Protesters demand changes to way sexual attack survivors dealt with by ACC

An article from the New Zealand Herald

A "small but committed" group of protesters gathered outside ACC's Auckland office this afternoon calling for sexual attack survivors to qualify for ongoing taxpayer-funded counselling without a mental health illness diagnosis. Green Party MP Jan Logie led the demonstration with support from victim advocate, Louise Nicholas.
Up to 14 hours of one-on-one therapy is currently available when someone lodges a sensitive claim with ACC, along with up to 10 hours of social work support. Up to 20 hours of whanau support is also available immediately.
After these are used, ACC decides whether to approve cover for further support, should the person need it. That included victims needing to be diagnosed with a mental health injury relating to the abuse.
"Some survivors feel having to have a diagnosis puts judgment on them," Ms Logie said. "It takes them back to the the feeling that there's something wrong with them; that they're at fault.
"In other cases, survivors who need support are turned down because they don't have a diagnosis, or some don't apply for support because they think they'll be turned down."
She said a small but committed group of about 20 protesters gathered outside ACC's Auckland office at 12pm today.
"What we're asking for is incredibly simple. A counsellor can assess a survivor and whether they need help without them needing a mental health diagnosis."
The Green Party has also begun a petition which will be presented to ACC Minister Nikki Kaye.
Ms Kaye has said she believes the system is supportive of survivors but she will meet with providers to discuss possible changes to the scheme. That would include looking at different ways to assess mental harm to victims.
Ms Kaye said a "mental injury diagnosis" could be provided by any ACC registered and appropriately qualified assessor, which in many cases is the client's counsellor.
Changes were made in 2009 to the way support was accessed through ACC by sexual violence survivors, bringing in the requirement for a mental injury diagnosis in order to access help. After a 2010 review of the scheme and consultation with those working in the sector, further changes were made so survivors could have immediate access to support.

© 2016 NZME Publishing Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11647644

ACC Minister must help sexual violence survivors

A press release from the Green Party by Jan Logie

The Green Party is calling on ACC Minister Nikki Kaye to remove the obligation for sexual violence survivors to be diagnosed with a mental illness before being allowed additional ACC-funded counselling.
Green Party MP Jan Logie and survivor advocate Louise Nicholas today launched a new campaign and petition to demand that survivors don’t need a mental illness diagnosis in order to have their sensitive claims proceed.
“Being the victim of sexual violence is not a mental illness,” Ms Logie said.
“Being subjected to sexual violence is trauma enough. Being a victim of sexual violence on its own should qualify survivors for the help they need.
“It’s great to hear the Minister Nikki Kaye say she’s open to a better way of helping the survivors of sexual violence. Removing the obligation for them to be diagnosed with a mental illness is an appropriate start.”
The petition is available here: http://action.greens.org.nz/remove_the_barriers
Under current ACC practice, in order for survivors of sexual violence to have their ACC sensitive claim approved, they must be diagnosed with a psychiatric condition. Up to 16 hours of one-on-one therapy is initially available when someone lodges a sensitive claim with ACC, however accessing help after that requires a diagnosis.
“In many cases this labelling of sexual violence survivors can be re-traumatising and stigmatising, and is a significant deterrent for those who need treatment.
“ACC needs to change its processes so that people are able to access the help that they need,” Ms Logie said.

More information is available here http://www.parliament.nz/en-nz/pb/business/qwa/QWA_03866_2016/3866-2016-jan-logie-to-the-minister-for-acc

© 2016 The Green Party of Aotearoa New Zealand

https://www.greens.org.nz/news/press-release/acc-minister-must-help-sexual-violence-survivors

