Rape victim: ACC cut my lifeline

An article from the Sunday Star Times by Tim Hume

Last month, an Auckland mother died after her claim for ACC-funded counselling was rejected under ACC's new 'clinical pathway' for sensitive claimants. But many existing ACC clients claim they are also having their counselling for sexual abuse terminated. One multiple rape survivor tells Tim Hume how having her therapy discontinued has pushed her to the brink, and why she is speaking out to call for changes to the way abuse victims are treated.
The worst part is the nightmares. "Getting raped every single night when I go to sleep. I can only sleep for 45 minutes before I wake up screaming," says Danielle Martin. "I've got a hammer in my bed. If I knew it was going to be like that every night for the next 30 years, I'd kill myself."
The 32-year-old was first raped when she was 16. The attack happened at Red Beach, north of Auckland. Her attacker was known to her and she says he had a serious drug problem. As she ran from the scene, he chased her to the side of the road and laid into her with his boots.
A private-school girl who had been going through a tearaway stage after becoming estranged from her family, Martin took refuge in a caravan park. A few weeks later, her attacker tracked her down, tied her up and held her hostage for 38 hours, subjecting her to all kinds of indignities. "He cut up or destroyed everything I owned: clothes, photos. He was burning me with knives."
Martin eventually escaped by pleading to be allowed to do her park-cleaning duties, then running to the home of the managers, but not before the man had made a cut on her throat and threatened to kill her and her family if she told anyone.
She didn't, trying instead to forget and move on with her life, and eventually got a job at a bar in Auckland's Viaduct. But after a staff party one night, when she was 18, she was drugged and raped by one of the regulars. She remembers only brief flashes of what took place, but the attack left her with lasting physical injuries.
Her trauma went untreated and unacknowledged, and the subsequent years were filled with depression, addiction, nightmares and self-harm until she finally sought help from a counsellor. In October 2000, her claim as a rape survivor – a "sensitive claimant" – was accepted by ACC, entitling her to heavily subsidised counselling.
At first, the counselling had limited success. She went through about 20 counsellors and psychiatrists without feeling comfortable divulging or addressing the trauma at the core of her issues.
"I never felt safe or made that connection," she says. Life was hard, sometimes unbearable. As a result of the attacks, she had chronic post-traumatic stress disorder and major depression, conditions which constituted a disability and made it extremely difficult to leave the home, use public transport, or maintain social links.
But in the past two years she established a connection with a regular counsellor and a psychiatrist, who allowed her to finally "get into the grit" of her trauma. She made what her psychiatrist called "slow but significant progress" and began to study for a counselling degree.
This was all reversed in October when, out of the blue, Martin received a call from her ACC case manager telling her that her twice-weekly sessions with her counsellor were to come to an end.
In November came a letter: "We're pleased to tell you we've approved your decision for a final 20 sessions. Please note there will be no further counselling sessions approved."
Martin was devastated. "I've been suicidal as a direct result of this."
ACC senior medical adviser Dr Peter Jansen said that while Martin and her psychiatrist might have felt she was making progress with her present regime, the opinion of ACC's experts was that "the long-term counselling has created a dependency that has been counter-productive".
He said Martin had already had 280 ACC-funded counselling sessions. One of ACC's expert assessors, through an assessment which included a review of her case history, determined she would be better off at Segar House, a mental health treatment centre operated and funded by the Auckland District Health Board.
"We want the right care so that people recover from their injury."
Martin, who has had trust issues and finds it difficult leaving the security of home, felt she was incapable of undertaking the programme at Segar House, which has a group therapy component and would involve revisiting the trauma of her rapes with new counsellors.
Her psychiatrist agreed and wrote in a letter to ACC last month: "Since having funding for this intervention discontinued, she has in fact deteriorated significantly – is currently in fact more severely unwell than when first seen but is not accessing any care or follow-up other than that provided by her GP."
Martin said she had been "revictimised" by ACC, which had taken away her lifeline. "I don't have anybody I can talk to about this," she says. She has been calling mental health crisis helplines just about every day but they are not equipped to properly help.
During a recent call, after she woke up hyperventilating from a nightmare, she was advised to take a walk around the block.
"Rape is the ultimate form of powerlessness, the ultimate form of having your choices taken away. And I've been kept in the dark and given no options," she says.
"Therapy helped. My quality of life was improving, my prospects, my ability to be cohesive with other people and my chances of being a productive member of society. I've gone from having some semblance of a normal life ... [to being] a rape victim with worsening symptoms and no help."
Since her counselling was discontinued, Martin has made her blog publicly accessible and has been tweeting about the ordeal, including messages to the prime minister's account. (She received no reply).
"If I'm dead next week, I need this documented," she says. "I've done the right thing. I've been really honest with my treatment providers. I've worked really hard, I've stepped out of my comfort zone to get well. I can still potentially have a really good future. But they're not going to do the right thing unless they're shamed into it."
David Wadsworth of Access Support Services, who is advocating on Martin's behalf, said her case was symptomatic of ACC's "assault on sensitive claimants". "If ACC can get out of any funding of sensitive claims claimants, they'll do it by hook or by crook, as I see it. And they're really the most vulnerable group."
The corporation's new "clinical pathway", which required new clients to be diagnosed with "a significant mental injury" before their applications for sexual abuse counselling could be accepted, had seen the number of sensitive claims approved drop from 472 in the first two months of last year to just 32 in the same period this year. Last month, an Auckland mother died four days after her claim for counselling was rejected.
Meanwhile, many longer-term sensitive claimants were being subjected to reassessments of their treatment regime, which saw them pushed off ACC-funded counselling into DHB-funded programmes.
"They're leaving the claimant high and dry. Four months down the track the person hasn't had any counselling. It's caused a lot of damage to them. They're essentially being retraumatised," Wadsworth said.
Jansen said perceptions that ACC was turfing long-term claimants off counselling regimes to cut costs were incorrect. However, until recently, ACC had been funding treatment for many people who weren't covered by the legislation or weren't getting appropriate treatment.
"If the community is concerned that people are exiting from ACC, my concern would be that they exit because they are recovered."
For regional Rape Crisis help line numbers visit www.rapecrisis.org.nz.

http://www.stuff.co.nz/national/3702810/Rape-victim-ACC-cut-my-lifeline/