The usefulness of Luke 17:3 “if your brother offends you rebuke him; if he repents, forgive him” in responses to profess

1. The usefulness of Luke 17:3 “if your brother offends you rebuke him; if he repents, forgive him” in responses to professional sexual abuse Dr Janet Melville-Wiseman Principal Lecturer in Social work Canterbury Christ Church University Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

2. Reasons for the study • Limited research in this field • Driven by psychological therapies • Focus on negative psychopathology of victim • Leads to victim blaming • Other focus on demonising of perpetrators • Leads to lack of attention to institutional context • Little systemic or relational thinking in this area • Relational risk not considered in mental health services in favour of assessment of physical risk • No evidence of organisations developing policies of restitution of apology Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

3. Overview of the study • In depth literature review • Instrumental case study • Analysis of documentary and archival sources • Stakeholder interviews using ‘real life’ case vignette • Systemic approach • Emancipatory approach • Hypothesis generating Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

4. Prevalence studies (self report) • a). Sample included: 1600 psychiatrists, 1600 psychologists, 1600 social workers. • b). No significant difference among the three professions. • Reference Key: 1) Holroyd and Brodsky (1977); 2) Pope, Levenson and Schover (1979); 3) Gechtman and Bouhoutsos (1985); 4) Pope, Keith-Spiegel and Tabachnik (1986); 5) Gartrell, Herman, Olarte, Feldstein and Localio (1986); 6) Pope, Tabachnik and Keith-Speigel (1987); 7) Borys and Pope (1989); 8) Garrett and Davis (1994) (UK). Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

5. Regulatory Bodies Conduct Cases Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

6. Prevalence • Study of 250 cases • 10% and 15% of male professionals • 2% and 3% of female professionals • Majority of perpetrators were male and majority of victims were female (Schoener 1995) • Most psychiatrists and psychologists do not report abusive colleagues or support service users with complaints • Workers within mental health services are not encouraged or permitted to acknowledge abuses of power (Williams and Keating 2000) Consultant psychiatrist Christopher Allison has been found guilty of two rapes and nine indecent assaults on six women patients – BBC News Archive 9/12/02 Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

7. Somerset nurse struck off for relationship with vulnerable woman • “She (the GP) added that Mr Hyde must have known how vulnerable the woman was and that if the relationship ended it might trigger her to self harm. • Mr Hyde was not at the hearing, but at a previous session he said it was "inhuman" that he had been suspended and confirmed he had told the woman words to the effect that he did not have room in his life for "someone like her" and blocked her from his Facebook page.” • 6th September 2010 • http://www.bbc.co.uk/news/uk-england-somerset-11204178 Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

8. Pathologising the victim • Roots in psychoanalytic movement • UK study • learned helplessness • failure “to acquire social skills” • “these victims may accept that they deserve to suffer” • over-sexualisation • dissociation • borderline personality disorder (Jehu 1994 Ch 7) Trainees need experience with the whole range of patients and their problems, but a senior psychotherapist should have known that it could be dangerous for a junior trainee, in the throes of personal difficulties, to work with a male patient with borderline personality disorder, however well supervised. Royal College of Psychiatrists – Vulnerable Patients, Vulnerable Doctors Case Vignette - 2002 Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

9. Historical Influences • Freud “The way these women manage to charm us with every conceivable psychic perfection until they have attained their purpose is one of nature’s greatest spectacles” (Rutter 1989) Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

10. Unhelpfulness of the ‘few rotten apples’ theory • Most perpetrators are older, well established members of their profession • Demonised as predatory psychopaths • Discourages open debate • Fails to take account of the relational issues for associate victims, colleagues etc. • Does not recognise the need to restore the victim or the good name of the profession Botryosphaeria obtusa Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

11. Unsafe services MIND Ward Watch Campaign Normative and common experiences Physical and sexual violence are normative experiences in the lives of women with mental health needs However, they are also common experiences in the lives of health and social care professionals who also suffer high rates of depression • 18% sexually harassed • 5% sexually assaulted • 7% racially harassed • 3% racially motivated assault • 10% harassed because of their sexuality • 5% assaulted because of their sexuality • 56% of assaults or harassment perpetrated by a patient or service user • 31% by ward staff • http://www.mind.org.uk/News+policy+and+campaigns/Campaigns/Ward+Watch/ Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

12. Apology theory • This is about a relationship that goes wrong • It almost certainly causes harm to victims and associate victims • and ‘damages public confidence in the professions’ • There is a need for restitution • The Age of the Apology - Brooks 1999 • Tavuchis (1993) argues that without it the social order (safe services) cannot be recovered • It is the way we restate that the rules are important • Bad apologies worse than no apology Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

13. Apologies on behalf of nations • FW de Klerk – apologised for apartheid • The Queen apologised in 1995 to the Maori people for the UK government taking their land in 1893 • 1995 Jaques Chirac apologised for the actions of the Vichy regime who supported the deportation of Jewish people to concentration camps • 1998 Australian Anglican church and in 2008 Australian government apologised for the forced removal of aboriginal and mixed race children from their families Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

14. Alice • History of mental health needs as an adult • Experience of mental health services characterised by poor boundaries by multiple professionals • Raped by her Community Psychiatric Nurse • Experience of reporting the incident characterised by poor boundaries by multiple professionals • Investigation characterised by pathologisation of Alice • No-one apologised Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

15. Luke Ch 17:3 “If your brother offends you rebuke him; if he repents, forgive him” Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

16. Some findings • Alice never returned to mental health services – is now an activist • Original mental health problem remains untreated • Perpetrator struck off but still able to work in social care • Not enough evidence to prosecute • 63 questions about her mental health needs • Only three about the impact • No one has ever apologised • Civil claim achieved greater sense of justice Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

17. Some findings • Stakeholders main concern is that it is very difficult to speak about these issues • All had personal experiences of a colleague who had abused a vulnerable person • No examples of it being dealt with well – or even within procedures • ‘Swept under the carpet’ Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011

18. Last word • “When I read it I just cried. I’m not used to taking compliments but the way you have written it you have made my story sound so interesting. But it hit me. All those times in hospital and that treatment – you have described what it was like but it doesn’t tell the half of it. And as for xxx [the CPN] – I would still like to nail him before I go. I would like to make sure he is not working in some care home where he can do it again to somebody else. And if anybody tells me again that it gets better. It doesn’t get better Janet. Take my word for it – tell them that.” • Alice Dr Janet Melville-Wiseman - Beyond Belief Conference Bradford 2011