Being a victim is not illness

An article from the Herald on Sunday by Tess Nichol

Requirements for sexual attack survivors to be diagnosed with a mental health illness to get ongoing taxpayer funded counselling could be reviewed, ACC Minister Nikki Kaye has revealed.
Green Party MP Jan Logie will tomorrow lead a demonstration at ACC's Auckland office protesting the current process, which requires survivors receive a mental injury diagnosis before their claim for further assistance can be approved.
Up to 14 hours of one-on-one therapy is available when someone lodges a sensitive claim with ACC, along with up to 10 hours of social work support. Up to 20 hours of whanau support are also available immediately.
After these are used, ACC decides whether to approve cover for further support, should the person need it. That included victims needing to be diagnosed with a mental health injury relating to the abuse.
"We believe that survivors of sexual abuse should be able to get all the help they need without the requirement of being diagnosed with a mental illness," Logie said. "The advocates are very clear that it is still acting as a barrier, [that] the consequences are harmful and that it's unhelpful."
Logie said she had been told of survivors who had to retell painful details of their abuse to people they had not previously met so they could get the mental health diagnosis they needed to keep seeing their therapist, a process they described as traumatic and revictimising.
Kaye told the Herald on Sunday she believed the system was supportive of survivors. But the minister said she would meet providers this week to discuss possible changes to the scheme. That would include looking at different ways to assess mental harm to victims.
"I'm really keen to work with providers and opposition parties to see if there is a better way [of doing things]."
Kaye said a "mental injury diagnosis" could be provided by any ACC registered and appropriately qualified assessor, which in many cases is the client's counsellor.
"If the assessor is someone different, the client's counsellor can be with them throughout the process, including during the assessment to ensure they feel safe and supported, and can provide background information to the assessor beforehand if the client doesn't wish to speak about some things again."
Changes were made in 2009 to the way support was accessed through ACC by sexual violence survivors, bringing in the requirement for a mental injury diagnosis in order to access help. After a 2010 review of the scheme and consultation with those working in the sector, further changes were made so survivors could have immediate access to support.
Since the review, ACC has been working with providers to improve the care of sexual assault survivors, something Kaye said had been hugely successful.
"We've come a long way [since 2009]," she said. "ACC has given me feedback that a lot of providers have been quite positive about the new service. But that doesn't mean that we can't do better."

© 2016 NZME Publishing Limited

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11646773

Recent Sensitive Claims Advisory Group (SCAG) meeting

Information from the New Zealand Christian Counsellors Association

The Sensitive Claims Advisory Group (SCAG) met on the 18th and 19th October in a working session to focus on:
* Service issues, gaps and improvements for children and adolescents
* Approaches to mental injury assessment and alternatives to DSM-IV
* Feedback on the implementation of the 16 hours of support
* Support for returning clients
* Sexual abuse provider workforce development needs

Outcomes from the session included:
* Agreement on a number of principles for working with children and adolescents and subsequent recommendations for further service improvement and development.
* Formation of a working party to focus on and progress child and adolescent service improvements. The working party will included representatives from the New Zealand Association of Psychotherapists, New Zealand Association of Counsellors, Aotearoa New Zealand Association of Social Workers, New Zealand College of Clinical Psychologists and Te Ohaakii a Hine - National Network Ending Sexual Violence Together (TOAH-NNEST). The first meeting will be held on 2 December in Wellington. ACC is also investigating a range of possible representatives from the wider sector including health, education, DSAC and Maori and Pacific groups to act as a secondary consultation and advisory group.
* Generation of a range of alternative assessment methods for mental injury which are currently being reviewed by ACC.
* Establishment of a Maori working group to focus on developing culturally appropriate and safe services for Maori with the first meeting on 26 November in Wellington.
* Endorsement for ACC to work closely with the professional bodies representing service providers to establish a process for addressing quality and workforce issues.
* Identification of a preferred approach for working with Pacific people in sensitive claims and discussion regarding the formation of a working group.

http://www.nzcca.org.nz/acc/

ACC's flawed review

A letter to the editor of the Dominion Post by Gordon Waugh

No wonder the report by the independent panel reviewing ACC sexual abuse claim procedures has been kept quiet.
The panel relied heavily on emotive sex abuse industry anecdotes, myths and misinformation.
It ignored good science and the interests of taxpayers who pay for ACC sex abuse claims.
It recommends a diluted, weakened and more costly process. Instead, the need is for fairness, healthy scepticism and robustness.
The panel made much of the supposed causal link between sexual abuse and mental injury. I understand no sexual abuse syndrome exists because there is no scientific evidence that sexual abuse causes any specific psychiatric, psychological or behavioural condition.
Disdaining such elementary science, the panel relied on the Massey Guidelines, which claim more than 700 symptoms or indicators of sexual abuse have been identified. That covers almost every human behaviour.
The panel accepted sex abuse industry myths that most victims never disclose their abuse, and only 9 per cent of sexual offences were reported to police. It is impossible to know about undisclosed or unreported events. The panel failed to apply critical thinking. It was a deplorable waste of our resources.

http://www.stuff.co.nz/dominion-post/opinion/letters-to-the-editor/4158659/Letter-ACCs-flawed-review

And now for the apology...?

A blog entry from Off The Couch by Kyle McDonald

I may be old fashioned, or conditioned by my profession to focus on “the relationship” but perhaps it’s now time for ACC to apologise.
In these times of “systemic failure,” independent reviews and Ministers who are unable (or unwilling) to take a position, there is still a lot to be said for a good old fashioned “sorry.” So what have ACC got to be sorry for?

