A case study of an incident of professional sexual abuse in UK mental health services

This paper presents and instrumental case study involving the rape of a vulnerable women with mental health needs (Alice) by her Community Psychiatric Nurse within UK mental health services. It provides an alternative feminist emancipatory paradigm for the understanding of professional sexual abuse in such settings. Previous studies and policy developments in the UK have sought to explain such crimes by forensically examining the victim (usually a woman) in terms of her psycho-pathology and mental health history in order to find the root causes of her abuse within that. These approaches are ineffective and can easily lead to victim blaming. A wider systemic view is called for with the voices of victims at the centre. The study drew on a number of informants connected to the case but primarily supported Alice to tell her story. The results revealed that there is a culture of collusion and secrecy in services which mitigates against challenges to boundary violations. There is little awareness of the difficulty victims have in disclosing such abuse and the long term impact on them and their families is largely ignored. The paper considers the implications of these findings for individuals, services, regulatory bodies and educators and presents Alice’s own reflections on telling her story.