Tracey Barnett: Mental illness label will send sex abuse victims back to silent agony

If I need more than two counselling sessions to heal from rape or childhood sexual abuse, I must be officially diagnosed as mentally ill before ACC will help further, under new guidelines.

I will have to choose. Though it takes 16 years on average for sexual abuse survivors to finally open that long, tragic, festering wound, I would have to decide if getting therapy is important enough to have a mental illness diagnosis put on my official records for the rest of my life.

The next time I apply for a job, a mortgage, an insurance policy, or even take the case to court, and they ask, "have you ever had a mental illness?", I would have to say yes and potentially justify why.

ACC has requested a diagnosis of mental illness for years, says senior clinical advisor Dr Peter Jansen. "We've let it slide at times." Not any more.

What does that look like for real victims? ACC will now cut their assessment sessions by half, endorse shorter treatment plans and now insist that survivors won't get coverage unless they're declared mentally ill.

Ken Clearwater, of Male Survivors of Sexual Abuse Trust, says he has never seen the counselling community this angry. The men he sees may have taken 20 years to finally walk in that counsellor's door.

They may not even reveal the abuse for five to 10 sessions. If they know they'll be slapped with a label of mental illness, they'd be gone.

Whereas previously therapists have danced around a diagnosis with comments about post-traumatic stress, counsellors now fear re-victimising the victim, "It's like you put someone on the operating table, split them open up the middle, see a lot of poison inside, then have to leave them open and say sorry, I'll get back to you." said Clearwater.

It couldn't come at a worse time. Sexual abuse numbers have spiked recently.

Louise Nicholas may have lost a lot of battles but she's winning this war. The prominence of her case, coupled with the "It's not okay" campaigners are drowning in their success, and it's not pretty.

In the last nine months, sexual abuse claims have spiked from 520 to 650-700 a month - a damning, yet ultimately hopeful, number.

Sadly, today 67 per cent of those ACC claims have either been declined or are still pending. Translation, more people are coming forward, with fewer getting help.

How are we fixing this swamped system? Clearwater has worked for two years on a government-partnered taskforce of sexual abuse professionals addressing ACC issues that is due out in a few weeks. But strangely, Dr Jansen's new guidelines landed on the therapy community's desk before the taskforce's work had even been presented.

Dr Jansen has already backed away from a disastrously received initial proposal that would have had survivors potentially vetting their story to three different counsellors before ACC funding continued.

Many practitioners feel this is about cost cutting, plain and simple - weeding out those unable to prove a direct causal link to sexual abuse - though Dr Jansen insists it is not. Others see this as deceit.

Why didn't he consult them, I asked Dr Jansen, frankly confused he wouldn't wait to hear what the taskforce's two years of work would say. Their work was around "sexual violence" and his was around "mental injury", he explained.

They were different.

I'm no expert in the field. I'm not a survivor myself. I don't claim to understand if the statistics of pending cases should be an indictment or a celebration of progress.

But one thing is clear to me, why not incorporate the ideas of your most experienced people in the field?

The experts behind the words "mental injury" and "sexual violence" need to work together to heal very real people.

Maybe the good intentions of trying to build a better agency are so encompassing, Dr Jansen forgot one bigger idea. The best measurement of success for this new policy is if it encourages more and more people to come forward.

That means bigger numbers for ACC. The worst outcome is to frighten or discourage them.

These aren't shoulder injuries that can be measured when you can't lift your arm. These are people who can't lift the weight of their anger and sadness - or perhaps dysfunction - any more.

No, the current policy isn't consistent. Yes, some people will be comfortable with a mental illness diagnosis and still continue treatment.

But many will run. They will run back to what they knew. Silence and suffering that will continue to come out in other ways that still cost us hugely as a society.

"We're not mentally ill," Louise Nicholas said, disbelieving what she sees as the inhumanity of these new guidelines. "This isn't looking at survivor needs. We've had crimes committed against us. These guys need to stop, step back and listen. That's all we ask."

www.traceybarnett.co.nz