55. Child victims of sexual abuse are likely to benefit most from timely access to therapeutic support services. Recent research shows that early interventions are effective at reducing the impact of child sexual abuse and preventing significant mental health problems in later life.^[1] Support workers for child victims and survivors of sexual abuse confirmed that when young victims and survivors received timely support this reduced long-term detrimental impacts.^[2] Delayed or inadequate support can have serious consequences, with some young victims and survivors developing physical or mental health issues, dependency issues, or antisocial or criminal behaviours.^[3] As set out above, reliance on statutory health provision can lead to long waiting times and insufficiently specialist treatment.

56. The National Institute for Health and Care Excellence (NICE) recommends therapeutic interventions for children, young people and families after sexual abuse. Services such as trauma-focussed cognitive behavioural therapy, counselling, and socio-educative and creative therapy are given as examples of these interventions.^[4] A recent NSPCC evaluation report of a therapeutic intervention for children affected by sexual abuse and their carers concluded:

“children and young people who have experienced sexual abuse need therapeutic support. At present, the availability of such support is much too little and much too late”.^[5]

57. The Inquiry heard evidence that CAMHS is unable to provide therapeutic services to child victims and survivors in a timely fashion. The 2022 report by the Children’s Commissioner for England suggested that, although there have been improvements in waiting times given an increase in investment, there is still a postcode lottery for accessing CAMHS services. It found wide variation between local areas, with the percentage of children waiting for treatment at the end of the year 2020/21 varying from 14 percent to 78 percent.^[6]

58. The COVID-19 pandemic has also increased the pressure on CAMHS, making access even more difficult. A recent survey (from March to April 2022) of more than 1,000 GPs found that 95 percent of GPs described CAMHS as in crisis or inadequate. A CAMHS service in eastern England declined to take on a 12-year-old boy found with a ligature in his room because the lack of any marks on his neck meant its referral criteria had not been met.^[7]

59. The 2021 Tackling Child Sexual Abuse Strategy stated that the UK government wishes “to encourage all healthcare professionals and organisations to take trauma-informed approaches” and has made some further investment in services, but plans are still being developed by NHS England and NHS Improvement.^[8] The Welsh Government’s National Action Plan: Preventing and Responding to Child Sexual Abuse states that children who have been sexually abused should have access to trauma-informed services and appropriate therapeutic support based on their individual care and support needs.^[9] Despite specialist therapeutic support being recommended by NICE and supported by the UK government and Welsh Government, child victims and survivors struggle to access timely therapeutic support.

60. As well as simplifying access to support services for all victims and survivors, there is an urgent need to provide specialist therapeutic support for child victims and survivors of sexual abuse. The Inquiry therefore recommends the introduction of a national guarantee to enable child victims of sexual abuse to access specialist therapeutic support in a timely way.