89. The support needs of victims and survivors of child sexual abuse vary greatly and can change over time, triggered at different points in their lifetime, sometimes in unpredictable ways. They might need practical support about how to report abuse and obtain medical assistance, advocacy support and therapeutic support such as counselling and psychotherapy. For some, recovery may be dependent on being able to understand their history and they therefore need access to their records.
90. Accessing the right support at the right time from the most appropriate service can be difficult for both adult and child victims and survivors. Support services can be accessed by those involved in the criminal and civil justice process or from the health service or specialist voluntary sector organisations. On occasions, services may also be accessed via the institution where the sexual abuse occurred.
91. For those who become involved in the criminal justice system, the Victims’ Code gives them the right to be referred to support services and to have services tailored to their needs. The Inquiry heard evidence of the positive support offered by specialist independent sexual violence advisers and also by the ‘Barnahus’ or Child House model. This model provides a single service-point for forensic interviews with the child, medical examination, therapeutic services and family counselling or support in a child-friendly environment. However, the quality and availability of support varies considerably between local areas.
92. The Inquiry heard that during civil proceedings victims and survivors will not always have access to the support they need. In 2019, the Inquiry recommended the introduction of a code to ensure that victims and survivors bringing civil claims can access therapy and support as soon as possible. The International Underwriting Association of London has been working to introduce such a code, which the Inquiry hopes can be issued in the near future.
93. Support can be provided by the health service, such as GPs and Children and Young People’s Mental Health Services (CYPMHS, but referred to in this report by its previous acronym CAMHS). There is, however, often a high threshold for treatment. Victims and survivors also told the Inquiry that health services were often only accessible if the impacts of abuse that they experienced matched a specific physical or mental health problem recognised by the NHS.
94. Cope and recover services – which include therapy as well as support such as advocacy and employment advice – provided by charities and voluntary organisations are often highly rated but can be difficult to access. Many suffer from short-term funding and availability varies considerably between local areas, creating “a postcode lottery”.
95. Some victims and survivors do not wish to access therapy from the institution where the abuse may have occurred. However, some institutions offer formal support in the form of access to advice, therapy and counselling. Initiatives such as ‘Safe Spaces’ (funded by the Church of England, the Church in Wales and the Catholic Church, and operated by Victim Support) are welcome, but there is often inconsistency and inadequacies in the provision of or referrals to services such as counselling and therapy by institutions. As a reflection of their moral responsibility for abuse, institutions should provide – either directly or by commissioning – therapeutic support for victims and survivors who would like to access such support.
96. Therapeutic services are beneficial to victims and survivors of child sexual abuse. Indeed, the National Institute for Health and Care Excellence recommends therapeutic interventions for children, young people and families following episodes of sexual abuse, including services such as trauma-focussed cognitive behavioural therapy, counselling, and socio-educative and creative therapy.
97. There are, however, a number of problems. Victims and survivors are not consistently directed towards relevant support services by institutions connected to the abuse or by other statutory agencies, and there are different statutory duties and referral mechanisms. There is variation in the availability of support services nationally and locally. Victims and survivors can often experience long delays waiting for support, ranging from months to years. The number of sessions available differs dramatically depending on the type of support accessed and where in the country the support is being accessed. Support may be inaccessible to those without a qualifying medical diagnosis or the right personal circumstances. Specialist services – reflecting for example, sex, ethnicity, sexual orientation and age – are often difficult to obtain.
98. This reflects, in part, the fragmented and complex funding and commissioning of support services across England and Wales from the public, private and voluntary (or third) sectors. The Ministry of Justice has acknowledged that the support available to children and young people who have experienced sexual abuse encompasses a wide range of services, funded by several different national and local commissioners, which can lead to variations and inconsistencies in local provision. It makes accessing support difficult and confusing for victims and survivors.
99. 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. Timely support can reduce long-term detrimental impacts. Conversely, delayed or inadequate support can have serious consequences, such as physical or mental health issues, dependency issues, or antisocial or criminal behaviours. As well as simplifying access to support services for all victims and survivors, there is an urgent need to provide specialist therapeutic support for children who have experienced 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.
The Inquiry recommends that the UK government and the Welsh Government introduce a national guarantee that child victims of sexual abuse will be offered specialist and accredited therapeutic support. There should be sufficient supply of these services so that children in all parts of England and Wales can access support in a timely way.
These services should be fully funded. Responsibility for commissioning these services should be given to local authorities.
There must be no eligibility criteria for children to access these specialist therapeutic services other than having been a victim of child sexual abuse.
100. Victims and survivors who wish to understand their past – including decisions about their care, the circumstances in which the abuse took place and why the abuse was able to continue – often wish to access their records. Relevant records may include social care records and safeguarding records, as well as for example safeguarding policies and procedures, personnel records and details of investigations or disciplinary procedures. Many records are also often of significance in criminal and civil proceedings. The absence of records hindered a number of police investigations into allegations of child sexual abuse considered by the Inquiry. Some records were simply missing, others had been destroyed in accordance with retention policies in place at the time.
101. Retention periods vary across institutions, as permitted under data protection legislation. However, the retention of records by institutions in the context of child sexual abuse cases is particularly important, as years may elapse before victims and survivors feel able to disclose sexual abuse. The Inquiry encountered cases where records had been destroyed in accordance with the retention policies in place at the time. By the time victims and survivors wished to access them, it was too late.
102. Specific records relating to child sexual abuse should also be subject to a longer retention period, to allow for delayed disclosure and to recognise the difficulties that may be faced by victims and survivors in being able or ready to access this information. Longer retention periods exist in other areas. For example, records relating to adoption are retained for 100 years, and those concerning a looked after child are kept until his or her 75th birthday.
103. Victims and survivors have also faced difficulties when requesting their records from institutions under subject access provisions, including long delays, procedural hurdles, and poor communication and explanations from the institutions. They may also need practical and emotional support when exercising their legal rights, as records may bring back traumatic memories and cause distress.
104. The Information Commissioner’s Office (ICO) already has a general code setting out how organisations should respond to subject access requests. The Inquiry recommends that the Secretary of State directs the ICO to address the issue of access to records about child sexual abuse.
The Inquiry recommends that the UK government directs the Information Commissioner’s Office to introduce a code of practice on retention of and access to records known to relate to child sexual abuse.
The retention period for records known to relate to allegations or cases of child sexual abuse should be 75 years with appropriate review periods.
The code should set out that institutions should have: