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It concerns all of us

July 14, 2015

By Basket Press

Trigger warning: Contains material that some readers may find distressing

Sexual abuse of children has been prominent in the news lately (for example here and here) and rightly so.

Why look at this in a nursing blog?

Well, it concerns all of us: many nurses will find themselves in a position where someone might disclose and must act on that information; the aftermath of abuse leads to mental and physical health problems so we will meet survivors; we often work in settings in which abuse could take place or has taken place; we will meet abusers; we must be able to recognise the signs and know what to do next. We cannot escape it. We cannot ignore it. My sister worked at Leeds General Infirmary; I have friends who worked at Broadmoor…

At least as far back as my nursing finals in the 1980s the potential importance of sexual and physical abuse in mental health problems was already pretty well established. One of the essay questions in my finals, set by the then English National Board, was about why a middle aged woman admitted to an acute psychiatric ward would have waited so long before disclosing childhood sexual abuse. This tied in with things I heard during my training from patients on acute wards and in community placements.

Now, note that I took my finals in the 1980s and that clearly, the UK nursing establishment, embodied by the ENB, was well aware of these issues. Scroll forward a couple of years and we have the 1989 Children Act, which generated much discussion about child protection matters and further demonstrates that the political establishment was aware of these issues.

I bring this up because it gives the lie to the claims made repeatedly by senior clerics of various flavours and other institutions that they weren’t so aware of child protection issues in the 1980s and ’90s. To be that unaware must have taken some great effort…

Then there remains the thorny question, which I have yet to hear answered by any of these senior clerics nor any apologists for abusers: at what point did you think sex with children was actually legal? Nor the related question: why do you think you are exempt from the laws which apply to every other person in the country?

Back to nursing…During my Child and Adolescent Mental Health Service in-patient days in the ’90s a certain young lady, who I will call A, was admitted with a mix of bulimic-type eating disorder and self harming, a constellation of behaviours we now know to be associated with abuse. I was her key-worker, and we developed a good working relationship, which allowed A to address many things while acknowledging that there was still something very important she was not able to talk about.

A went on home leave one weekend, as was standard for most of our young people, and took a massive overdose with clear suicidal intent. Fortunately she was found by someone coming home unexpectedly. When A returned to us from the medical ward I spoke to her about the overdose: she disclosed long-standing sexual abuse. The subsequent investigation led to prosecution of the perpetrator, whom I shall call Perp. To spell that out, the local police felt there was convincing evidence and the Crown Prosecution Service thought that it met their criteria for prosecuting.

Why mention A in this context? Well, Perp was a senior lay figure in a local church. A’s family were members of said church, which is how they knew Perp; not only that, but Perp was on the Diocesan Committee looking at vetting volunteers for working with children and was well known for being especially solicitous of young single mothers in the congregation.

It gets worse…During the trial of Perp (I was a prosecution witness because A disclosed to me) the vicar from the church came every day, sat at the front of the public gallery, glaring at every prosecution witness, tutting and harrumphing to the point that, as I was informed by colleagues, during A’s time in the witness box the judge actually warned him about his behaviour and threatened to have him removed.

Now, I will let you draw your own conclusions from the above two paragraphs…I drew mine, as did my colleagues and the local social services department…Subsequently at least two vicars in that diocese have been convicted of sexual offences against children.

On a brighter note, A worked through what she needed to and last I heard of her was heading off to a Russell Group university with a clear professional pathway in mind.

There’s a group of blokes I knew (I say blokes as they are very bloke-y), who grew up together, have been friends since school, went to the same church, where they were altar boys…And all bar one were sexually abused by the priest (they do discuss this publicly)…The one who wasn’t feels left out, that he wasn’t “special” like the others…The priest did, apparently, talk of his “special boys” who got “special treats”…

Amongst this group, two display what appear to be Obsessive Compulsive Disorder behaviours, two are heavy drinkers (and I mean HEAVY), one has regular, but not clearly explained, sickness absence from work. None have ever, as far as I know, sought mental health support…

I make no apology for using religious organisations as examples, as most of the stories I know involve such and I hold those who espouse an ideology of apparent caring and compassion to a higher standard than the man and woman in the street. There are, however, many more stories out there and many different institutions implicated in causing serious, life-limiting and life-threatening damage to young people, especially involving people in a position of power and authority (odd how that can aid grooming) who owe a clear legal and moral duty of care to those young people and yet choose to ignore that or to actively use it for other ends.

This is why I find the attempts by various official and semi-official bodies to squirm out of their clear responsibilities even more reprehensible.

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