The Scottish Government

Survivors of Childhood Sexual Abuse

A survivor-centred strategic approach

Foreword by Lewis Macdonald, Deputy Minister for Health and Community Care, September 2005

When the Cross Party Group for Survivors of Childhood Sexual Abuse (CPG) was set up in 2001, its clear aim was to evidence the need for a strategy to improve the quality of life for those affected. This national strategy is the culmination of its efforts and those of many others. It draws together the recommendations of a Short Life Working Group established by the Health Minister in 2003, views of those involved in the CPG and commissioned research findings.

The strategic outline sets out what the newly established Adult Survivors Reference Group will be tasked with achieving in order to create and strengthen co-ordinated services where staff are aware of, and are able to respond to, the effects of past abuse. Membership of the group includes adult survivors, voluntary and public sector representatives including In Care Abuse Survivors (INCAS) and officials from across the Scottish Executive to ensure that essential cross-cutting work continues. Input from survivors in identifying what works best will be critical.

While the primary emphasis is on ensuring that existing services can deliver improved support to survivors of abuse, Scottish Ministers have recognised a need to pump-prime activity. The Health Department has established a Survivors' Fund with an allocation of £2m, and invited the Survivors Reference Group to co-ordinate bids for demonstration projects consistent with its remit and workplan.

I do not underestimate the scale of the challenges ahead. Health and social care services must become more responsive to individuals' needs, and offer the sensitive responses survivors of abuse need, when they need them. The strategic approach, as outlined, is designed so that the Reference Group can lead in rising to this challenge. I am confident that its groundbreaking work will pave the way for better quality and choice in the future.

Comments on this outline strategy should be sent to: Jeannie Munroe at jean.munroe@scotland.gsi.gov.uk

Or in writing to:
Scottish Executive Health Department
Room 2ER
St Andrew's House
EH1 3DG

Contents

Foreward

Executive Summary

Section 1 - Childhood sexual abuse in context

Section 2 - Future Action

Useful Contacts

return to top

1. Many survivors of childhood sexual abuse have complex care needs, arising from its devastating and long term effects which may be overlooked by statutory service providers, and care professionals. Too many survivors report a 'revolving door' experience being moved from service to service without having their needs satisfactorily addressed. Survivors frequently present in Health services with other symptoms e.g. depression, self-harm, drug/alcohol misuse, and in Maternity, Genito- Urinary Medicine and Accident & Emergency.

2. In 2001 the Cross Party Working Group for survivors of Childhood Sexual Abuse was set up as a forum to debate and to create a programme of action on the issue, its long-term effects and links with mental health problems. As a result of this activity, the Health Minister established a Short Life Working Group in 2003 to consider the care needs of people who had survived childhood sexual abuse. Its membership comprised a broad range of interest groups including health and social care professionals, voluntary sector providers, representative organisations and Executive advisers. Activity covered evidence gathering, prevalence rates, existing service models, existing training /awareness levels, and identifying gaps in current provision.

3. The outcome of this joint activity is outlined within this document, which sets out a strategic way forward, agreed by Scottish Ministers, which will be led and coordinated by a national Survivors Reference Group.

4. The Survivors Reference Group, which met for the first time this month, has also agreed that, while the main focus will be on survivors of sexual abuse, wider issues of abuse will also be considered. It is in the early stages of developing a working plan spanning an 18 month to 2 year period to deliver on these key action points. The work to date has highlighted the complexity of issues which surround sexual and other forms of abuse, and of the need for consistent, co-ordinated action to shift cultural and service barriers to change.

return to top

1. Childhood sexual abuse (CSA) is increasingly recognised as a major cause of morbidity and mortality. Two recent World Health Organisation (WHO) reports - World Report on Violence and Health (2002) and World Health Report 2002 (2002) - acknowledge that CSA is common in both females (20%) and males (5-10%). CSA is even more prevalent in specific populations including substance abusers, the homeless and psychiatric inpatients.