Click here to read more.

ACC backdown welcomed

An article from the Manawatu Standard by Janine Rankin

Sexual abuse survivors denied help under tough new rules introduced last October can look forward to better services in future now that ACC has backed down on the changes. Palmerston North counsellor Paulette Berryman says she is battle-weary but elated that ACC has accepted a caning from an independent panel condemning its approach and forcing a back-down.
The New Zealand Christian Counsellors' Association representative on the sensitive claims group told the Manawatu Standard that the quality of help available for survivors could become better than ever once all of the panel's recommendations were put into place. She said her hard work in protesting against the changes, including taking two of her clients to Wellington to provide evidence about the harm the changes were causing, had paid off. "For almost a year we have been fighting, but it's been worthwhile, with positive changes for sexual abuse survivors," she said.
The review found that the changes, which required clients to gain a diagnosis of mental injury before they could get treatment, were introduced "prematurely and precipitously". The ACC changes had discouraged survivors from seeking help and caused a halving in the number of claims submitted in the first three months of the cuts. Delays were unacceptable and ACC's communications with sexual abuse survivors and providers had often been "inappropriate and inadequate". The panel recommended fast-tracking of the introduction of 16 sessions of support for new clients ahead of the full report's release last week.
Mrs Berryman said the 16-session scheme was a "welcome measure, in the right direction", but the response from potential clients had been low key. She remained concerned that people who could benefit still had not realised how easy it was to contact an ACC treatment provider directly to begin the healing process. Mrs Berryman is continuing her fight to ensure survivors of sexual abuse get the help they need, and is involved in consultation in how other recommendations can be implemented. These include recognising alternative ways for diagnosing mental injury, dealing with the particular needs of children, providing support for Maori and helping people with complex health needs.

http://www.stuff.co.nz/manawatu-standard/news/4142528/ACC-backdown-welcomed

Psychotherapists welcome review report

A press release from the NZAP by Kyle MacDonald

The New Zealand Association of Psychotherapists welcomes the Independent Review Panel´s report into the ACC´s failed new clinical pathway and its recommendations for changes.
"The report is clearly an indictment of both the intention and application of the change process ACC embarked on in October last year," says Kyle MacDonald, NZAP spokesperson. "It is validating for all clinicians and survivors that the review panel´s report echoes the concerns that we have had since the very first draft of this new pathway was released."
Most damning is the review panel´s view that "the Panel found no evidence of formal planning for implementation ... Evidence obtained from presentations and submissions was that implementation was poorly planned without adequate consideration of the impact on clients and the Pathway was introduced prematurely and precipitously." They further have grave concerns about the fact that ACC failed to follow rudimentary processes about change implementation required of State Services.
"The picture is one of grave incompetence, and New Zealanders deserve to now know how this was allowed to happen," says MacDonald.
Of most encouragement to clinicians and survivors will be the clear recommendation that ACC cease using the DSM-IV as the measure of a mental injury, and that the legal opinion obtained by the review panel states that ACC have "over-reached" in their interpretation of the law justifying this. Furthermore the review states that the higher level of proof of "causality" is not supported by the current common law.
"The key thing now is for ACC to quickly implement all the recommendations, and remove the unreasonable impediments to survivors wanting to access treatment. While some moves have been made in the right direction, we will wait and see how the actual implementation of these recommendations plays out over the net few months."

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

Response from Denise Cosgrove

A letter to the editor of the Sunday Star Times

Your story "Academic with link to sex abusers silent on role in drafting ACC rules" (News, August 29) was misleading in some important respects. The article suggests that Dr Felicity Goodyear-Smith was involved with the development of the ACC clinical pathway for sexual abuse claims. She was not. Goodyear-Smith had no role in the development of the pathway. The report she and two other researchers produced five years ago was an inconclusive study which compared treatment rates provided to ACC sexual abuse clients by psychologists, psychiatrists and counsellors. So it was not relevant to the development of the pathway.
Yes, one of their recommendations was that there should be diagnosis before treatment, using an assessment tool called DSM-IV. Yes, that is what we've been doing. But we didn't do so because it was in their report. Far from it. We did it because it was internationally seen as best practice, because the courts in NZ had endorsed DSM-IV as an appropriate method and because no suitable alternative options have been put forward. Goodyear-Smith had no part in any of that.
The article also failed to mention the work that ACC is currently doing with the Sensitive Claims Advisory Group and others to ensure that, moving forward, we continue to provide the most appropriate services for our clients.
Denise Cosgrove
General manager, claims management ACC

Copyright Fairfax New Zealand Ltd 2010
http://findarticles.com/p/news-articles/sunday-star-times-wellington-new-zealand/mi_8185/is_20100912/sexual-abuse/ai_n55232011/

Sexual abuse survivors applaud report which criticises ACC

A news report from Morning Report on Radio New Zealand National

Critics of the Accident Compensation Corporation's system for dealing with victims of sexual abuse are applauding a highly critical report into ACC's management of sensitive claims. Click here to listen.

