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

Sensitive claims

An editorial from the Otago Daily Times

Unless it is a statistical blip, evidence points to procedures within ACC's Sensitive Claims Unit having radically altered.
Figures show 32 sexual-abuse claims for counselling were approved in the first two months this year, compared with 472 in January and February 2009.
That is not far off a tenfold decrease.
And, on Monday last week, ACC Minister Nick Smith announced the way the corporation managed the claims of sexual-abuse victims was to be reconsidered.
To this end, he named a panel to undertake a "clinical review to ensure best possible practice in this sensitive area".
It is, of course, possible that the figures for 2009 were uncharacteristically high, or perhaps amplified in some way shape or form, but - much as it would be desirable - it is almost impossible that a dramatic fall-off in actual instances of sexual abuse a year later could account for such a wide discrepancy.
The conclusion must be that changes to the way in which ACC handles such claims, introduced in October last year by Dr Smith, have been responsible for the drop.
On the one hand, this will undoubtedly be helping to meet the savings of which the minister has made something of a mantra; on the other, it could mean that the changes have been "overcooked", laying the minister open to charges of callousness and injustice.
Labour's ACC spokesman, David Parker, was quick to oblige in this respect, saying that Dr Smith had "failed victims of sexual crimes".
Dr Smith firmly rejects a fiscal motive, insisting that the changes were never about "cost savings" and that he has "repeatedly stressed to the corporation that the focus must be on delivering to victims of sexual abuse or assault . . . the best help available to achieve a timely and successful recovery."
This much is politics.
In fact, it appears the guidelines were developed and launched in March 2008 under the previous Labour-led government.
What is less clear is the extent to which these were then altered or finessed under Dr Smith's purview.
Regardless, there were certainly warnings from the counselling professions before the introduction of the changes last year that they were poorly conceived and potentially dangerous to victims.
Notwithstanding an inevitable degree of self-interest in such protestations, valid points were made at this time.
Among these was perhaps the critical intervention that every client have a psychiatric diagnosis to determine "mental injury" and thus eligibility for ACC-funded counselling.
There are, of course, victims who might struggle and require help in the aftermath of sexual abuse who do not show the precise symptoms of recognised psychiatric diagnoses such as depression, anxiety disorders or post-traumatic stress disorder who might previously have qualified but who under the new regime now do not.
This will be a profitable area of study for Dr Smith's new panel, which will want to establish guidelines that strike a balance between a necessary degree of rigour in assessing the validity of claims but also make sure that genuine cases receive appropriate care.
The announcement of the review comes on the heels of publicity concerning the possible privatisation of some ACC provisions - a motive long ascribed to the Government by its critics, who suggest that any such move would be to the benefit of the mainly Australian insurance companies likely to be involved, and to the detriment of ordinary citizens, particularly the elderly, who tend to claim most and be hit hardest by age-related premium increases.
These are familiar objections and pay little heed to the constant necessity to find new ways of managing the burgeoning costs of ACC.
There is nothing wrong with private provision in and of itself - indeed it should be looked into - as long as it can be shown that it works to the benefit of New Zealanders.
Following an interim report by the ACC Stocktake Steering Group on such matters, Dr Smith may now have such evidence.
If that is the case, he is in a position to silence critics by sharing it with the employers, taxpayers and wage-earners of the country for whom the system is ultimately designed.

http://www.odt.co.nz/opinion/editorial/104370/sensitive-claims

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Question for written answer

7214 (2010). Lynne Pillay to the Minister for ACC: What was the total cost of sexual abuse counselling provided in each calendar month of 2008 and 2009 and 2010, by region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached tables, which show net amounts paid for counselling for sensitive claims clients by month, broken down by the region where the event occurred, for the 2008 and 2009 calendar years, and for the 2010 year up to March. Please note that counselling costs include cover determination services, Psychological and Psychiatric services and assessments, and other related assessments. These costs represent only part of the expenditure for clients with sensitive claims.
http://www.parliament.nz/en-NZ/PB/Business/QWA/1/5/5/QWA_07214_2010-7214-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Sexual abuse survivors to challenge ACC changes

