On Wednesday (26th August 2026) the Royal College of Psychiatrists (the College) issued a powerful and substantial position statement, Addressing the impact of non-recent child sexual abuse on the mental health of adults.
First and foremost, we honour the testimonies, expertise, and efforts of the working group who developed the position statement: expert women, specialists and survivors of non-recent child rape and sexual abuse. Their truths are rightly front and centre in the statement.
Secondly, we hugely welcome the apology from the College, with the immediate past president Dr Lade Smith CBE stating:
“The fact that any child is sexually abused is appalling and terrible. It is also wrong that many survivors and victims have suffered avoidable harm as adults because they haven't received the care they need. They deserve compassionate, holistic, person-centred and trauma-informed support, and I am sorry that too often this has not been the case."
Crucially there is an important recognition of systems, not simply individuals, being the cause of harm to survivors:
“we need to acknowledge that sometimes unintentional harm can be caused by what is considered best or normal practice, by a lack of training or awareness, or by how healthcare systems and structures can impede the delivery of holistic care.”
The statement speaks directly to the negative and harmful effects that psychiatric treatment and broader mental health interventions can have on survivors, including inappropriate or misdiagnoses, the over-medicalisation of survivors, disbelief and minimisation of trauma, the use of physical restraint in psychiatric in-patient settings, and survivors being forced to take medication.
Rape Crisis has identified and challenged the pathologisation of survivors in our work for well over a decade. In the context we work in, pathologisation means survivors’ understandable responses to trauma (including distress, dissociation, fear, anger, coping strategies, difficulty trusting professionals, or reactions to being disbelieved or made unsafe) being treated primarily as symptoms of disorder or non-compliance, rather than as survival responses shaped by sexual abuse and by the systems around them.
These are issues within the mental health system that women and survivors in the Rape Crisis movement have been raising for many years, and we hope this statement marks the beginning of meaningful action. The College must now work more closely with the specialist sexual violence and abuse sector, including Rape Crisis, to transform psychiatric responses to survivors so that care is compassionate, trauma-informed, and rooted in an understanding of the lifelong impacts of sexual violence and abuse.
Finally, Rape Crisis services see significant numbers of survivors (like those cited in the College’s position statement), who have been failed time and again by statutory mental health services. We know that the specialist knowledge and skills needed to respond to sexual violence and abuse already exists within the Rape Crisis network, but demand outstrips resource and capacity. As much as we must see improvements to the quality of the statutory service offering for survivors, it is vital that health commissioners recognise the expertise held within Rape Crisis Centres and fund them accordingly, so that survivors can access the specialist, trauma-informed and holistic support they need and deserve.
Amelia Handy, Head of Policy and Public Affairs, says:
“This position statement is a very meaningful step forward, and the apology and accountability from the College’s leadership really matters. Facing up to systemic failures in the mental health system and naming the profound harms meted out to victims and survivors is vital if responses and treatment for those subjected to child rape and sexual abuse is to significantly improve.
It’s essential now that the whole mental health system recognises sexual violence and abuse as major determinants of mental health and can respond with compassion and trauma-informed care.
Accountability must also extend to health commissioners who have too often failed to understand what survivors need, including the value of specialist therapeutic and advocacy work delivered by sexual violence specialists, such as those within Rape Crisis Centres.”