About-turn on abuse

An article from the Taranaki Daily News by Lyn Humphreys

Taranaki campaigner for sexual abuse victims Bob Stevens is celebrating ACC's about-turn on strict new claims criteria which denied help to hundreds of sexually abused New Zealanders. "For those of us willing to stand up and fight, it has come to pass," Mr Stevens said.
An experienced sexual abuse counsellor, Mr Stevens was among the first to condemn ACC's toughened stance which required claimants to have a diagnosed psychiatric condition.
Last week an independent panel, the Sensitive Claims Pathways Review Panel headed by Dr Barbara Disley, strongly criticised ACC for implementing the new pathways. It has called for urgent action to ensure sexual abuse survivors, especially children and those with special needs, get fast-tracked assistance from ACC in future. It also wants to see a representative working party put in place to ensure processes are improved and are focused on the client.
Last year, Mr Stevens was so incensed with ACC that he threatened to return the QSM awarded for his pioneering work in the field of sexual abuse.
Mr Stevens says he is gratified by the panel's 14 recommendations to ACC Minister Nick Smith, calling it a credit to those who put it together. "While they have certainly given ACC a lot of reasons to reconsider their clinical pathways, they have done it in a respectful and helpful way that will help ACC to reconsider," Mr Stevens said. "At the end of it all, let's hope the people who have been affected by this can now receive the help that is due."
Mr Stevens was particularly angered that, since October last year, ACC required victims to be "labelled" with a mental illness.
ACC Minister Nick Smith implemented the investigation in May this year after acknowledging many were missing out on assistance. ACC had already taken action when last month it implemented an interim recommendation from the panel, immediately offering 16 counselling sessions to all sexual abuse claimants. After receiving the panel's final report last week, Dr Smith confirmed he was not satisfied with ACC's handling of the issue.
The minister, who had earlier said he would not involve himself in clinical decisions, promised that ACC would now be putting the panel's recommendations in place. "The report is quite critical of the way that ACC managed [the changes] and I accept the criticisms that are directed at ACC regarding that," Dr Smith said.
The panel said ACC's communications with sexual abuse victims and providers had often been inappropriate and inadequate. "These need to be improved as a matter of urgency," the panel said. Some claimants, especially children and young people, had been waiting 10 months to be assessed. The panel's recommendations include:

• Priority is given to claims for children.
• All communications with survivors of sexual abuse be urgently reviewed.
• Establishing a working party to examine whether the workforce is meeting quality standards.
• That ACC works with the sector, survivor representatives and relevant government agencies to develop and implement a comprehensive quality framework.
• Ensuring all claims processes protect client safety, take a client focus and recognise the special needs of groups such as children and people with mental illness etc.
• Future changes are made in meaningful consultation with the sector and relevant government agencies.
• That in determining a mental injury, the test should be that the sexual abuse was a substantial or material cause of the injury.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/taranaki-daily-news/news/4121555/About-turn-on-abuse

ACC about-turn for victims

An article from the Taranaki Daily News by Lyn Humphreys

Sexual abuse counsellor Bob Stevens says ACC has acknowledged a travesty of justice in announcing immediate reinstatement of counselling for victims.
From Monday, ACC's about-turn will give claimants 16 hours of counselling "to ensure their safety and wellbeing", spokeswoman Denise Cosgrove, of Wellington, said.
"The feedback I've had has been positive," Mr Stevens, New Plymouth, said yesterday. "It's a small victory for common sense over bloody-mindedness – but at what expense for the anguish and misery it has caused victims."
The decision appears to have come from pressure from the ACC Sensitive Claims Clinical Review Panel. The review panel was put in place by ACC Minister Nick Smith to look into ACC's methods of dealing with sexual abuse claimants after he was made aware of the large drop in claims since October when the tougher measures were put in place. The panel was to report to the minister last month but has asked for an extension until next month.
In a statement, review panel chairwoman Dr Barbara Disley said ACC's decision this week went part way to addressing the panel's concerns. The panel had met with the minister in early July telling him they were concerned that only half as many victims of sexual assault were applying for ACC support this year compared to last, Dr Disley said. "And many who do apply are declined or face significant delays in getting support," she said.
"ACC's changes mean that from next week new victims or those with a new claim already in the system but awaiting a decision will be eligible to get immediate support and this begins to address the panel's concerns," Dr Disley said.
The panel would make no further comment and was to present its report next month, Dr Disley said.
Since October, ACC has required sexual abuse victims to be diagnosed with a psychiatric illness caused by the abuse. The hard line was met with an outcry from Mr Stevens and others speaking out on behalf of sexual abuse victims across the country. It has led to led to hundreds either not filing claims or being left in limbo waiting for decisions to be made. At least one woman is suspected to have taken her own life.
Last year an angered Mr Stevens threatened to return his QSM, awarded for work with abuse victims. Mr Stevens said ACC was wrong not to have first trialled the new system with a small number of people instead of causing misery to hundreds by running over everyone's advice.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/taranaki-daily-news/news/4019707/ACC-about-turn-for-victims

Support agencies 'near collapse'

An article from the Taranaki Daily News by Lyn Humphreys

Support agencies for the sexually abused are within months of collapse after ACC rejected up to 90 per cent of claims in the last six months, says national rape crisis advocate, Dr Kim McGregor.
"It's a critical situation. Because of the impact [of the new clinical pathways] put in place in October, it has almost destroyed our sector," Dr McGregor said.
The New Plymouth Safer Centre is an exception however, with management saying the bulk of its work comes through work from other agencies.
Dr McGregor heads Rape Prevention Education, in Auckland, and is a member of the Taskforce for Action on Sexual Violence.
She and New Plymouth advocate Bob Stevens are battling to get justice for those they believe have been abandoned by ACC. ACC's figures released last week show that since October last year 90 per cent of people making ACC claims for sexual abuse counselling have either been refused cover or have been left waiting for a decision.
As a result, ACC Minister Nick Smith last week announced an independent review of ACC's new management of sexual abuse claims.
For six months, ACC assessors have required that claimants are diagnosed with mental illnesses which can be proved to be directly attributed to the abuse.
But Dr McGregor said the independent review would not be completed until July which was too late for some.
"The fact is, many survivors are suicidal and there was no alternative put in place," Dr McGregor said.
One Auckland woman had died since she was declined counselling, Dr McGregor said.
Safer Centre manager Lynne McKenzie-Brown, of New Plymouth, said Safer's funding had been greatly reduced by the new ACC regime but they would continue to work hard at finding alternative funding for those denied cover.
The ACC process was particularly unsuited for children for whom the review should be made urgent, she said.
The centre's major concern was that some who had been sexually abused were not coming forward for help because of the negative publicity.
The message for these people was to ensure they did get assistance, either from their GP, Victim Support or the Safer Centre. "Don't give up," Ms McKenzie-Brown said.
Dr McGregor said most of the 600 registered private practitioners in New Zealand, had been forced to find other work. This had left only about 30 specialist sexual assault support agencies, such as Taranaki's Safer Families Centre, which were still employing registered ACC counsellors.
Unless there was a major injection of funding into these specialist services they too would be lost in the next few months, Dr McGregor said.
ACC had estimated that their changes would mean $5 million of the $20m paid out to claimants each year would be saved.
However, Dr McGregor praised the Government's move to support the recommendations from the Taskforce for Action on Sexual Violence. "It was fabulous news for us."
Minister of Justice Simon Power has promised $1m over the next two years for sexual violence prevention education programmes. In addition, abuse survivor advocate Louise Nicholas was given continued funding for her role working across government agencies for the next three years.

http://www.stuff.co.nz/taranaki-daily-news/news/3653089/Support-agencies-near-collapse