© 2010 Radio New Zealand

ACC changes "adding to" abuse victims' trauma

An article from the Dominion Post

Sexual abuse survivors are being retraumatised by ACC's new "sensitive claims" process, an independent review has found.
The agency tightened criteria for sexual abuse victims last October, limiting ACC-funded counselling to those clinically diagnosed with a mental injury resulting from abuse. As a result, sensitive claims submitted to ACC halved.
After protests, ACC Minister Nick Smith set up an independent review panel in April to assess the new process. Last month, ACC accepted an interim recommendation from the panel that sensitive claimants should receive 16 initial counselling sessions immediately.
The panel has now issued its final report, which found the criteria changes had led to long waiting times for claims to be processed, retraumatising vulnerable victims and prompting many to give up seeking help..
It was particularly worried about the time taken to process claims from children and teenagers – up to 10 months.
Relying on a clinical diagnosis meant many people were now being denied treatment, and ACC and counselling services needed to agree on other ways to identify whether a person had a "mental injury". The changes were "poorly planned".
Dr Smith said ACC would put its recommendations in place.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/national/politics/4114385/ACC-changes-adding-to-abuse-victims-trauma

Sex abuse cuts "all about costs"

An article from the Sunday Star Times by Tim Hume

A former senior ACC manager says the corporation's cuts to sexual abuse counselling are "all about costs", contrary to ACC Minister Nick Smith's claims they were about ensuring best practice for clients.
David Rankin, now Child Youth and Family's senior medical adviser, has also revealed an advisory group of eight eminent psychiatrists cautioned ACC against introducing a Diagnostic and Statistical Manual (DSM-IV) diagnosis of mental injury as the threshold for victims of sex crimes to access support. "They said, 'Be very careful, this is not what it's used for, this is not what it's all about'," Rankin told the Sunday Star-Times. "They said: 'It doesn't indicate severity, it only indicates the presence of a condition and it doesn't in any way tell you what treatment is needed."'
ACC controversially introduced the requirement last year, cutting access to treatment for hundreds, before partially restoring support last month. Two suicides have been linked to the cuts.
Rankin, who was ACC's general manager of health purchasing until 2006, says the main goal of the changes was to cut costs. "ACC's an insurance company. Its premium-payers are grizzling."
ACC was "under extraordinary pressure to reduce its costs" and "anybody that looks at the counselling costs for sexual abuse must come to the conclusion that there is wasted money," he said. Although sensitive claims represented only a small amount of ACC's total spending, it was an area where the corporation had "extraordinary exposure" to liabilities.
In 2004, Rankin commissioned research into sexual abuse counselling that was co-authored by Auckland University professor Felicity Goodyear-Smith. He said the research was commissioned because "ACC was concerned at the increase in cost in counselling".
ACC has been criticised for commissioning the research from Goodyear-Smith, who is married to a convicted sex offender and is the daughter-in-law of Centrepoint's convicted paedophile founder Bert Potter. She has been an outspoken critic of sexual abuse counselling, labelling it "a scam".
Her research included a recommendation that victims be assessed with a DSM-IV mental injury diagnosis, which later appeared as a requirement in ACC's "clinical pathway", despite not having been specified in the Massey guidelines, a widely accepted "best practice document" which ACC said guided how the pathway was formulated.
Rankin said Goodyear-Smith's research had set out to determine whether psychologists provided more effective treatment than less-qualified counsellors. He had been "stunned" when her research had not borne out their expectation that they would.
He said he had been aware of Goodyear-Smith's links to sex offenders and strong views, and for that reason stipulated "that I personally read what she said before we published it". He blocked a number of her recommendations. "We acknowledged the agenda and protected both herself and us against it," he said.
He did not feel her background disqualified her from objective research, stressing that the research was "numerical" and adding "most people researching in that area have got a bias one way or the other".
Green MP Kevin Hague said he believed the commissioning of Goodyear-Smith reflected the corporation's agenda to cut costs. "If it's a numerical analysis you want, the public health departments of our universities are packed with biostatisticians who could do that. Why would you choose the researcher with the most extreme view about the topic itself to do this neutral task?
"They used Goodyear-Smith because they knew she would recommend less treatment and less costs for people who had been sexually abused. That, to me, is a scandal."
ACC Minister Nick Smith said he couldn't comment on ACC's objectives in Rankin's time. But he insisted that changes to sensitive claims over the past 12 months had had nothing to do with cost-cutting, but focused on clinical care. He said an independent clinical panel came to the same conclusion. "There's been a lot of politics around trying to frame the debate around sensitive claims in context of bigger financial issues around ACC, but the paper trail and the involvement of the clinicians driving this makes it plain these are quite distinct."
He was "uneasy" about Goodyear-Smith's involvement, but had seen no evidence her work had influenced the pathway.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/national/4096892/Sex-abuse-cuts-all-about-costs

