Abstract
About the Royal Commission
The Royal Commission into Institutional Responses to Child Sex Abuse has been established by the Australian government to investigate where systems have failed to protect children, and make recommendations on how to improve laws, policies and practices to prevent and better respond to child sexual abuse in institutions.
Institutions include any private, public or non-government organisation that is, or was in the past, involved with children, including government agencies, schools, sporting clubs, orphanages, foster care, and religious organisations.
The Chair of the Commission is The Hon. Justice Peter McClellan. There are five further Commissioners including Professor Helen Milroy, a Consultant Child and Adolescent Psychiatrist. The Commission will prepare an interim report by no later than 30 June 2014.
Relevance to RANZCP
This is a major inquiry and particularly pertinent to psychiatry, given the significant links between child sexual abuse and developmental and mental health problems.
Suffering abuse in an environment designed to offer protection can have devastating effects for the victim, and leave them vulnerable to psychiatric disturbance and impaired development, which also results in significant social and financial costs. Feasible and effective measures should be undertaken to prevent such abuse from occurring. Psychiatrists have a critical role in identification, reporting, assessment and treatment of victims of child sexual abuse, many of who are initially referred by general practitioners and others following deliberate self-harm, behavioural disturbances, alcohol and drug abuse, depression and post-traumatic stress disorder (PTSD).
The RANZCP has a significant interest in ensuring optimal mental health outcomes for all victims of abuse, and in preventing such abuse from occurring.
RANZCP process for developing a response
The RANZCP Board has appointed the Faculty of Child and Adolescent Psychiatry (FCAP) to lead the College response to the Commission, with appropriate and extensive consultation with other relevant College committees. This was discussed at the Members’ Advisory Council on 26 October 2013.
The RANZCP is developing a comprehensive response based on the terms of reference of the inquiry to inform the Royal Commission interim report, due for publication by June 2014. This will focus on two major areas:
alleviating impact of abuse; and
better protection in future.
To develop this response, the FCAP has established a working group of members covering child and adolescent psychiatry, forensic psychiatry, and psychotherapy.
This work will involve undertaking scoping and research into what policy, administrative and legislative changes are required to help prevent child sexual abuse in institutions, and make recommendations for treatment of those who have been abused. This will include reviewing similar inquiries in different countries.
In addition to a more general response, the RANZCP is monitoring the release of issues papers from the Royal Commission and responding to those of relevance. A comprehensive submission was made in response to the discussion paper Preventing sexual abuse of children in out-of-home care.
Children in out-of-home care
A key focus for the RANZCP is children in out-of-home care. Children in out-of-home care are particularly vulnerable to mental health problems, and the RANZCP has previously developed reports, guidelines and submissions for children at risk of abuse.
In its submission to the Royal Commission the RANZCP made representations for:
increased monitoring, evaluation and research to ensure that the provision of care and protection to children in out-of-home care is safe, accessible, relevant, culturally appropriate and cost-effective;
increased access to health services, particularly mental health support, which should incorporate the development of specialist mental health services and provide multi-modal mental health assessments before entering care and trauma-informed response treatment plans delivered by competent multidisciplinary teams;
more intensive checks of individuals who sign up to provide out-of-home care;
better support for foster and kinship care families, including improved incentives and comprehensive training;
additional training for staff working with children in care who exhibit problem sexual behaviour (PSB) and those caring for children who have sexually abused other children; and
a strong emphasis on ensuring positive, safe, long-term relationships for young people.
How to contribute
Further information about the work of the Royal Commission into Institutional Responses to Child Sexual Abuse can be found online at http://www.childabuseroyalcommission.gov.au/
The FCAP is keen to hear from all members with an interest in this area who may wish to contribute to the RANZCP response.
Members who wish to receive further information or contribute to developing a College response should contact Felicity Kenn, Policy Advisor, via