Editorial: Don't give up on victims of sex abuse

Opinion

One of the most contentious imminent changes to accident compensation was not among those announced by the Government this week. The counselling of sexually abused people will no longer be funded by ACC unless the person has been diagnosed to have suffered a mental illness.

The corporation does not regard this as a significant change in its coverage since its legislation has always required proof of "significant mental injury". It says it has simply adopted new treatment guidelines designed to provide an individualised plan for sexually abused people to recover and return to normal life.

However, counsellors say the requirement for their clients to be diagnosed with a mental injury will deter many from seeking help, possibly with disastrous consequences. Some counsellors say they could not ethically work under rules which would require sexual abuse victims to be diagnosed with mental illnesses.

The proposals have been under discussion for three years and the scheduled implementation date has been twice deferred. They are now to take effect from October 27. Should the corporation think again?

Sexual abuse leaves scars that do not easily bear comparison with other forms of assault. The emotional harm is usually much greater than the physical injury and certainly more lasting.

The victim feels defiled in a way that too often discourages them from seeking justice or help. If they were a child at the time, the damage can strike them years later when they realise what happened.

Perhaps the worst element of sexual violation is that, almost uniquely among violent crimes, it can leave the innocent victims with a sense of guilt that it happened to them.

Frequently, they have been robbed of their confidence in close relationships and even their self-respect.

If these and other consequences do not amount to "significant mental injuries", ACC must be adopting a demanding definition of the phrase.

Opposition to the proposed new terms of treatment has come from professional bodies representing psychologists and psychotherapists as well as counsellors, suggesting it is not merely a territorial issue for the latter. If all believe the required psychological diagnoses of a mental illness will do more harm than good, the corporation needs to change tack.

It will hardly help victims recover self respect, and may deter them from seeking help, if they are going to infer they are mad.

But the corporation is right to require some sort of objective assessment of injury. The founding purpose of ACC was practical. It is designed to assist recovery, it is not a public expression of sympathy for all misfortune no matter how much we might wish it were.

Sexual abuse counsellors who want their services paid by ACC need to meet practical tests. They need to be able to define their clients' injury in reasonably clear terms and plan a course of therapy that can be monitored and that offers a prospect of recovery in a reasonable time.

ACC's senior medical adviser defines a mental injury as "a significant cognitive, behavioural or emotional dysfunction", which surely covers the consequences of sexual abuse. But he implicitly concedes that the diagnostic measure adopted will exclude some who, he says, could find help at ACC-assisted rape crisis centres.

Those financially struggling agencies probably cannot provide the therapy many need. Victims have endured a personal violation with effects that perhaps cannot be fairly measured by standard mental diagnoses and deserves a category of assessment all its own. The corporation and counsellors can surely find one.