NHS Accused of Failing Adult Victims of Child Sexual Abuse by Psychiatrists

The Royal College of Psychiatrists has issued a public apology for what it describes as decades of mismanagement and misdiagnosis of adults who were sexually abused as children, warning that the NHS mental health system is failing this vulnerable group. In a report shared with the BBC, the college’s immediate past president, Dr Lade Smith, expressed regret that victims have too often suffered "avoidable harm when seeking help." The report details how inappropriate treatment, repeated assessments, and a systemic lack of belief have compounded the traumas of those attempting to access care.

Dr Smith told the BBC that the problem was not merely a failure of individual psychiatrists but a fundamental flaw in the entire mental health system. "Services are so fragmented," she said. "The system is set up to provide short, discrete episodes of care. Psychiatrists do not get the time to build up a relationship with patients so they can be properly supported." She added that patients are "lucky if they get eight sessions of therapy, when it could take eight sessions for a person just to disclose the abuse," and noted that many do not get seen by mental health services at all because of the immense strain on resources.

The profound consequences of this systemic failure are illustrated by the experience of Caroline Thompson, a 65-year-old former ear, nose and throat specialist. Despite a successful career and family life, she was haunted by terrifying nightmares at the age of 55. When she sought help, the psychiatrist she saw dismissed the link to her childhood sexual abuse, citing the delay in presentation and her professional accomplishments. She was diagnosed with anxiety and prescribed anti-psychotic drugs, a treatment she believes was misguided. "It was astonishing to me that it was not understood that traumatic memories are buried in order for you to survive, and that those memories can surface years later," she said. It was only after she sought private therapy with a specialist in childhood trauma that she began to recover.

The college’s apology and report follow a decade of increased reporting of abuse, driven by high-profile scandals involving schools, children's homes, and figures like Jimmy Savile. Estimates suggest nearly one in ten adults in England and Wales were sexually abused in childhood, a trauma that significantly elevates the risk of a range of mental health problems, including alcohol and drug misuse, eating disorders, complex PTSD, and anxiety. Around two-thirds of those abused have not disclosed it to services by adulthood, and one in five never will, often taking decades to speak out.

In response to these findings, the college is calling for mandatory training for all mental health staff on trauma-informed care, the development of specialist training materials for psychiatrists, and national guidance on responding to disclosures of historic abuse. It also advocates for an overhaul of services to provide the long-term support survivors require. Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood, welcomed the "significant and welcome" apology, but stressed it must lead to "meaningful change," adding that for too many survivors, mental health services have not felt like a route to safety.

An NHS England spokesman said specialist services, including 24-hour sexual assault referral centres, were available and that steps were being taken to provide additional training for mental health support teams in schools and colleges. However, the Royal College’s report makes clear that a chasm remains between policy and practice, leaving a generation of abuse survivors feeling abandoned by the very system meant to help them heal.