2. It is clear that CSA is common. Historically, however, the prevalence of CSA in the UK may have been underestimated at 12% for females and 8% for males. Comparing the estimate for females with international studies shows that this estimate is at the lower end of the range (7-36%). The World Health Organisation (WHO) puts the prevalence of CSA at 20-25% for women.

3. Childhood sexual abuse has remained a taboo subject. That it happens is not in doubt, yet for many its existence challenges the accepted view of a caring and compassionate society which places a high value on the safe care and development of our children, to ensure they are nurtured to adulthood free from harm and exploitation. Even in adulthood, abuse and exploitation exist, sometimes going hand in hand with domestic violence, sometimes as part of organised criminal activity connected to prostitution and the sex trade. The physical and emotional damage for the victim can often be lifelong, and requires sensitive handling by committed and caring services which understand the trauma, and can offer responses which help survivors move on.

4. Many courageous individuals have chosen to speak out and to demand that their voices are heard. They, and those who advocate for them, have helped bring these issues to the public eye, and the increased focus on child protection has helped raise levels of public awareness of abuse and its long term effects. It is clear however that more can be done in this area, and the strategic approach outlined in this document sets out a clear way forward to redress some of the inadequacies within existing services, and to deliver improved help and support for survivors.

5. The key emphasis is on improving care and support services, listening to survivors and providing them with choice in how they access help and support when they need it. Improving services for survivors of abuse is not a matter of creating a new suite of additional services. It is about getting existing services to respond to needs in a more co-ordinated way. While some good practice exists, there is still some way to go. There is a continuing need to remove barriers to joint working and co-operation in delivery of care services. For this to happen requires commitment and direction from service planners and commissioners - to better understand how and when survivors access services and what their needs are.

6. Survivors must be comfortable in trusting workers to feel able to disclose abuse and staff will need to know how to respond appropriately. Survivors make clear that the people who help them do not come from any one professional background or use a particular therapeutic approach. They do not necessarily have high professional status.

7. The majority of these staff have not attended specific training courses on child sexual abuse, although they had gathered expertise in other ways. Rather, they are secure and firm about boundaries, but relate with warmth and kindness. They are informed and aware about the main effects of CSA trauma and have examined their own personal issues around working with sexual abuse. They work non-hierarchically, consulting respectfully with survivors about what their main needs are and what their service can offer. They neither hide behind confidentiality nor break it insensitively. The strategy will develop training that promotes these ways of working.

Section 2 - Future Action

return to top

The following action steps have been agreed as necessary by Scottish Ministers following the work of the Short Life Working Group, and in discussion with representatives of the Cross Party Group. It will be for the Survivors Reference Group to discuss and agree detailed implementation. Integral to this will be scoping of what Community Health Partnerships and Managed Clinical Networks may offer to further develop existing services. A lead professional in the field will be invited to work with the Executive to assist with this and with the use of a £2 million Survivors Fund, including commissioning of training and education.

Better data collection

1. Whilst it is known that the consequences of CSA include mental health problems (including suicide and eating disorders), physical illness, and behavioural and social problems, only 1% of cases of childhood sexual abuse are documented in health records. One estimate of the increased cost to hospital services of managing the health consequences of CSA for women in Scotland is put at £30-60 million per annum.

2. There is no clear requirement placed on primary care or mental health services to identify those affected and so what current information systems are able to do is measure behavioural and pathological patterns, but not their underlying cause.

3. CSA is not widely enough recognised as a major contributing factor to a range of seriously disabling behaviours such as self-harm and substance abuse. The emphasis in practice is largely placed upon treating the symptoms and minimising harm rather than supporting service users to explore aspects of their sexual abuse history or to develop strategies for coping positively with daily life.

