Accidental Rape?

The battle between counsellors treating sexual abuse victims and ACC continues with some counsellors refusing to “label” their clients with a DSM IV mental health diagnosis. The counsellors correctly point out that many of these (mostly) women do not have mental health problems, but do need help. ACC’s obsession with mental health diagnoses extends to them insisting that a registered clinical psychologist assesses the client prior to ACC approving the funding. The media have mostly portrayed this as some sort of crass attempt by ACC to save money. In reality, however, it is just an inevitable result of Labour extending ACC cover to include sexual abuse trauma. ACC was never an appropriate vehicle for this funding.

ACC is an accident insurance. They are fairly liberal with their definition of an accident, but there is one thing that they always insist on – there must be some evidence of causality. An event, or series of events, must be shown to have produced the trauma. While there is good evidence that sexual abuse increases the incidence of mental health disorders, it is very difficult, if not impossible, to link a specific sexual abuse incident, or series of incidents, to a particular mental disorder or trauma in individual cases.

Nearly a third of women say they have had some sort of sexual abuse in the lives. There is no way on this earth that ACC can afford counseling for all of them (even if they desired it), so ACC falls back on insisting on some evidence of causality to prove the ACC is liable to fund. This is normal insurance company behaviour.

To back evidence of causality, ACC insist on a mental health diagnosis (e.g. depression, stress related disorder, anxiety etc.) in order to be able to check that this was not an underlying condition before the sexual abuse.

It is obvious to me that the essential problem here is that the wrong department is funding this treatment. Treatment for sexual abuse consequences should never have been funded via ACC. The simplest solution would be to scrap ACC funding altogether and place the funding with the DHBs. The DHBs already fund treatment of depression and anxiety in this way, it should not be a lot of effort to set up a similar scheme for sexual abuse victims. Determining whether then patient meets the criteria for funding would then sensibly rest with the patient’s GP, rather than ACC’s insurance assessors.

Rape and other forms of sexual abuse are not accidents and placing them under the aegis of an accident insurance will always create confusion. It is time to clean up this mess that the lack of insight of the last government has left.

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