ACC’s Insensitive Claims Unit

I’ve been trying to blog about the proposed new clinical framework for treating survivors of sexual abuse who make claims to the ACC Sensitive Claims Unit for a while.

I haven’t managed it, because the issues are too complex to cover in one post.  So I’m going to split them up over the next few days, and stop the writing paralysis.

Firstly, for those unfamiliar with sexual abuse and ACC, this is what they will and will not cover: 

ACC accepts claims where there is evidence of a physical and/or mental injury (such as depression or post-traumatic stress disorder) that is caused directly by sexual abuse or sexual assault and that requires treatment.

We can’t approve cover for any medical conditions that are not caused directly by the abuse or assault event.

Anyone in New Zealand, including visitors, can make claim for injury (physical or mental) suffered as a result of sexual abuse or assault, as long as the event happened in New Zealand.

Next month, the process for assessing and treating survivors of sexual abuse will undergo a radical overhaul.

Picture this.  You’ve been sexually abused or raped.  

You may have been having flashbacks, or cutting yourself, or thinking about suicide.  Or you might have been unable to imagine having sex with your partner, despite how wonderful they are, because you don’t want to be that vulnerable with anyone.  Maybe you’re having trouble sleeping, eating, concentrating.  Or getting out of bed, caring for your children. 

If the rapist was your partner, you might be trying to work out how someone who says they love you can totally disregard what you want, can literally not care if you are happy with having sex.

You go to a counsellor, perhaps at your local sexual violence support agency, or maybe you look up ACC-accredited counsellors in the phonebook.

After filling in ACC forms with a counsellor – which requires you telling them exactly what kind of abuse you suffered, from whom, and when – the sensitive claim will be sent to ACC to process.

There a multi-disciplinary team (with no counsellors or psychotherapist) will assess the claim before passing to a Claims Manager, who, with a psychological advisor, will decide whether the claim is accepted or not.

So you’ve told someone about being raped, thinking you’ll get some help.  And after getting the courage – because believe me, that is what it takes – to tell someone you want help, you then, under the new ACC system, have to wait up to 60 days (they hope 28 but are realistic in how long it might take) for a decision to be made about your claim for counselling.

Next step, if it’s deemed serious, a psychologist, who will have three sessions with the person wanting help in which to make a treatment plan and refer to a counsellor for up to 16 sessions of counselling.  My emphasis. 

Those up to 16 sessions will be with another professional, there is no expectation that the original counsellor will be the one who follows up this work.  So the abuse survivor will now have to tell a third person about their abuse and the impact it is having on their life.  In 5 meetings. 

After the 16 sessions, with the counsellor sending monthly reports to ACC about their client’s attendance and ability to meet the psychologist’s ideas of “treatment plan”, the abuse survivor will go back to the psychologist, who will be able to give them up to 10 modality sessions with a psychiatrist (the fourth person they would have to see), refer them to mental health services, or sign them off as treated and well.

The impacts of these changes are pretty easy to predict, and I’m sure we will be hearing plenty from survivors about how this new framework will impact on them. 

Many survivors will not want to even try to wrestle with a system which requires them to talk about violation to complete strangers a minimum of three times.  ACC costs will go down, while the numbers of survivors of sexual abuse living in our communities trying to cope with what that abuse has done to them will increase.

The maximum 16 hours of treatment – because the 3 hours with the psychologist will be merely to decide on what treatment is required – will not be adequate for many survivors, particularly those for whom their sexual abuse was long-term rather than an isolated incident.

Victims of sexual violence are the least likely of all victims to report to the Police, according to the Ministry of Justice.  They also say that sexual violence is also by far the most costly crime in Aotearoa New Zealand.

Yet if we don’t treat those damaged by rape and sexual abuse effectively, not only are we allowing violations of human rights to go unremedied, we are extending costs for the future.

Survivors who access quality treatment early, and for long enough, are less likely to develop the most serious mental health problems – which are the most costly of all to treat.

This treatment plan is inhuman, and likely to cost us all more in the long term.  It looks awfully like beating up on the vulnerable to me.

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