Hearing voices, sexual abuse and service system responses

Research indicates that routine effective screening for sexual abuse by mental health professionals is infrequent, and when experiences of sexual abuse are disclosed to mental health professionals it is unclear whether these disclosures are meaningfully incorporated into professional formulations and treatment plans. Screening rates and inclusion of trauma details on formulations and treatment plans appear to be less common amongst consumers with psychotic diagnoses. The aim of this study was to further investigate the work practices of mental health professionals who engage with consumers who hear voices and have experienced sexual abuse. The results indicate over half of respondents were not routinely screening voice hearers for sexual abuse or assault. The findings also point to a number of mediating factors that influence whether or not mental health professionals screen for abuse. When respondents were aware of sexual abuse histories most included this information in their professional formulations and treatment plans but struggled to implement effective trauma related treatment plans due to a lack of trauma-specific services. These findings indicate a need for organisational and systemic leadership to address barriers to effective responses to sexual abuse survivors.