An article from the New Zealand Herald by Elizabeth Binning

A group of sexual abuse survivors plan to send Accident Compensation Minister Nick Smith a strong message this week through a silent protest over changes to subsidised counselling which they say are putting lives at risk.
One of the women, who was subjected to years of abuse by her then boyfriend, said counselling had been a lifeline, allowing her to start living her life again.
But with that lifeline now under threat following changes to ACC funding for sexual abuse victims, the woman is struggling and slipping back into a depression it had taken years to break out of.
"I can't go to see my counsellor at the moment because I can't afford to pay," said the young woman, who has been told she will have to wait until her case is reviewed before ACC decides whether she is entitled to any more counselling.
"I really do need to see her to ground myself and get some perspective, but it hasn't happened for three weeks ... Now it's too much - I'm crumbling."
The woman, a member of a group called Courageous Women, is one of dozens who will this week make their views and struggles known in a silent protest during Rape Awareness Week.
The members have all signed and written messages on T-shirts which will be taken to Wellington and given to Dr Smith by anti-rape advocate Louise Nicholas. Some of the women outline in their messages what counselling means to them and how the changes will affect them.
The new rules stipulate ACC-subsidised counselling is only for victims with a diagnosed mental condition caused by sexual abuse, and is generally for 16 weeks, subject to further review.
Another victim joining the silent protest is the Pukekohe woman who was subjected to a 4-hour sex attack when Roger Kahui invaded her home.
She said counselling had helped her through her darkest times, especially the court trial in which she not only had to be in the same room as her attacker again, but relive everything he had done to her.
She said that at times she was so depressed she had considered driving her car into the median barrier to end it all, but counselling had helped her get through the process.
She said it was unfair the new system would not make things so easy for future victims.
"What bugs me more than anything is these guys who did this are in prison getting 'rehabilitation'. Here we are having to beg to get counselling. It's so unfair."
The woman said sexual abuse victims were not like others who were able to protest in public. Many struggled even to get out of their homes following their ordeals. A silent protest was, however, one way of getting their message across.
Courageous Women facilitator Tania Blomfield said her role had significantly changed since the impact of the ACC changes started filtering down.
"I now spend a lot of time each month providing crisis support to group members who are not coping, who are self-harming or who are suicidal. This sort of crisis situation was previously dealt with by their counsellors."
The Herald revealed last week how a South Auckland mother died four days after her claim for ACC-funded counselling was rejected on the grounds that she had not suffered "a significant mental injury".
Dr Smith announced at the time that there would be a review of the new rules.

http://www.nzherald.co.nz/politics/news/article.cfm?c_id=280&objectid=10642370&pnum=0

ACC denies subsidisation of counselling for rape victims due to lack of “mental injury”

An article from Nexus by Hollie Jackson

The new rules regarding ACC-subsidised sexual abuse counselling has hit rape victims hard across the country. Now, in order to acquire funding for counselling, the victim must first be diagnosed with a mental condition caused by sexual abuse.
In February this year, a South Auckland mother of three died four days after her submission for ACC-subsidised counselling was denied. She had applied for help six months beforehand for sexual abuse she had suffered as a child, but was denied because she had not suffered “a significant mental injury”. She had reportedly suffered from suicidal tendencies and self-inflicted harm due to the sexual abuse.
Another victim, a 15 year old girl, is still awaiting a decision on her claim for counselling after she was raped over Christmas. The Association of Counsellors' representative on the ACC's sensitive claims advisory group, Elayne Johnston, said the girl hadn’t received counselling because ACC required her to be assessed by a psychologist to see whether she had suffered “a mental injury”.
ACC Minister Nick Smith announced last Monday that the new rules will be reviewed by a four person panel for efficiency. According to Dr Kim McGregor, the co-chair of the national sexual violence network, the four person panel fails to include any one of their “specialist experts that work day to day with survivors of sexual violence”.
Approved submissions for ACC-subsidised sexual abuse counselling has gone down from 472 in the first two months of last year to only 32 in the same period this year. Dr McGregor said almost all of the 600 to 700 private counsellors who were registered for ACC-funded work had also stopped taking applicants for ACC subsidies because of an ethical objection to labelling assault victims as mentally ill.

http://www.nexusmag.co.nz/news/acc-denies-subsidisation-counselling-rape-victims-due-lack-%E2%80%9Cmental-injury%E2%80%9D