ACC adviser silent on links to sex abusers

An article from the Sunday Star Times by Tim Hume

Concerns are being raised over changes at ACC that denied sex crime victims access to treatment. Critics allege the changes were partly based on advice from an academic who is married to a sex offender.
Auckland University medical and health sciences faculty professor Felicity Goodyear-Smith was one of the authors of a 2005 paper on sexual abuse counselling funded by ACC.
She is the daughter-in-law of Centrepoint community leader and convicted paedophile Bert Potter. His son, her husband John, was jailed in 1993 on historic charges of indecent assault at Centrepoint. Her paper recommended a diagnosis of mental injury, as defined by the American Diagnostic and Statistical Manual, be made at the outset of treatment. Last year ACC accepted that criteria for those seeking support, denying hundreds of victims counselling and outraging counsellors, who said labelling sex crime victims mentally ill was stigmatising and unethical.
New Zealand Association of Psychotherapists' sensitive claims spokesman Kyle MacDonald said there were "obvious parallels" between the new rules and the research, and his group was opposed to Goodyear-Smith's involvement in ACC-commissioned sexual abuse research.
The mental injury diagnosis was not included in a 2008 Massey University guideline, a widely accepted document outlining best practice in the sexual abuse field, which ACC says guided its policy.
Last year's changes saw a drop in sexual abuse claims, prompting ACC Minister Nick Smith to set up a review panel that reports next month, but ACC has already reinstated 16 hours of counselling for victims.
Goodyear-Smith, who lived for years on Centrepoint land, working as the community's GP, is an outspoken critic of sexual abuse counselling, saying it can be as damaging as sexual abuse itself, and once telling a newspaper the "ACC scam's one of the biggest there is". She is the founder of a support group for men accused of sex crimes, and has acted for them in the courts and the media over the past 16 years.
Counsellor Barri Leslie – herself a former Centrepoint member – alleges Goodyear-Smith provides "an academic veneer" for attitudes similar to Bert Potter's. "It's outrageous she's been commissioned by ACC in the area of sexual abuse counselling," she said.
A special investigation in today's Focus outlines similarities between Bert Potter's and Goodyear-Smith's positions, including that not all sexual activity between adults and children is damaging.
ACC told the Star-Times last year it had not commissioned research from Goodyear-Smith but now admits it did. Smith's spokesman distanced him from the research, saying it occurred three years before he became minister, and that he had no information on the matter. "The minister does have concerns about the pathway and that is why he established the independent clinical review panel."
Goodyear-Smith would not be interviewed for the story.

© 2010 Fairfax New Zealand Ltd

http://www.stuff.co.nz/sunday-star-times/news/4072453/ACC-adviser-silent-on-links-to-sex-abusers

Conflicting interests?

