trauma as a result of their interactions with mental health services.
The college identified several systemic problems within mental health care delivery. Mental health professionals have primarily focused on treating visible symptoms rather than investigating how past traumatic experiences continue to affect patients in adulthood. Treatment has sometimes proven inappropriate, and patients have reported being re-traumatized through repeated assessments and having their experiences questioned. Dr Lade Smith, immediate past president of the college, emphasized that the failures extend beyond individual psychiatrists to encompass the entire mental health system.
A key concern raised by leadership involves the structure of mental health services themselves. The system operates through short, discrete episodes of care that prevent psychiatrists from building meaningful therapeutic relationships with patients. Many survivors receive only limited therapy sessions, with some getting just eight sessions when disclosure of abuse alone may require that many appointments. Additionally, many survivors never access mental health services at all due to service capacity constraints.
The college estimates that nearly one in 10 adults in England and Wales experienced childhood sexual abuse. Such trauma significantly increases vulnerability to various mental health conditions, including complex PTSD, anxiety, depression, eating disorders, and substance misuse. Many survivors delay disclosing abuse for decades; approximately two-thirds have not reported it to services by adulthood, and one in five never disclose.
In response, the college has proposed multiple reforms including 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 historic abuse disclosures. NHS England stated that specialist services are available through sexual assault referral centres and counselling services accessible 24 hours daily, with additional training being provided to mental health support teams in schools and colleges.
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