Executive Summary

Survivors of childhood sexual abuse (CSA) experience a wide range of physical and psychological symptoms and are users of health care services. Health care services include medical services (such as visits to physicians, medical specialists and chiropractors), hospitalization, emergency room services and prescription drugs. This report details the financial costs of insured health care services for 12 women survivors of CSA over a 10 and 11 year period.

BACKGROUND

Women consistently show a higher rate of CSA than men. Research suggests that one in three to four females and one in six to eight males have been sexually abused by age 18 (Finkelhor et al., 1990; Holz, 1994). Evidence and anecdotal reports suggest that many survivors use a disproportionate share of health care resources, often without solving the underlying problem.

PURPOSE & OBJECTIVES

The purpose of this study was to determine the cost of health services used by survivors of child sexual abuse, whether insured health care services helped in the healing process and whether there are other means of providing healing which fall outside insured health care services.

The study asked survivors to review their health care services costs for a ten, and in some cases eleven-year period; "tell their story" about the medical interventions in focus groups and in one-on-one interviews with the principal investigator; judge whether the medical system helped their healing process; identify what other services helped them in their healing journey and make recommendations about appropriate care for women survivors of CSA.

The research reported here examined the following questions:

• How much did it cost to provide insured health care services to twelve women survivors of childhood sexual abuse?
  
• Did the insured health care services help in the healing process?
  
• What other services, other than insured health care services, helped in the healing journey?

1. The Government of Saskatchewan ensure that education on the prevalence, impact, gendered differences and cost of childhood sexual abuse be part of the health care and human service professional educational training. The professional groups include Medicine, Nursing, Social Work, Physical Therapy, Dentistry, Pharmacy, Allied Health Science Programs, Complementary care programs, Law, Education, Theology, and Psychology;
   
2. Health care and human service professionals include the concept of violence, in particular childhood sexual abuse, as an integrated diagnostic concept in the assessment of clients;
   
3. Health care and human service professionals pay particular attention to the symptoms associated with CSA which often lead to costly misdiagnosis;
   
4. The Government of Saskatchewan fund the development and distribution of a public information package with an educational poster and pamphlets to all health, social services, justice and education providers in the province. The information package should include information on the prevalence, impact, gendered differences and cost of childhood sexual abuse, the public's role in eliminating this crime and the steps to be taken if one suspects it is taking place.
   
   In particular:
   
   a. Such material be made accessible and available to children, professionals and the general public;
   b. Such material make reference to a child's right, under provincial, federal and international law (The United Nations Convention on the Rights of the Child) to protection from abuse and the duty of society to protect children;
   
   
5. Professionals who work with and on behalf of CSA survivors be accredited by their professional bodies and governed by a professional Codes of Ethics.
   
   
6. The Saskatchewan Departments of Health, Social Services, Justice and Education actively address broad social and economic factors relating to prevention of and healing from CSA and work together on integrated collaborative solutions and services while being cognitive of the gender differences. In particular:
   
   A multi-sectoral initiative be undertaken to fund and host a national conference on the prevalence, impact and cost of child sexual abuse, its gendered differences and the prevention, detection and treatment of CSA, including complementary/alternative care.
   
   
7. Saskatchewan Health, establish a committee to assess the potential of selected complementary and alternative therapies for improving health outcomes and reducing health care costs in the treatment of symptoms resulting from childhood trauma, and to make appropriate recommendations concerning the inclusion of selected complementary and alternative therapies as publicly insured health services for trauma survivors. The committee should include representatives from Saskatchewan Health, Department of Social Services, and trauma survivors;
   
   
8. Saskatchewan provincial funding and budgetary commitments be provided for community-based agencies to provide comprehensive, holistic healing services to survivors of CSA;
   
   
9. Complementary/Alternative care workers be licensed under a professional act which will require adherence to a Code of Ethics.


The authors of this Report further recommend that:


10. Participatory action research continue to be funded by Health Canada; such research can make use of the substantial body of knowledge possessed by CSA survivors and could serve as the basis for designing programs of prevention, early detection, and treatment of CSA.
    
    
11. Health Canada and other funders provide funding for research into complementary and alternative medical care.