An article from the Sunday Star Times by Tim Hume

Professor Felicity Goodyear-Smith is a senior academic and doctor who was commissioned by ACC to research sexual abuse counselling. She is also the daughter-in-law of Centrepoint guru and paedophile Bert Potter, is married to a convicted sex offender and has controversial views on the workings of the 'sexual abuse industry'. Tim Hume examines allegations of Goodyear-Smith's influence in ACC's recent drastic cut in support for victims of sex crimes.
Last October, ACC changed the rules governing the support available to victims of sex crimes, introducing a heavily criticised new regime that severely restricted access to counselling.
But what most concerned critics was an apparent similarity between a requirement in the new "clinical pathway", and a recommendation contained in research ACC had commissioned from a controversial senior academic. The research was led by Professor Felicity Goodyear-Smith, who has been a vocal detractor of the field of sexual abuse counselling and who, as the daughter-in-law of Centrepoint founder Bert Potter, has ongoing personal relationships with convicted child sex offenders.
During the eight months following the clinical pathway's introduction, ACC paid out $7 million less to 2889 fewer claimants than it had over the same period a year previous. Approved new claims, running at 1313 in the eight months prior to the pathway's introduction, subsequently dropped to 240 over the same length of time. Among the hundreds to have their claims denied were two women believed to have later committed suicide.
Despite a record $4.8 billion loss sustained by ACC the previous financial year, ACC Minister Nick Smith stressed the policy was not an attempt to cut costs, but was driven by a desire to implement best practice for sexual abuse victims, known as "sensitive claimants". Critics dubbed the new pathway a "rapists' charter".
The scheme's many detractors were primarily concerned by a new requirement that, before they could access ACC counselling and support, claimants had to be diagnosed formally with a mental injury as defined by the American Diagnostic and Statistical Manual (DSM-IV). Whereas previously, ACC might have accepted a GP or counsellor's description of symptoms such as flashbacks, panic attacks or nightmares resulting from a sex crime, now a formal diagnosis of a mental illness such as post-traumatic stress disorder was needed.
It's unclear exactly why. Nowhere was a DSM-IV mental illness diagnosis specified in the so-called "Massey guidelines", the widely accepted 2008 best practice manual which ACC had commissioned from Massey University researchers, and which it cited as having guided the formulation of the pathway ...

Click here to read more.

© 2010 Fairfax New Zealand Ltd

ACC has buckled to the crowd

A letter to the editor of the Dominion Post by Gordon Waugh

ACC has shamefully surrendered to the rants of a petulant sex-abuse industry and backed down over changes to the way claims are handled.
The legislation is clear. Cover for sexual abuse depends on a sexual crime having been committed and a consequent mental injury. Evidence of that crime is the starting point for claims. Mental injury must be correctly diagnosed. Those fundamental criteria are being conveniently ignored. In the absence of evidence of the claimed crime, every counsellor who submits a sex abuse claim to ACC commits the offence of using a document to gain financial advantage.Counsellors are unable to detect sexual crimes. Most cannot diagnose mental injury. But based on their amateurish beliefs, assumptions and claims of competence, ACC accepted more than 120,000 sex abuse claims in the past 20 years. That must stop.
ACC must stick to its legislative guns and ensure all sex-abuse claims are based on testable evidence of the claimed abuse and correct diagnosis of mental injury by genuine mental health professionals. Only then can appropriate treatment be provided.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/dominion-post/opinion/letters-to-the-editor/4049555/Letter-ACC-has-buckled-to-the-crowd

Sexual abuse treatment in shambolic disarray

An article from the Nelson Mail by Susan Hawthorne

"If this is supposed to be the gravy train, I'm on the wrong train." So said a colleague of mine about her experience of being part of the so-called "sexual abuse industry".
I echo her comments, applicable now to an even greater extent with the introduction last October of the New Pathway in the Sensitive Claims Unit of ACC. As a provider of treatment for injury from sexual abuse I am seen to benefit from this industry. It is, however, this experience which enabled me (and others) to predict with sickening foreboding likely developments if the proposed changes to the service went ahead. Every effort was made to warn the Minister of ACC, Dr Nick Smith, that the changes would be disastrous. He chose to rely on his policymakers, who appear to be pursuing ideological agendas which are favoured by this Government.
Chaos reigns in the SCU with staff overwhelmed, with therapists demoralised and many withdrawing their services, with potential clients left totally bewildered and lost. A tiny fraction of new claims only has been accepted since October. It has taken the independent review panel appointed by the Minister to intercede last week on behalf of clients to force the reinstatement of 16 hours to support each new claim. There is much confusion about who can submit claims, who can provide treatment or what will happen next if more sessions are needed. Apart from one media release, no further information has been forthcoming from ACC.
As ACC Minister, Dr Smith spent considerable time and energy blaming the previous minister for allowing policymakers to make apparently unwise property purchases and investments. Under his watch, the SCU has been all but destroyed.
Dr Smith has continued to claim that this process was begun under Labour. Indeed Massey University was asked to develop guidelines as a basis for therapy for treatment of sexual abuse. Under the current National Government, the guidelines were so badly misused that the authors of the report wrote to every newspaper in the country to distance themselves from the new pathway.
Dr Smith has repeatedly stated that "These changes are not about saving money." Presumably this is correct, as the result of deciding to require assessment for mental disorder for each new claim is that psychiatrists and psychologists have been flown around the country at vast expense to establish that the claimant is mentally ill rather than mentally injured. This gives each person accessing the service a mental diagnosis which goes with them for the rest of their lives. This policy still applies.
ACC is taking months to communicate decisions about whether they will or will not pay for sessions for clients in the system. Therapists face the dilemma of continuing to work at the risk of not being paid, or breaking our own ethical codes by stopping work with clients and leaving them feeling abandoned, isolated and unsupported.
For years now, sexual abuse clients have been specifically excluded from accessing mental health services because funding for their treatment was available though ACC. A proportion of our population has been abused, through no fault of their own and which untreated, can detrimentally affect them as individuals, as partners and as parents for the rest of their lives. The apparent overall plan under National is to cut back on social services to the community. Many such cuts are under the radar except for those people directly affected. More radical changes have been promised in their second term, should they win the next election.
Many therapists with specialist skills and years of experience in the treatment of sexual abuse have withdrawn their services and will not work for ACC again while current conditions apply.
Regrettably I am one of these. I am off the train.
(Susan Hawthorne is a registered psychotherapist, a member of the NZ Association of Psychotherapists, and a campaigner against injustice.)

