Sunday, October 18, 2009

On ACC...

When writing about my analysis of sexual violence and prisons, one of the points I keep coming back to is how centred it is on the perpertrator. It's not a new or original thought to point out that everything about the way a criminal law system deals with sexual violence is entirely focused on 'the offender'. The follow-on from this is our society's way of dealing with sexual violence revolves around the court system.

A few year ago, I wrote about a nursing student, who was raped by a fellow student, after a typical, ridiculous, defence, the rapist got off. She had to drop out of school, because the school wouldn't do anything to ensure she wouldn't have to see her rapist regularly. I think it's important to understand how structural the problems within our justice system are. These systems are not designed to support survivors of sexual abuse, and therefore they will always fail at that task.


But, in New Zealand, we do have a system that is set up to meet, to revolve around, what survivors of sexual violence need. There are many things it cannot provide - ACC will not help student find a way to continue to study without seeing her rapist. But it can provide counselling and income support.

I don't have any personal experience, or depth of knowledge, of ACCs sensitive claims system. I am sure, as it currently operates, it has flaws, and some people fail to get the help that they need. But, at the moment, it can be centred around what a survivor needs, based on her relationship with her counsellor (or his).

If these changes go through, it will be much harder, maybe impossible for ACC to be survivor-centre. Currently, a survivor can have up to four sessions of counselling to disclose their abuse, but the changes will cut this down to one session (or maybe two, Peter Jensen, the person in charge of the proposal, was unclear on nine to noon).

At the moment a survivor can access up to 50 sessions with a counsellor before they have to obtain a psychological assessment. The changes will require psychological assessments much earlier in the process, and that process will be directed much more by clinicians. In order to get funded counselling, a survivor of sexual abuse will require a DSM IV diagnosis.

This is not a survivor-centred approach to sexual abuse; it is a clinician-centred approach.

ACC has already begun tightening the screws. And in doing so it has turned funded counselling into another area where a survivor has to prove her (or his) experience – maybe not beyond reasonable doubt, but close.

Dr Kim McGregor explained how ACC restricts access to counselling on an interview on 9 to Noon 9 to Noon. ACC declined cover for a young boy who had been sexually abused as the behaviour described: mood swings, tearfulness, and sitting alone sucking his thumb, did not necessarily have a clinical link with sexual abuse. They said these behaviours could just as well have been caused by settling into school and a new environment rather than the sexual abuse events.

Imagine the difficulty of someone who has survived sexual abuse will have in proving that the difficulties she (or he) is experiencing are directly and only a result of the abuse. Those who had what insurance companies call ‘pre-existing conditions’, could find support denied – if they had previously been depressed, how can they know that depression after the sexual abuse is a result of that abuse? (not a question that could be asked by anyone who cared about the experiences of survivors of sexual abuse, but a question that is being asked by ACC). While those who do not seek help for a long time, will have to prove the effects the abuse has had on them, and the more complex their survival strategies in the intervening time, the harder it will be for them to access the support they need.

The parallels between the perfect victim of the court system and the perfect survivor of ACC are strong. In both cases the onus of proof falls on those have been abused to prove either that there was abuse, or that that abuse affected them. Just as previous sexual history is used against survivors in the court system, ACC can use previous mental health history against survivors.

My point is not just that the changes to ACC need to be fought (although they do – Monday is a national day of action – come along), but to show how important, and how fragile, a survivor centred approach to sexual violence there is.

As well as pushing against these threats to survivor support, I want us to push further. I want us to imagine what a response to sexual violence which prioritised survivors look like.

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