Historical Abuse Policy

Read alongside

Protection of Vulnerable Adults Policy

Safeguarding Children Policy

1.0 Purpose

1.1 This policy covers situations where a patient may disclose to a member of Clinical Partners team or their clinician that they were abused as a child.

1.2 Whether the abuse happened once or hundreds of times, a year or 70 years ago, whatever the circumstances, these allegations must always be taken seriously.

2.0 Aim

2.1 The aim of this policy is to ensure that appropriate action and support is provided to the patient.

2.2 That when required steps are taken to ensure that the alleged perpetrators do not pose a risk to other people.

3.0 Scope

3.1 This policy covers all staff and clinicians.

3.2 This policy should be read alongside the documents listed above.

4.0 Effects of historical abuse

4.1 The impact of a child can last a lifetime. Abuse can have a huge effect on a person’s health, relationships and education and can stop them from having the childhood and life they deserve. Many might find it harder to cope with life's stresses, getting a job or being the type of parent they want to be. Some may also develop mental health problems and drug or alcohol issues.

4.2 The effects can be short term but sometimes they last into adulthood. If someone has been abused as a child, it's more likely that they'll suffer abuse again. This is known as revictimisation.

The long-term effects of abuse and neglect can include:

• emotional difficulties like anger, anxiety, sadness or low self-esteem

• mental health problems like depression, eating disorders, self-harm or suicidal thoughts

• problems with drugs or alcohol

• disturbing thoughts, emotions and memories 

• poor physical health

• struggling with parenting or relationships.

5.0 Options for response

5.1 There is growing evidence that a disclosure on nonrecent abuse may reveal current risks to others from the perpetrator. Everyone in Clinical Partners has a duty to safeguard clients and the public. Some high profile cases have now shown the potential extent of abuse by one person.

5.2 In all cases

• A client’s allegations should be taken seriously, regardless of their presenting problems or mental health diagnosis.

• All staff and clinicians need to be alert to the possibility that abuse may be organised, severe and complex.

• It is always best practice to share information with the client’s knowledge and consent.

• In exceptional circumstances it may be necessary to breach the client’s confidentiality either with or without their immediate knowledge and consent. This could be the case where there are significant risks to the client’s psychological wellbeing; where the alleged perpetrator may be a current risk to others; or there is risk of jeopardising a potential investigation.

• Any decision to breach confidentiality cannot be taken lightly, but can be justified and accounted for if made in good faith because of safeguarding concerns. These decisions will be made by the safeguarding lead for Clinical Partners.

Triage or non clinical staff

5.3 Whilst it is not expected that on a triage call the patient will disclose historical abuse staff should be aware of what to do.

• Make notes recording the time and copying verbatim what the client tells you.

• Try to ascertain if this abuse was ever reported.

• If the abuse was reported make a note and inform the clinician.

• If the abuse was not reported the risk of the perpetrator abusing others should be ascertained for example, are they still alive, where do they work. This should be done sensitively.

• The adult making the disclosure should be asked whether they want a Police investigation and should be advised of the Police's role in investigating matters of abuse with adults who are vulnerable because of mental health or learning difficulties.

• Professionals should be aware that if the person reports the matter to the Police, any notes taken by the professional may be subject to disclosure and/or a witness statement required. This ‘evidence of first complaint’ is an important evidential issue for sexual abuse cases. It is critical to handle these situations as sensitively as possible.

• Where the alleged perpetrator can be identified because details such as name, date of birth/age, address etc are known, this information should be reported to the Police. If the alleged perpetrator is known to currently have contact with children, then in addition this needs to be reported to Children’s Services. If the adult disclosing sexual abuse refuses to consent to share information with the Police, then duty to safeguard children will necessitate the need to share with Children’s Services with or without consent.

• If possible, the member of staff to whom the disclosure is made should establish if the adult is aware of the alleged perpetrator's recent or current whereabouts and whether they continue to have contact with the alleged perpetrator and if they are aware if the alleged perpetrator has any contact with children.

• Report on SalesForce so the safeguarding lead will be notified.

Clinicians

5.4 Clinicians are responsible for safeguarding people in addition to accessing what effect the alleged abuse may have had on their mental wellbeing and proposing treatment and support.

5.5 The GMC advises that all adult safeguarding processes and laws in the UK say that safeguarding procedures must be person-centred and must take account of the views and wishes of the adult concerned. Safeguarding is not something that is ‘done to’ a person and the steps you take will usually be agreed with your patient, in line with local safeguarding processes. 

5.6 Challenging situations can however arise when confidentiality rights must be balanced against duties to protect and promote the health and welfare of patients who may be unable to protect themselves, and who refuse offers of help.

5.7 If you are faced with this situation, and there are no legal requirements to disclose information, ask yourself the following questions.

• Do they have capacity to decide whether to accept help?

• Is anyone else at risk of serious harm?

• Could disclosure be justified even if no one else is at risk of harm?

5.8 RBPS informs its members that not sharing concerns beyond the consulting room could mean that other children and young people could be at risk. In addition to the above they also advise

• Assessments should always be thorough, and detailed assessment of information is paramount in such cases.

• The lack of access to children identified through familial relationships, work or volunteering roles should not eliminate concerns about risk, given opportunities for abuse to occur within communities.

• It is crucial that practitioner psychologists seek advice from colleagues, particularly colleagues in safeguarding services, Clinical Partners Safeguarding Lead and also from other agencies tasked with leading on safeguarding (i.e. social service.

• Practitioner psychologists should use regular supervision to ensure their own wellbeing when working with complex cases.

6.0 References

https://www.bps.org.uk/guideline/guidance-management-disclosures-non-recent-historic-child-sexual-abuse-2016

Adult safeguarding