© Fairfax New Zealand Ltd 2010
http://findarticles.com/p/news-articles/nelson-mail-the/mi_8062/is_20100821/sexual-abuse-treatment-shambolic-disarray/ai_n54911803/

Sunlight is the best disinfectant

An article from Beehive Chat by Tariana Turia

Last week's announcement by ACC to provide up to sixteen counselling sessions to sexual abuse survivors while their claim is being dealt was welcome news. Last year ACC implemented a new policy that required people subjected to sexual abuse to prove they had suffered a mental injury before they would pay for counselling.
I cannot think of a worse ordeal for anyone who has endured the life-changing crisis of sexual abuse, to have to then prove that it had affected their mental health and wellbeing. And so I am not at all surprised that when the Clinical Review Panel looked into the impact of the policy changes, they found that only half as many victims of sexual assault are applying for ACC support this year compared to last. But if that is not bad enough, many who do apply are declined or face significant delays in getting support. Fliss Newtown's comments in this newspaper over the weekend that she is receiving two new enquiries a week from sexual abuse survivors is consistent with other reports I have received over the motu.
A World Health Organisation study in 2007, found that one in four New Zealand girls is sexually abused before the age of fifteen, the highest rate of any country studied. The rate is even higher for Maori women and for women with disabilities. And yet despite the high rates of prevalence, sexual abuse is still something that society fails to recognise as being significant.
Sexual abuse has devastating impacts on the lives of far too many New Zealanders. It decimates your confidence, it can destroy your faith and trust in others, it literally throws your life out of balance. Childhood sexual abuse has been shown to effect educational chances; the impacts are played out in courtrooms and prison cells and hospital beds and drug and alcohol treatment units and psychiatric institutions.
I am pleased that ACC has recognised the importance of providing immediate support for sexual abuse survivors but we cannot put all the responsibility on Government agencies to fix this problem. Quite simply ACC is the ambulance at the bottom of the cliff.
Of course Government must ensure we have quality services available and effective programmes to provide immediate support for individuals and whanau dealing with sexual abuse. But most importantly we have to look in our own backyard and be sure that we are doing everything we can to ensure the safety of our own family and community. It is unacceptable to know that sexual abuse is going on and to do nothing about it.
I know that for families facing this issue, the road to creating a safe environment is long and fraught with so many challenges. But we must mobilise public support and attention to ensure we bring it out into the open. As they say, sunlight is the best disinfectant. The bright light of scrutiny and openness enables all of us the opportunity for change.

© 2010 Maori Party
http://www.maoriparty.org/index.php?pag=nw&id=1216&p=beehive-chat-sunlight-is-the-best-disinfectant-hon-tariana-turia.html

