Preventing sexual abuse is a public health issue

We are in a time when the focus on allegations of sexual abuse is intense. Accurate and comprehensive statistics on the prevalence of sexual abuse remain elusive, but the figures that do exist indicate sexual abuse is widespread. Up to one in five adult women, and one in 20 children have been sexually abused. Adult men are also victimised, with figures from the Crime Survey for England and Wales showing on average 72,000 men a year are victims of a sexual offence.

We have been working in this field for more than ten years, researching the experiences of victims, perpetrators, professionals and those at risk of committing abuse. From this vantage point, the time is right to revise our approach to sexual abuse that focuses less on the criminal justice system response (though that remains important), and more on sexual abuse as a public health issue.

Put another way, we could see sexual abuse as a disease that affects society. It can lead to long-term problems for individuals affected. Substance misuse, depression, suicidal ideation, are just some examples of this. Looking at the prevention of abuse from a disease perspective requires a focus on three groups: actual or potential perpetrators, victims and their families, and ourselves, the public.

Perpetrators

Multi-Agency Public Protection Arrangements were in place for more than 40,000 people registered as sex offenders in England and Wales in 2012.

On this scale, of course we need a criminal justice system response, but also provide appropriate and effective treatment to those who are convicted for sexual offences. The focus must also be on how to prevent these offences occurring in the first place by providing support to those concerned about their own sexual thoughts and behaviour before they become offenders.

We are currently evaluating the Stop It Now! Campaign in the UK, which offers advice to those who are concerned they or someone they know may sexually abuse a child. It also supports families and partners when sexually harmful behaviour is identified. It is hoped this approach could be adopted across Europe, and we are working with project partners from Germany, Finland and the Netherlands to identify ways in which to reach potential sexual offenders effectively. Prevention is essential, from work with offenders, to those who are concerned that they may offend.

Victims

We must always ensure the needs, rights, and voice of victims/survivors of sexual abuse are heard. Victims ultimately want to prevent sexual abuse happening to others. One of our recent studies with victims (or survivors as many prefer to be called) and the public was undertaken on behalf of the Sentencing Council for England and Wales. Some people that we spoke to accepted that, once in prison and where it works, treatment should be offered to offenders in order to reduce the chances of re-offending.

We know from our separate study of sexual offenders against children that many regard Cognitive Behavioural Therapy as enormously helpful in enabling them understand what led them to commit their crimes, come to terms with what they have done, and make better choices in the future.

While it may be beneficial for some offenders to receive psychological and behavioural support, it is only right that victims are equally supported. Indeed we know that the extent to which they have access to advice during the investigation and judicial process greatly influences their satisfaction with the outcome once the case ends. Significant steps have been taken to address these issues in recent decades, yet victims’ experiences still vary greatly.

As the victims we work with make clear, their needs do not stop along with the court case and some do not wish to report the offence: they should be able to access long-term counselling whatever their circumstance. Across the country budget cuts are leading to the closure of services for victims, and as media focus on sexual abuse continues unabated the number of victims coming forward and seeking support increases. Rape Crisis, for example, has a waiting list to provide counselling despite their best efforts to expand and meet need as more and more people come forward seeking support for abuse that may have happened many years ago, or yesterday.

Again if we see sexual abuse as a public health concern, we must ensure that appropriate, effective treatment to reduce symptoms and help people fully recover are available across the country. We know from our research with survivors of abuse that this support needs to be long-term, intensive and consistent for it to be effective. This is not a quick fix.

Bystanders

There is a third element to this too, which touches on the responsibility professionals have to report abuse, and also the role we all can play in preventing and responding to sexual abuse. The Savile case and others currently in the media has cast light on opportunities that were missed by people and organisations to intervene.

Passive acceptance does not help. Nor does the demonisation of sexual offenders; this means we cannot see them when they are people we trust or know. We can educate ourselves and others on the risk factors to look for, we can listen to victims when they try to disclose abuse, and challenge behaviour we do not think is appropriate. It may be difficult, but we must try to help sexual offenders integrate back into society so they can make a positive contribution, not just revile them. We must all also bear the responsibility for preventing abuse and doing all we can to help victims or those at risk.

We need a responsible, open discussion that acknowledges the part we all can play, not to just stand by watching each story unfold.

This piece was authored by Carol McNaughton Nicholls, Director of Crime and Justice at NatCen Social Research, & Stephen Webster, Senior Research Director at NatCen Social Research.
    
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