Tag Archives: sexual abuse

As advertised

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Late last year, when the ACC ructions were underway, the professionals working in the sector warned that people would die as a consequence of the reforms mandated by the new Clinical Pathway on the assessment and treatment of sexual abuse victims.

Since then, and on the basis of the pathway, ACC has taken to declining claims despite publicly claiming consistently throughout the past six months and as recently as today that there was no cost-cutting imperative. This has resulted in a drop of more than 90% in the number of claims approved year-on-year. Explain that, if you can. Nick Smith couldn’t, though he tried to do so during Question Time. It has also caused a chilling effect in which people are simply not applying, since they’d have to undergo the trauma of the exhaustive documentation and excessive review required by the pathway only to have their claims declined.

It’s impossible to separate these reforms from the overarching government plan to privatise — partially or wholly — ACC, and when viewed in this light it becomes clear what’s going on: this is how insurers make their profits. And, just lilke it said on the box, people are dying. It’s a good thing there’s going to be a review, but what’s better is that the sector is organising their own review in parallel. Should make for an interesting compare-and-contrast. I am aware that certain senior National party MPs are aghast at the conduct of ACC, so there may begin to emerge some pressure from within the party for change, as well as from outside. We’ll see.

L

ACC: tell ’em

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I have received the following communique originated by NZ Association of Psychotherapists member Kyle MacDonald; an easy means for you to tell the Minister for ACC what you think about sexual abuse recovery rationing:

Grass Roots Political Action, a step by step recipe.

“The death of democracy is not likely to be an assassination from ambush. It will be a slow extinction from apathy, indifference, and undernourishment.”
— Robert M. Hutchins

  • Time required: 10 minutes.
  • Ingredients: Four pieces of A4 paper. Two envelopes.
  • Method: go to Kyle’s website www.psychotherapy.org.nz and click “Grass Roots Political Action: A step by step recipe”.
  • Select which Minister, and print one out for Pansy and one for Nick.
  • Read the letter; react and critique.
  • Insert your details into the angle-brackets. Change the wording to your heart’s content; the more varied the letters the better!
  • Print, and sign.
  • All mail to Parliament is free, so simply pop in an envelope!
  • Bask in the glow of flexing the democratic freedom you are lucky enough to possess, and pass both the word, and this email, on to everyone who you can possibly think of…

Update: There’s also a petition, for what that’s worth.

Grass Roots Political Action Part II – Gather Support.

“In a democracy dissent is an act of faith. Like medicine, the test of its
value is not in its taste, but in its effects.”
— J. William Fulbright.

Dear friends, colleagues and supporters of counseling and therapy in
Aotearoa New Zealand,

Many of you will now be aware of attempts by ACC to change the Sensitive
Claims Scheme which provides counseling to victims of sexual assault and
abuse. These changes are being rushed through with inadequate consultation
and the professional organizations representing the providers of this
treatment have been lobbying parliament to stop the changes.

Now there is something you can do to help! Follow this link to an online
petition and sign up to show your opposition to the proposed changes.

http://www.petitiononline.com/ACC0909/petition.html

Please also circulate this petition as widely as you can to friends, family,
colleagues, clients and your professional networks. The aim will be to
present this to The Minister for ACC Hon. Nick Smith prior to the 12th of
October.

Thank you for your time,

Kyle MacDonald
Psychotherapist

There. Easy.

L

Sexual abuse recovery rationing by the ACC

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This morning the New Zealand Association of Psychotherapists delivered an open letter to the Minister for ACC asking him to explain and justify the proposed changes to ACC’s sensitive claims policy. This issue was covered by Anjum last week and is now picking up steam.

Briefly, the proposals (which are due to come into effect in September) would change both the nature and amount of entitlement of treatment to which sexual abuse or assault victims are entitled. The changes represent a move from a therapeutic model mostly operated by psychotherapists and counsellors to a symptom-management model mostly run by the mental health system. Victims’ entitlement to treatment will generally be reduced to a maximum of sixteen hours, essentially meaning that many victims of the most severe abuse will not be fully treated. In addition, victims will need to explain themselves to as many as three different assessors in order to access this limited treatment, with each assessment a form of revictimisation. As if that wasn’t enough, knowing that many cases simply will not be treatable in the mandated 16-hour timeframe, some psychotherapists have indicated that they will refuse on ethical grounds to begin the work, knowing that they cannot finish it, on the basis of the ‘first, do no harm’ principle which underscores their practice as clinicians.

This means the already-high barriers to effective treatment of sexual abuse trauma are about to get higher. In effect, they are being rationed so as to exclude the ‘worst’ cases who require the most work (and therefore the most cost) to treat. However the revictimisation of repeated assessments and the uncertainty of treatment form a strong disincentive – not wanting to open a wound without being sure it can be closed, many people will simply not seek treatment, and many counsellors will simply not be able to provide it on ethical grounds. This chilling effect will lead to sexual abuse being pushed further underground and the problem fading from the public view to a greater extent than it already is, with potentially catastrophic long-term social consequences. At last count, sexual abuse cost NZ about $2.5 billion per year including the costs of crime, imprisonment, drug and alcohol, other health issues, unemployment and the cycle of abuse which an absence of treatment sustains. For the cost of a few million dollars in treatment, how much will that be allowed to increase?

The most absurd thing is that these are cuts to front-line services for victims of serious crime; the very thing the government said it would be increasing. ACC’s Sensitive Claims Unit costs $30m or so annually to deliver $20m of front-line services, and these cuts will shift that balance much further toward the back-office by relying more heavily on already-overworked case managers and the top echelons of the practice – psychiatrists and clinical psychologists who currently do 10% of the work – rather than the relatively cheap and numerous psychotherapists and counsellors who do the other 90%.

For the inevitable conspiracy theorists, this also isn’t a matter of psychotherapists feathering their nests – for most, ACC work is a small part of their practice, and not an especially lucrative part of their practice, since most can charge (much) more on the open market than what ACC will pay.

Expect this to be a fairly big deal in the coming weeks. It is an issue which is deeply embedded in many policy fields: justice, victim’s rights, human rights, child abuse, crime, drug and alcohol abuse and mental health are just a few. It’s not going away, because sexual abuse is not going away.

L

Disclosure: I was involved to a small extent in the process around this open letter. I have family members on both ends of this issue – both providing and receiving treatment. You probably do, too, even if you don’t know it.