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Mental health commissions say governments must address 9 ‘essential elements’ in response to Royal Commission into child sex abuse

Australia’s mental health commissions on Wednesday have issued a consensus statement saying that the scheduled conclusion late this year of the Royal Commission into Institutional Responses to Child Sexual Abuse provides an unprecedented opportunity for governments across Australia to rise to the challenge posed by childhood trauma.

The statement, endorsed by the National Mental Health Commission, and the Mental Health Commissions of New South Wales, Queensland, South Australia and Western Australia, identifies nine ‘essential elements’ to be addressed by State and Federal Governments in the wake of the Royal Commission.

They are to:

  1. Recognise that childhood trauma is broader than institutional child abuse.
  2. Recognise the strength and resilience of survivors and use this, rather than an illness-based approach, to build positive outcomes.
  3. Build trauma capability across the full spectrum of services that recognises and responds to the specific needs of people managing the devastating impacts of abuse.
  4. Develop co-ordinated responses to the varied needs of consumers.
  5. Increase the capacity of phone and online services.
  6. Provide ongoing support.
  7. Prepare for increased demand.
  8. Increase community-based support workers.
  9. Develop culturally appropriate services for Aboriginal and Torres Strait Islander people.

The statement stresses the importance of a community-based response to many of these elements and notes that one significant gap in support is the limit to the number of funded Medicare psychology sessions.

It says that people with complex trauma may require many months of support, but currently Medicare reimbursement is capped at 10 to 18 appointments depending on the scheme. “Access to psychological treatment in the community is growing and well linked to GP practices, however treatment can be expensive and difficult to access,” it said.

The commissions say that services and systems established in response to the recommendations of the Royal Commission need not only to provide better responses to adult survivors, but also optimise opportunities for children and young people to disclose as early as possible and receive the right response and care.

“This is not just the responsibility of specialist services; organisations including government agencies, welfare groups, schools, sporting clubs, religious bodies, youth and social groups, all play a vital role in the safety, health and wellbeing of children and young people.”

The statement says the Royal Commission has uncovered the shocking scale and stakes of childhood trauma and that the task of providing adequate services to everyone identified, and those yet to be identified, could appear daunting. In fact, it says, it is not unmanageable and many of those affected are already engaged with diverse services, such as receiving the disability support pension, accessing health services for chronic pain, engaged with child protection, mental health, welfare or justice services.

However, it said, they are “often not getting the optimal response because services generally do not recognise or respond well to unresolved trauma.”

“This population can become the ‘revolving door’ or ‘helpless’ cases, who become perceived judgmentally, including amongst staff of the services intended to support them. With the right type of care and support, however this group can be appropriately supported to reengage with the community, and so deliver significant social, emotional and economic benefits.”

“In designing systems and services which are attuned to the particular vulnerabilities of survivors of child sexual abuse and other childhood trauma, it is important to use a trauma lens which recognises the complexity and sensitivities and minimises the risk of re-traumatisation.”

“The complexity of unresolved trauma and associated mental health impacts has important implications for the way in which services are delivered and the way in which those affected engage with services.”

To read the consensus statement, click here.

The Royal Commission is scheduled to deliver its final report to the Federal Government on 15 December 2017.

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