Review of ACC's sex abuse policy

An article from the Taranaki Daily News by Lyn Humphreys

An independent review into ACC's controversial new assessment process for sexual abuse victims has been welcomed by those at the coalface.
ACC Minister Nick Smith announced this week that an independent clinical review panel had been appointed to investigate the guidelines put in place in October to manage sexual abuse victims' claims.
The new system, which requires the abused person to be suffering from a mental illness diagnosed by a psychologist or psychiatrist, incensed many professionals working in the field.
They predicted that the sexually abused, who were not mentally ill but traumatised, would not meet the new criteria and they would no longer come forward for help to restore their lives. Those predictions appear to have been valid.
Dr Smith revealed this week that ACC figures show just 32 sexual abuse claims for counselling were approved in the first two months of this year compared with 472 in January and February 2009.
Dr Smith said he had been hesitant to interfere in clinical decisions but conceded that the changes had been controversial.
"That is why I have initiated this independent clinical review to ensure best possible practice in this sensitive area," he said.
One of the most outspoken against the new regime has been Taranaki's experienced sexual abuse counsellor, Bob Stevens.
Last year he threatened to return his Queen's Service Medal in protest.
Mr Stevens challenged Dr Smith's claim of best practice.
"I believe the minister is being obtuse and it almost smacks of deceit," Mr Stevens said.
"How can he suggest best clinical practice for sexual abuse when the claims aren't being accepted? Since when did you become mentally unwell following a sexual assault?"
Mr Stevens said none of the people who had come to him since October for counselling for sexual abuse had been accepted by ACC.
One, a man who was severely depressed and in obvious need of immediate help, was still waiting after five months for ACC support, Mr Stevens said.
"Children, adolescents and adults are being denied what I believe is their right under the legislation. It is being denied them under a reinterpretation of the law that has been their right since 1974 [when ACC was first established]," Mr Stevens said.
Dr Smith has appointed Mental Health Commissioner Barbara Disley to lead the review accompanied by clinical psychologist Clive Banks, consultant Ruth Herbert and psychiatrist Professor Graham Mellsop.
Mr Stevens asked why there was no professional appointed to the review panel that was doing coalface sexual abuse work.
"Who is better qualified to talk about the stresses they are meeting at the coalface doing the work? But they are not represented."You are going to get a clinical academic view that is devoid of the human impact on those who have been abused."
A spokesman for Dr Smith said the panel's task was to assess the implementation and impact of ACCs new clinical pathway for sensitive claims. It was impossible for the panel to include representatives of every perspective, the spokesman said.

http://www.stuff.co.nz/taranaki-daily-news/news/3635822/Review-of-ACCs-sex-abuse-policy

Victims of sexual abuse are feeling the effect

An article from the Taranaki Daily News

Some of those most affected by ACC's harder line are victims of sexual abuse.
"People who are victims of sexual crimes don't have a voice. They speak with their feet. They're not turning up for counselling, referrals are right down. People are not prepared to come in and be given a label of mental illness," New Plymouth Safer Centre counsellor Bob Stevens says.
The New Zealand Association of Counsellors is agitating across the country, he says.
"When do you suddenly become a mental health patient because you have been sexually assaulted?"
Since October, ACC has started to lay on an "unsuspecting public" new clinical pathways.
"They've decided arbitrarily, because there had been no change to legislation, that the only way you can fund ACC counselling is to have a diagnosis under the American psychiatry bible DSM-IV. Those of us who have being doing this work for half a lifetime, 18 years for me, are sidelined because we are not trained to use the diagnostic criteria, therefore we can't do assessments."
To become ACC approved, sexual abuse counsellors had to "jump through more hoops than a circus", he says. And yet now they are not deemed qualified enough to make the assessments.
He's appalled at the new approach.
"People come in here and tell me I can't take this any more."
Under the new rules, people who are victims of sexual abuse have to tell their stories to a sexual abuse counsellor, who passes on the information to ACC. The claim is then assessed by a psychiatrist and psychologist, out of the area, who make the decision whether or not to accept it, without meeting the clients. However, sometimes, an extra assessment is required by ACC and then the client may end up telling their story to a number of different people.
The psychiatrists and psychologists are "hell bent" on looking at whatever psychological problem they can find - to hell with the event, Mr Stevens says.
ACC senior medical adviser Peter Jansen says there has been a lot of coverage lately of the new "pathway", much of it uninformed and negative.
"It's important to understand that ACC is not cutting services to people who are entitled to them. Our legislation is very clear: we can provide cover only for injuries. The entitlements that follow from an accepted claim will depend on the nature of the injury."

So to pay for psychological treatment or therapy such as counselling for sexual abuse or assault victims, ACC needs to be satisfied that sexual abuse or assault has caused a mental injury. This is a clinical diagnosis, which can be made only by registered health professionals with appropriate training, qualifications and experience, Dr Jansen says.
"In the past, we have not followed this requirement as closely as we should have. The result is that we have paid for counselling and other benefits for some people not entitled to it. This is not to say that these people do not have psychological needs; it is simply that ACC cannot legally cover them. Other agencies such as Health and Social Development often can."

http://www.stuff.co.nz/taranaki-daily-news/features/3352813/Victims-of-sexual-abuse-are-feeling-the-effect