Hansard

I am pleased that the minister has now decided to join my campaign to reverse Scotland's declining birth rate. I wish her all the very best over the coming months and years.

This afternoon, I will speak very much as the vice-convener of the cross-party group on survivors of childhood sexual abuse. Sexual abuse is obviously an horrific experience for any child. However, not only might the psychological and emotional consequences of sexual abuse in childhood have a profound impact on the victim at the time, they might significantly damage his or her ability to function successfully in society throughout adulthood, seriously impair personal relationships and in many cases result in serious mental health problems.

Sexual abuse that is perpetrated during the formative years of childhood undoubtedly has the most traumatic impact of all mental health difficulties in terms of severity and duration. Alongside struggling to achieve and maintain meaningful relationships, victims can frequently demonstrate individual emotional and psychological conflicts through repeated self-harm and other detrimental behaviour such as drug and alcohol abuse. Other victims present themselves to the psychiatric services with less dramatic but still prolonged mental illness. It is well documented that a high proportion of people committing suicide suffered sexual abuse in childhood.

Such factors combine to pose major problems for mental health services, most obviously in relation to admission rates to hospitals. A recent study conducted on behalf of Fife Health Board, "A Safe Place to Talk", identified that 10 to 20 per cent of all admissions of both sexes to psychiatric units involved a history of serious sexual abuse.

The same study showed a disturbing fourfold increase in the referral of victims of sexual abuse to psychological services in Fife over a three-year period. Furthermore, it provided an assessment of the views of service providers and users that highlighted the many limitations of existing psychiatric services, especially in the prevention of repeat admissions by sufferers. Statutory and non-statutory systematic evaluation of the services on offer highlighted patchy distribution, lack of co-ordinated resource planning and absence of shared best practice. In addition, given the identified inconsistencies in service provision, all participants agreed on the need for increased awareness and well-constructed training programmes for service providers.

The study's conclusions highlighted the need to develop a variety of services to address individual needs ranging, for example, from specialist psychotherapy to respite in crisis. The greatest emphasis was placed on the need to recognise the essential role played by non-statutory organisations within a properly co-ordinated national strategy.

Two recent studies conducted in Glasgow and Lothian produced broadly similar findings. Given the shortcomings that the Fife study referred to, if replicated throughout the country, such a scenario would imply that many thousands of sufferers are being denied the treatment and support that they justly deserve. Also, by interpretation, statutory services are already heavily involved with the problem, but in a way that does not resolve the deep-seated trauma endured by victims.

Evidence from across Scotland indicates that the level of funding of non-statutory services varies considerably from area to area and might be short term. That may impede the continued development of such services or, at worst, threaten their very survival.

In changing mental health law, we must fully recognise the extent of the problem of childhood sexual abuse within a national framework for mental health, given the victims' reliance on psychiatric services. That recognition should be reflected centrally in the requirement of psychiatric and social services in each locality to incorporate within their mental health strategies the development of services that are specifically designed to tackle the mental health problems of people who have suffered childhood sexual abuse. Each area should also clearly identify the level of funding that will be apportioned to develop non-statutory services on a continuing basis.

In developing services, we must pay attention to the need for a range of services and, given the particular difficulties of sexual abuse victims, the ability to respond with flexibility and sensitivity at a local level.

The policy statement rightly comments on protection of mentally disordered adults, although it does not mention victims of childhood sexual abuse. I hope that in future discussions about mental health—and, indeed, when the bill comes before Parliament—that matter will be addressed. I also hope that the deputy minister will respond to that in his summing-up speech.