New Zealand
Herald
October 5, 2002
Questions on abuse aid treatment
by Martin Johnston
Mental health workers are being trained in how and when to ask patients about
abuse as a child, in a bid to improve treatment.
More than a third of the Auckland District Health Board's 300 clinical staff
who deal with adult psychiatric patients have
received the training.
The scheme's backers believe it is important to give patients the opportunity
to disclose a history of being abused, saying it can help them to receive
more-appropriate treatment and reduce episodes of mental illness.
Dr John Read, a senior Auckland University psychology lecturer
involved in the training, said child abuse and neglect were strongly linked
with the development of mental illnesses as an adult.
He cited an Otago University study of more than
2000 women which found that those who had been sexually abused were five
times more likely than the rest to have been admitted to a psychiatric
hospital.
The study, published in the Lancet and the British Journal of Psychiatry,
also found that those who had been subjected to the more severe forms of
abuse, involving genital contact, were 16 times more likely than the
non-abused women to have been admitted.
Among other findings, Dr Read's own research has shown that half of female
psychiatric in-patients surveyed in 15 international studies said they were
sexually abused as girls.
These findings, linking abuse and schizophrenia, are controversial among some
psychiatrists, who argue that the disease is genetic and needs medication.
Dr Read was among the speakers at a Mental Health Foundation forum yesterday
on preventing child abuse. It is linked with next Thursday's World Mental
Health Day, for which the theme is the effects of trauma and violence on
children.
"Studies show on average that 70 per cent of mental health clients'
trauma histories are not known about by mental health services," Dr Read
said.
"People don't know how to ask and feel uncomfortable. That's not
acceptable for mental health professionals."
He hoped that other health boards would follow Auckland's lead.
Its clinical leader of mental health services, Dr Nick Argyle, said his staff were finding the training beneficial.
Gary Platz, a 50-year-old mental health consumer
adviser to a Wellington patients' support
organisation, said he had suffered years of hallucinations, voices and other
mind disturbances.
Mr Platz, who grew up in Australia, attributed his mental
illness to childhood sexual abuse by a teacher. He said he had been in and
out of hospital since about 1990 and had received therapy, which was helpful,
and a lot of medication, which was not.
He gave up the medication in 2000 and his mental state was now stable.
At Auckland University of Technology, researchers are encouraging local
authorities to take a lead in preventing the abuse of children.
Dr Ian Hassall, a senior AUT researcher and former Children's Commissioner,
said the key was each council drawing up a "social map". It would
list things like social agencies and services, survey people's attitudes, and
state why that community was fit for rearing children.
"The heart of it is a process of a community deciding that it's going to
do better in protecting its children."
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Response by
Gordon Waugh
Whenuapai
More
than a third of the Auckland District Health Board's 300 clinical staff who
deal with adult psychiatric patients are being trained in how and when to ask
patients about childhood sexual abuse, in a bid to improve treatment (Herald,
Oct 5). Dr John Read is at the forefront of this unscientific nonsense.
Patients are in psychiatric care because they are typically disturbed, abnormal,
irrational, unreliable, vulnerable, suggestible and ill. Asking them
questions about childhood abuse will inevitably elicit a high incidence of
positive response. I suspect a similar result would occur if the questions
were about alien abduction. Treatment will be influenced by their answers and
therefore based on unreliable, unverified information.
The glaring flaw is that accounts of abuse will not be externally corroborated.
Treatment will not be based on testable evidence of genuine abuse. The ADHB
needs its head read and its knuckles rapped for wasting funds and staff time
on this baloney. Psychiatric patients, their parents - and the alleged
perpetrators - deserve much better than this.
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