Background to the Research

• In recent years, the WHSSB has experienced an increasing number of people disclosing histories of childhood sexual abuse. This has lead to an increase in the demand for counselling and other services within the Board.
• In light of this, the Board decided to carry out local research on the prevalence of child sexual abuse amongst mental health service users in the WHSSB.
  

Research Approach

• A questionnaire was administered to 54 members of staff across all 7 Acute Community Mental Health Teams, addictions service, the psychosexual service and the Programme for Prevention of Sexual Abuse and units within both psychiatric hospitals.
• In all, the staff identified 202 clients who had been sexually abused.
  

Main Findings

• Twenty-three (11%) respondents were male and 179 (89%) were female.
• In 99 cases (49%) sexual abuse had been identified before referral and in 103 cases (51%) the abuse had been disclosed subsequent to referral. This was particularly the case in the addiction service where out of a total of 20 cases of sexual abuse, 18 (90%) became evident subsequent to referral.
• Of the 202 clients, most presented with a combination of symptoms, the most prevalent of which were depression, anxiety, alcohol abuse, sexual problems, self-harm, poor coping skills, eating disorders and suicidal thoughts/behaviour.
• Only 17 of the 54 staff working with sexually abused clients had received specialist training in this area and were working with a total of 98 cases of sexual abuse. The remaining 37 had received training ranging from 1 or 2 day workshops, to brief inputs during professional training and were dealing with a total of 104 cases.

Recommendations from Respondents

• Nearly all respondents stressed the urgent need for provision of skilled and experienced specialist supervision in order that they fell confident in using an appropriate approach and to provide personal support.
• Almost all respondents felt current levels of training were inadequate and that additional specialist training should be provided for those dealing with sexual abuse cases, as well as awareness training for all staff.
• Specialist dedicated teams should be established to work with supervisors of sexual abuse cases; these teams should have access to appropriate accommodation for counselling and perhaps be linked to psychosexual services.
• Residential units should be established to provide emergency care and supervision for vulnerable clients avoiding unnecessary and inappropriate admissions to hospital.
• Sexual abuse counselling should be separated from existing psychiatric services.
• Closer co-operation should be fostered with other agencies working with survivors of sexual abuse, e.g. Nexus Institute and Women's Aid.
• Specialist trained workers should be attached to Community Mental Health Teams and admissions wards.