NHS Apologises to Adult Survivors of Child Sexual Abuse

Published: 07 August 2026. The English Chronicle Desk. The English Chronicle Online

The Royal College of Psychiatrists has issued a public apology to adults who say they were failed by NHS mental health services after experiencing sexual abuse during childhood, acknowledging decades of mismanagement, misdiagnosis and inadequate trauma-informed care.

The College said some survivors were subjected to inappropriate treatment, repeatedly asked to recount traumatic experiences and, in some cases, were not believed when they disclosed abuse. It said these experiences could themselves contribute to further trauma.

The apology forms part of a report examining how mental health services have treated people who experienced child sexual abuse and later sought help as adults. Senior psychiatrists involved in the review said the problem was not confined to individual clinicians but reflected wider weaknesses in the organisation and delivery of mental health care.

Dr Lade Smith, the immediate past president of the Royal College of Psychiatrists, said she was sorry that survivors had too often experienced avoidable harm while seeking help.

The College’s findings come amid continuing pressure on mental health services, where stretched resources, fragmented provision and short treatment episodes can make it difficult for clinicians to establish the long-term relationships needed by people with complex trauma.

Dr Smith said services had frequently concentrated on treating symptoms rather than understanding the experiences that may have contributed to them.

She described a system in which patients could receive only a limited number of therapy sessions, potentially leaving little time to establish sufficient trust for a survivor to discuss abuse that may have remained hidden for decades.

For some survivors, disclosure itself can take years.

Estimates cited in the report suggest that a significant proportion of adults in England and Wales experienced sexual abuse during childhood. The long-term effects can include depression, anxiety, post-traumatic stress disorder, complex PTSD, eating disorders, self-harm and substance misuse. NHS guidance also recognises that childhood abuse can have serious effects on mental health long after the original experience.

Many survivors do not disclose their experiences to health services when they first develop mental health difficulties. Some may struggle to identify the connection between what happened during childhood and symptoms that emerge much later.

That delay can create another problem if clinicians incorrectly assume that a traumatic experience cannot be responsible for symptoms because many years have passed.

Caroline Thompson, now 65, believes that happened to her.

Thompson was psychologically and sexually abused as a child but went on to build a successful career as a specialist ear, nose and throat doctor and raise a family.

She did not seek mental health support until her mid-50s, when terrifying nightmares began to affect her ability to function.

The symptoms became so severe that she was struggling with exhaustion and sleep deprivation. She was eventually referred to mental health services.

According to Thompson, the psychiatrist she saw questioned whether her symptoms could be connected to childhood abuse because so much time had passed and she had subsequently managed to establish a career and family life.

She was instead diagnosed with anxiety and prescribed antipsychotic medication.

Thompson said she underwent therapy for about a year before being discharged, but she still did not understand what was happening to her. The nightmares and side effects from medication continued to affect her ability to function and she eventually had to leave the profession she loved.

She later sought private therapy from a specialist in childhood trauma. Over several years, she gradually began to recover.

For Thompson, the experience demonstrated why mental health services need a better understanding of how trauma can remain concealed for long periods before resurfacing.

The NHS itself acknowledges that traumatic experiences can continue to affect people for many years. Its guidance states that childhood trauma can increase the risk of mental health difficulties in adulthood, including PTSD, anxiety and depression.

The Royal College’s review was established in response to growing numbers of adults coming forward about historic abuse and seeking support. The increase has coincided with greater public awareness following investigations and scandals involving schools, children’s homes and religious institutions, as well as revelations surrounding Jimmy Savile.

The College brought together psychiatrists, other experts and survivors of abuse to examine the problems within existing services. Caroline Thompson was among the survivors involved in the working group.

The review concluded that significant changes are required.

One of the College’s priorities is improved training for psychiatrists, while it also wants mandatory training for all mental health staff on trauma-informed approaches to caring for survivors of child sexual abuse.

The concept of trauma-informed care places greater emphasis on understanding how traumatic experiences can influence a person’s behaviour, symptoms, relationships and response to treatment.

It can also reduce the possibility that patients are repeatedly required to recount painful experiences without receiving appropriate therapeutic support.

The College is also calling for national guidance explaining how mental health professionals should recognise and respond when adults disclose historic child sexual abuse.

Another major recommendation is a redesign of services so people with complex trauma can receive longer-term support rather than being moved through short, disconnected episodes of treatment.

That concern reflects broader criticism of fragmented mental health services.

Dr Smith said psychiatrists frequently lacked sufficient time to establish meaningful relationships with patients. She argued that survivors might require substantial time simply to feel safe enough to disclose what happened.

The issue is particularly important because disclosure does not necessarily happen at the beginning of treatment. A person may initially present with depression, anxiety, sleep problems, substance misuse or other symptoms without immediately discussing the experiences underlying them.

If clinicians focus only on those symptoms, the opportunity to identify and address trauma may be missed.

The consequences can be serious.

Survivors may leave treatment believing that their experiences are irrelevant, exaggerated or somehow responsible for their own difficulties. Others may become reluctant to seek help again after feeling dismissed or misunderstood.

Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood, welcomed the College’s apology but said it must lead to substantive reform.

For survivors, she said, mental health services have too often failed to provide a sense of safety or a clear route towards recovery.

The NHS has responded by pointing to existing specialist services and measures intended to improve support.

An NHS England spokesman said specialist services were available for people affected by historic child sexual abuse and stressed the importance of ensuring survivors know that trauma-informed support can be accessed even when abuse happened many years earlier.

NHS services already include specialist trauma-focused provision in some parts of the country. For example, dedicated NHS trauma services treat adults with PTSD and complex PTSD associated with childhood abuse and other traumatic experiences.

The NHS has also highlighted support available through sexual assault referral centres and counselling services.

However, the existence of specialist services does not necessarily mean that every survivor can access them quickly or receive the length and continuity of care they require.

That gap between policy and lived experience is central to the College’s criticism.

The wider mental health system is already under considerable pressure. The Royal College has separately warned that services are operating under severe strain, with insufficient capacity affecting access to early and continuing care.

For survivors of childhood sexual abuse, those pressures can be especially damaging because effective treatment may depend on stability, trust and continuity.

The College’s apology therefore represents both an acknowledgement of past failures and a challenge to the health system to change how it approaches complex trauma.

For Caroline Thompson, the issue is deeply personal.

Her experience illustrates how a survivor can build a seemingly successful adult life while still carrying the consequences of childhood abuse. The fact that symptoms emerge decades later does not make the original trauma less significant.

It also demonstrates why professionals must avoid assuming that a person’s education, career, relationships or family life mean they could not still be affected by abuse.

The College’s report argues for a more sophisticated understanding of that reality.

The goal is not simply to identify childhood abuse as another factor in a patient’s history. It is to ensure that mental health professionals understand when trauma may be central to a person’s difficulties and can respond without causing additional distress.

That requires training, resources and continuity of care.

It also requires survivors to be listened to.

The Royal College of Psychiatrists’ apology may therefore become an important moment in the UK’s approach to historic child sexual abuse. But the significance of the apology will ultimately depend on whether its recommendations translate into changes in everyday clinical practice.

For thousands of adults who waited years or decades before seeking help, recognition of past failures may matter. What they need now is evidence that the system has learned from them.

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