NHS apologizes for failing adult survivors of child sexual abuse, report reveals

The Royal College of Psychiatrists has issued a public apology for what it calls decades of mismanagement and misdiagnosis of adults who were sexually abused as children and are now seeking help for mental‑health problems. In a report released to the BBC, senior doctors said the National Health Service (NHS) has failed to provide adequate support, often treating symptoms rather than addressing the lasting impact of past trauma.

The apology, which follows an external review led by the college, acknowledges that many victims have been re‑traumatised by repeated assessments and history‑taking, and that some have not been believed. Dr Lade Smith, former president of the college, said the organisation was “sorry” that victims have suffered “avoidable harm when seeking help”. She added that the failure is not limited to psychiatrists but reflects a wider fragmentation of the mental‑health system.

The report notes that the NHS is set up to provide short, discrete episodes of care, with psychiatrists rarely having time to build a therapeutic relationship. Dr Smith warned that “they are lucky if they get eight sessions of therapy, when it could take eight sessions for a person just to disclose the abuse.” She also highlighted that many survivors never get seen because services are stretched.

Statistical evidence underpins the urgency of the issue. Roughly one in ten adults in England and Wales are estimated to have been sexually abused in childhood, and such trauma increases the risk of a range of mental‑health problems, including complex PTSD, depression, anxiety, self‑harm and substance misuse. Two‑thirds of those abused as children have not disclosed the abuse to services by adulthood, and one in five never do. Those who do speak out often do so after decades.

Caroline Thompson, 65, is one survivor who described the NHS’s shortcomings. After a career as an ear, nose and throat specialist, she began experiencing terrifying nightmares at 55 and was referred to mental‑health services. The psychiatrist she saw attributed her symptoms to anxiety, prescribing antipsychotic drugs and a year of therapy before discharge. Thompson says the treatment did not address her trauma and forced her to leave a career she loved. She later sought private therapy with a trauma specialist, gradually improving over several years. “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. “So any delay in presenting is quite normal.”

The apology follows a working group set up by the Royal College, chaired by consultant psychiatrists Jo Stubley and Maria Podlejska‑Eyres, which included doctors, abuse survivors and other experts. The group was convened after a rise in people seeking help in the last decade, prompted by high‑profile abuse scandals in schools, children’s homes, religious institutions and the Jimmy Savile case.

The college’s recommendations include developing specialist training materials for psychiatrists, mandating trauma‑informed care training for all mental‑health staff, publishing national guidance on recognising and responding to disclosures of historic child sexual abuse, and overhauling services to provide long‑term support. The college also pledges to create training resources for psychiatrists and to push for mandatory training across the sector.

Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood, welcomed the apology but urged that it lead to “meaningful change”. “For too many adult survivors, mental health services have not felt like a route to safety or recovery,” she said.

A spokesperson for NHS England highlighted that specialist services are available, including 24‑hour sexual assault referral centres and counselling services. “People who have suffered historic child sexual abuse may not have spoken about it for years, so it’s vital they know they can access specialist, trauma‑informed support through the NHS,” the spokesman added. He also noted steps being taken to better support children and young people, such as additional training for mental‑health support teams in schools and colleges.

Support services for those affected include the BBC’s Action Line. Those feeling emotionally distressed or suicidal can call Samaritans free of charge on 116 123 or visit samaritans.org in the UK.