Mental Health Healthcare Needs Assessment for Survivors of Sexual Assault and Abuse

Task 

Sexual assault and abuse are among the most serious and damaging crimes in our society. Recent national and global events, particularly investigations into widespread historical abuse, have shone a light on these crimes and their impact on survivors. Yet despite this increasing societal focus and prioritisation within the Government agenda, it is still difficult to evaluate the level of need, with only an estimated 16% of sexual offences being reported to the police.  

Women are as much as four times more likely to be victims of sexual assault than men, with those aged 16 to 24 more at risk than other age groups, regardless of gender. Survivors experience a wide range of serious consequences, from physical injury to long term trauma, with connections between sexual assault and abuse and lifelong mental health issues. Up to 70% of survivors may already have an existing mental health condition, and around 30% of survivors may require some level of support. 

Nationally, sexual assault and abuse support services are commissioned by a wide array of organisations, creating confusing referral pathways. This coupled with the fragmented landscape of services, long waiting lists, and lack of longer-term support all contribute to poor outcomes for survivors and their families, creating barriers which can exclude individuals from accessing the urgent support they need.  

As a result of COVID-19, services have been hit by a ‘perfect storm’ of increased demand and funding cuts. In July 2021, due to increasing demand and limited funding, West Mercia Rape and Sexual Assault Support Centre (WMRSASC) made the decision to close their waiting list for counselling services for external referrals for both adult and children and young people survivors of sexual assault and abuse, attracting local media coverage. West Mercia PCC, NHSE, Worcestershire County Council, Herefordshire County Council, and Herefordshire and Worcestershire CCG committed to work collaboratively on a longer-term sustainable solution based on findings from a Mental Health Healthcare Needs Assessment (MHHNA) for survivors of sexual assault and abuse, which was later extended to cover the whole of West Mercia. 

By assessing the mental health needs of survivors of sexual assault and abuse, referral processes, existing provision, and current best practice, this project aimed to empower commissioners with the evidence needed to improve decision making and the future planning, commissioning, and improvement of services. 

TONIC’s Approach 

With the help of local partners, support services, and social media, between November 2021 and January 2022, TONIC engaged with over 400 survivors, family members, mental health professionals and service stakeholders through a combination of online surveys, data collection, literature review, interviews, and focus groups. This generated a rich picture of quantitative and qualitative data highlighting the needs and experiences of local people who use services and those who deliver them.  

Together findings gave a strong message of the need to overhaul the way specialist support services are funded, if demand is to be met. Through Thematic Analysis techniques designed to compare and contrast qualitative findings, key themes emerged that confirm the scale of challenges facing both survivors and support services. Along with best practice around assessment of need, referral pathways, type of therapeutic and peer support, and multi-agency partnerships, these themes informed the recommendations resulting from this assessment.  

Outcome 

TONIC produced a comprehensive report, a table detailing specialist sexual assault and abuse counselling provision across the whole of England and Wales, and presented the findings along with system-wide and service-specific recommendations to the steering group.