Off the Couch

ACC to rethink abuse link

The following article appeared in the Sunday Star Times on 8/12/13 (Click here for the original article…)

To view the full judgement this story is reporting on click here…


“A judge has ruled in favour of an ACC claimant in a case expected to have “enormous” ramifications for the way mental health patients are treated.

In the decision, released recently, Judge Grant Powell in the Wellington District Court agreed with a psychiatrist who said a man’s schizophrenia had been caused by trauma from sexual abuse in childhood.

Two ACC-employed psychiatrists had earlier said there was no evidence schizophrenia was anything other than a biological condition passed down through families and so the man’s abuse had nothing to do with his condition.

However, the judge agreed with a growing body of research that says traumatic events can cause psychosis.

The research includes the work of clinical psychologist John Read, who has been at the forefront of research to show a relationship between childhood sexual and physical abuse and psychotic symptoms, including schizophrenia.

Read said the ramifications of the decision were “enormous”.

“It is gratifying that years of research on this issue is impacting the judicial system. These rulings will also make it harder for psychiatrists to ignore disclosures of sexual abuse by severely disturbed patients, or to dismiss them as either irrelevant or imagined.

“This is a significant victory for all those patients and researchers who have been saying for many years that the experiences which biological psychiatry believes are symptoms of a brain disease called schizophrenia are best understood as responses to adverse life events.

“Very often the voices abused people hear are the actual voices of the perpetrator of the abuse.”

Read said it was “alarming” that the two ACC psychiatrists “either knew nothing about the many studies documenting the relationship between child abuse and psychosis or were trying to mislead the judge”.

The man referred to in the finding had been covered by ACC for his history of sexual abuse but it was schizophrenia that had stopped him from working. He had sought to gain an independence allowance from ACC in December 2010. An independence allowance covers people who are permanently impaired as a result of an injury. The maximum weekly allowance is $84.97.

In 2011, ACC decided it would not cover the allowance because it said his schizophrenia was not linked to his covered injury – a significant history of sexual abuse between five and 13.

He was assessed by a psychiatrist who prepared three reports but concluded sexual abuse “is not likely to be the material cause of the current condition. There is no evidence of sexual abuse as an etiological factor [cause] in schizophrenia.”

His claim was declined and despite an appeal and subsequent reviews it was again found his incapacity related to his schizophrenia, which ACC said was a health issue unrelated to the sexual abuse.

After another appeal, psychiatrist David Codyre provided a report that completely disagreed with the previous psychiatrists.

“With due respect to my colleagues who undertook the prior psychiatric reports . . . their opinion that sexual abuse is not causally related to schizophrenia is not evidence based.”

Judge Powell said ultimately he found Codyre’s analysis “a more compelling and inherently more credible cause of the appellant’s schizophrenia”.

Read said the finding would reduce the frequency with which psychiatrists dismissed abuse disclosures as irrelevant or imagined and increased the probability of people being offered trauma-based psychological therapy instead of anti-psychotic medication.

New Zealand Association of Psychotherapists public issues spokesman Kyle MacDonald said the judgement was encouraging and could mean entitlements for many other people.

“The reality is there a lot of people who would be in the mental health system who would have a diagnosis of a psychotic disorder who may now be entitled to access some treatment under the ACC.

“For a long time there has been a mindset of how schizophrenia and psychotic disorders are treated, which is that it is a biological disorder which needs to be medicated and managed.

“The reality is that actually these people are underserviced in terms of therapy and psychological intervention. This is a way to get people more therapy and more psychological help.”

ACC said it would consider whether this decision “has any wider impact” but took the view it would have “limited” value as a precedent and it would “continue to carefully consider each person’s unique situation and circumstances”.

– © Fairfax NZ News”

Leave a Comment

  • csa adult December 9, 2013, 11:10 am

    At long last this practice of psychiatrists – those assessors SCU force any one with a mental injury to – is being highlighted for what it is in New Zealand. An undisguised attempt to mislead judges. Of course these assessors complicity allow SCU to enforce their interpretation of legislation and decline entitlements. In my case their senior psychiatrist was the only one to state that my mental injury was not related to csa. Every other 15 reports on file all clearly made the determination that there was a cause and effect. Even the DRSL reviewer acknowledged such. It defies belief that he upheld this psychiatrist in favour of 15 medical reports. However the ACC CEO overturned his review decision and that of ACC’s gatekeeper senior psychiatrist, apologized and granted cover for a mental injury related to csa. This was a battle that took over 18 months, much distress and shows the lengths that SCU is organized against those they supposedly support – yeah right!
    This ruling cannot come fast enough for those of us as adults and victims of csa to maybe gain a little compassion from SCU, however I seriously doubt it on their past 5 years of declining claims as environmental factors or attachment issues or parenting lack of skills. This Judge is to be commended for taking the issue of causation seriously and LS – I salute your courage in taking your case to the courts – (too overwhelming for me and public exposure) – when SCU had two psychiatrists stacked against Dr Codyre. May more psychiatrists be encouraged to write reports citing current case studies and allowing the link to be made between the impact of csa upon vulnerable children and the possible mental injury suffering during adulthood.

  • Anne Zeeland December 9, 2013, 8:47 pm

    What a victory – about time! Wake up ACC ! ACC’s position has limited many many people accessing therapeutic help,
    and the financial assistance they deserved to receive. Some psychiatrists have been convenient money watchdogs for
    the purpose of ACC making more profit. Have they ever really listened to the “consumers” they have assessed?
    This is a worthy issue that needs more publicity.

  • Alison Giblin December 11, 2013, 5:17 pm

    As usual, ACC with a disgustingly cold response.

TO BUY MY NEW BOOK "Shit Happens: Lessons for Dealing with Life's Ups and Downs"... CLICK HERE