A needed correction

An editorial from the Southland Times

A storm of reproach has rightly prevailed and ACC's shabby cutback of sexual abuse counselling has been reversed, writes The Southland Times in an editorial.
The idea that only victims with a diagnosed mental injury resulting from sexual abuse or assault should be covered for the counselling drew compelling criticisms from victim advocates. These simply could not be rejected as the self-serving whines of vested interest groups. Rather, they were an emphatic message from seasoned clinicians and were endorsed by an independent panel appointed by minister Nick Smith.
ACC portrays the backdown as, in effect, evidence that it can listen and react to a strong case. Dr Smith, to some extent, can portray it as a case of him intervening usefully.
It's arguable that some encouragement can be taken from this for the southern campaign against the proposal to strip Dunedin of its neurosurgery unit, which is also at the "minister's panel" stage. Certainly the case is no less strong.
What we now have, with ACC, is a stopgap provision by which up to 16 hours' counselling will be available for victims of rape and other sexual abuse "sensitive claims". The panel's final report isn't due to be released until the middle of next month and something more permanent may result from that. Popular opinion is that it better.
This doesn't exactly take the heat off Dr Smith, however. He says he was concerned when he saw an increase in claims being turned down and that the Government had not asked for cuts in the sensitive claims area. Of course it hadn't. Governments hardly ever do anything as plain as saying "do less for victims of sexual abuse".
What they do, as many a health board can attest, is make more generalised requirements for funding cutbacks that leave the boards to make the sharply focused decisions like this, and then cop the criticisms.
In cases such as this, the Government gets to wade in like this and insist that, well, obviously, this wasn't what it had in mind. There really is a short distance politically, from an instruction that is no more detailed than the ridiculously generalised Nike slogan – "just do it" – to the outraged specificity of a "you did what"? And sure enough, Dr Smith says ACC handled this matter badly.
Now opposition parties, notably the Greens, are fully entitled to say other changes that ACC has made should also be given pointy scrutiny by independent reviews.
Such reviews would be rather spoilt for choice. Not so much the decision to push the date by which ACC is fully funded back five years to 2019, which is widely accepted as sensible, but sore changes to the work assessment regime, the diminished entitlements for seasonal workers and the tougher standards before people can get hearing aids. Less likely, purely for populist reasons, is that there will be a revisitation of the decision taking away compensations for criminals in jail.
But surely there can be a rethink of the notion that the families of suicide victims might need ACC help. Given, as we have lately been reminded by the Chief Coroner, that the suicide rate is far worse than the road toll, it doesn't take much of an imaginative leap to see a real need, if not in all cases, then certainly a substantial number, for some practical assistance to be given. And by the State.
The suspicion that ACC is being privatised by stealth still lingers.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/southland-times/opinion/4024289/A-needed-correction

ACC reverses sex abuse decision

A news report from the NZPA

Victim advocates are relieved to see a reversal by ACC on its decision to cut funding for sexual abuse counselling, but the Greens say independent reviews should also follow other changes the Crown organisation has made.
Last October ACC cut counselling for victims of rape and other sexual abuse "sensitive claims", and funding was restricted to those with a diagnosed mental injury resulting from sexual abuse or assault, sparking outrage and protests from victim advocates. But it back-tracked yesterday and said from next week people with a new ACC sensitive claim, or with a new claim already in the system but awaiting a decision, would be able to access up to 16 hours with a counsellor.
ACC said the decision was made after concerns were expressed and followed advice from an independent panel appointed by ACC Minister Nick Smith to review the sensitive claims pathway in light of advice he had got from clinicians.
Dr Smith said the 16 hours was an interim provision, and a long-term plan would be made after the final report from the panel was released in mid-September. He said while he had been careful not to interfere with what was a clinical matter, he didn't think ACC had managed the issue well.
The Mental Health Foundation, Human Rights Commission and National Council of Women NZ (NCWNZ) all expressed relief over the u-turn today, although the organisations have raised questions as to whether the 16 hours will be enough for some victims.
NCWNZ national president Elizabeth Bang said the situation showed how critical it was to test new policy approaches before rolling them out. She said savings made during the nine month "experiment" would no doubt be spent on an envisaged influx of claimants. "Again, ACC will need to ensure they have sufficient staff on deck to manage the opening of the flood-gates," Ms Bang said.
Green Party ACC spokesman Kevin Hague said the u-turn "strongly suggested" that all changes ACC has made to its cover, entitlements and assessment criteria needed to be independently reviewed. "An independent review is needed to ensure ACC is doing its job and not causing re-victimisation of accident victims," Mr Hague said. He said Dr Smith had introduced other changes to ACC over the past two years which were not supported by evidence.
Labour's ACC spokesman David Parker said it was unacceptable that Dr Smith was pointing the finger at the ACC board over the sexual abuse funding issue. "The minister was repeatedly and clearly warned by clinicians and the Labour Party that his changes were so obviously wrong. Why have a minister if he will not take responsibility in the face of prior warnings?"

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/national/politics/4018575/ACC-reverses-sex-abuse-decision