Around eight in ten women seeking support after experiencing sexual violence were formally diagnosed with psychiatric disorders, according to a new report.
The research, by Victim Focus, which campaigns for trauma-informed responses to rape, found women were still likely to be given psychiatric diagnoses even if they stated they did not deem themselves mentally ill but were traumatised by their sexual abuse.
Sexual violence survivors told researchers they were informed it would be unlikely they would be eligible for therapy or additional support unless they accepted their psychiatric diagnosis and agreed to take antidepressants or anti-anxiety medication.
One in ten women were repeatedly given the option to be given a psychiatric diagnosis but rebuffed this process due to insisting they were not suffering from a mental illness.
The report found around six in ten of those diagnosed with a psychiatric disorder were labelled as having depressive disorder, while around half were diagnosed with anxiety disorder. Four in ten were diagnosed with post-traumatic stress disorder (PTSD), while a quarter were identified as having borderline personality disorder.
Some 395 women who sought help for their mental health after experiencing sexual violence were polled for the report. While some women said their diagnosis of a psychiatric disorder had helped them feel validated, others said it was damaging and stigmatising.
One sexual violence survivor said: “I thought I had a problem with intimacy in the days after the rape - was in shock and had stopped eating - so I saw a uni counsellor who was the first person to use the word ‘rape’. She made me see a GP.
There were a lot of women in the sample who knew they were not mentally ill but the only way to get counselling is to accept the diagnosis and take the medication.— Jessica Taylor
“I tried to get help again three years later with another uni psychiatrist but he told me I was too complex for their service and suggested I pay a religious charity he knew for support. I got cognitive behavioural therapy (CBT) 10 years after the event which helped the most but had to go on meds as part of the condition of having CBT”.
While another woman said: “I was in and out of A&E and received no formal support until I accepted the borderline personality disorder which allowed me to get treatment in a therapeutic community. I never believed the borderline personality disorder label but it was the only way to access the support”.
One more woman said while she “knew” her diagnosis “was wrong”, she felt like she was “powerless to question it”.
Jessica Taylor, a prominent psychologist who wrote the report alongside Carrie-Anne Bailey, told The Independent she was surprised to learn such a high proportion of those polled had been handed a psychiatric diagnosis.
Dr Taylor, who specialises in sexual violence, victim-blaming and the pathologisation of women in mental health settings, added: “There were a lot of women in the sample who knew they were not mentally ill but the only way to get counselling is to accept the diagnosis and take the medication.
“In the UK, it is very common to expect women to go on medication first because they tell women it stabilises them before therapy and makes the therapy work better.”
Dr Taylor, who is Victim Focus’ director, noted therapy services for sexual violence victims are so over-stretched that they have a criteria for their patients.
She added: “Some women were reluctantly accepting their psychiatric diagnosis to get their therapy.
“There are women in these appointments knowing full and well what the root of their trauma is and yet it is being made about their mental health. Their mental health is then used against them.
“For example, if they tell their doctor they are worried as they found a lump they might be told this is in your head. The psychiatric diagnosis label follows you around for years.”
Dr Taylor warned GPs “hands are tied” as diagnoses and medication are the main options at their disposal, while talking therapy services are overwhelmed.
Another impact of the diagnosis is the “family, friends and professionals are going to perceive the woman as mentally ill instead of naturally traumatised because of being subjected to sexual violence”, she added.
Dr Taylor said: “It shifts the focus from the sexual trauma to being mentally ill. It shifts the focus from the perpetrator to the victim. It individualises what the women has been subjected to as being in her own head.”
Researchers found three quarters of the women they polled reported sexual violence to their GP and asked them for help, while almost half of women surveyed told a psychologist about their sexual abuse.
Just over one in ten women reported their healthcare professional had a strong knowledge and awareness of sexual violence and trauma. Roughly half of women polled had reported the sexual violence they suffered to the police.
Dr Taylor states previous research shows women and girls are seven times more likely to be given a borderline personality disorder diagnosis than men and boys, while women are also more likely to be diagnosed with anxiety, depression, panic disorder, phobias, suicidal thoughts and attempts to kill themselves, PTSD and eating disorders.
The fresh research comes after London’s mayor recently demanded the government urgently address the “severe” court backlog as he warned that services to help rape and sexual assault victims were “stretched to breaking point”.
Last week, Sadiq Khan urged the justice secretary, Dominic Raab, to introduce measures to address the court backlog and help over capacitated services that provide sexual violence survivors with therapy and other help.
In an open letter addressed to Mr Raab, shared exclusively with The Independent, Mr Khan warned that the justice system was “in crisis from end to end” – with these issues exerting growing pressure on support services.
Mr Khan warned that the combination of delays and the fact that sexual offences had surged by 35 per cent in the last year was pushing crippled support services into “an impossible position” because there had been a rise in the number of people seeking help, while victims needed support for more protracted lengths of time.
He noted the London Survivors Gateway had stopped taking in new referrals for the interim period, while some London Rape Crisis Centres had been too overstretched to add any more victims to their waiting lists for counselling.
The mayor warned: “I cannot overstate the impact this is having on victims and survivors of rape and sexual assault, exacerbating existing trauma and leaving vulnerable people feeling isolated.”
An NHS England spokesperson said they have 24-hour support available via their “Sexual Assault Referral Centres (SARCs) which offer confidential specialist, practical, medical and emotional support to anyone who has been sexually assaulted – regardless of when the incident happened”.
The representative added: “The NHS world class talking therapy service (IAPT) also supported over a million people with mental health conditions such as anxiety, depression and PTSD in 2020/21.
“We are also investing an extra £20 million in sexual assault and domestic violence services over the next three years to provide even more support for victims and survivors.”