4. Obtaining better baseline data from current services is therefore a priority. The voluntary sector has considerable expertise in helping adult survivors of CSA and has data that could be the foundation on which to build. Additionally, it may be appropriate to set up better data collection systems in other services likely to have high numbers of adult survivors such as addiction services, mental health services, prisons, primary care, genito-urinary medicine (GUM), obstetrics and gynaecology and accident and emergency.

5. The Executive's Primary Care Division is part of the Information Services Directorate initiative to develop generic data standards for care information about people in Scotland. The standards developed by the eHealth National Clinical Datasets Development Programme and the Scottish Social Care Data Standards Project are for core and generic information about any individual person, in a health or social care context. The purpose is to facilitate the integration and sharing of information to support effective person-focused social and health care services for individuals, whether joined-up or single agency. There is no restriction on local partnerships collecting other data relevant to their local area/processes. It is recommended that the national generic data standards should be implemented within existing and emerging national clinical information systems.

Public awareness raising, creation of self-help tools and training for professionals across all disciplines and at all levels

6. Current work on developing appropriate responses to the needs of adult survivors needs to be enhanced by increased awareness of the stigma and discrimination that survivors feel. A positive climate of discussion, honesty and safe space for letting go of and working through feelings is essential.

7. Media campaigns to date in the UK and Scotland have addressed the need to challenge and report childhood abuse, and focused on domestic violence - which may include sexual abuse. National and regional campaigns have been run successfully in Australia and Canada, primarily in response to major investigations of sexual abuse activity within religious institutions, and child care services. There are lessons to be learned from the See Me campaign and the possibility of a campaign directed at improving public understanding of the issues is one that will be explored further in the Survivors Reference Group.

8. The present developments underway to improve the training and education of the existing health and social care workforces also provide a timely platform to take this recommendation forward. The emphasis on continuous professional development will help underpin this process. It is expected that Community Health Partnerships will continue to support the continuous professional development of their workforce by promoting initiatives such as protected learning times.

9. More specifically, improved health assessment within the Scottish Prisons Service is highlighting a significant proportion of prisoners with past sexual abuse history, particularly for women. While training for prison staff incorporates equality and diversity issues, and addresses health and psychological matters in general terms, with some inclusion of abuse issues, more can be done to improve screening and support services.

10. Developing self-help tools should form part of wider educational and awareness raising. There is a wealth of existing material which can be accessed via individual websites but its availability requires improved co-ordination. The 'Safe Hands' initiative developed by the Moira Anderson Foundation for primary school children and teaching staff to better understand protective behaviours is one example of useful self-help material.

A network of survivors, practitioners and researchers to collaborate on the systematic development of good practice across Scotland

11. Scotland is uniquely placed with a small scientific community closely linked to clinical services. Consideration is to be given to how best to formally develop a network of practitioners and researchers from different disciplines and services alongside survivors to enhance our understanding and to find new ways of responding to the needs of this population. This network, which could be virtual, would have a wide remit e.g. from evaluating good practice in settings such as the voluntary sector or making inroads into the understanding of the neurobiological impact of early trauma. The cross fertilisation of these approaches will enhance knowledge of the biological underpinnings of trauma which can be utilised to maximum effect in the therapeutic field.

Local demonstration projects to develop and disseminate good practice nationally

12. There are currently a limited number of discrete specialist services for survivors, the majority of which are provided by the voluntary sector but it is more common that projects cover other issues e.g. rape, domestic violence. The Survivors Reference Group will discuss the main themes that demonstration projects are needed for and will develop a mechanism by which to receive and assess applications for funding.

13. A search of services provided by the voluntary sector revealed a number of innovative support and information services but with little evidence of systematic evaluation. However, the organisations that offer these services appear to involve survivors in their development, and are committed to ensuring their provision reflects what survivors value.

14. As far as individual and group counselling is concerned, the largest source of help in local areas tends to be in non-statutory services. Their main source of referrals is the health service, yet few receive funding from NHS boards. There also needs to be recognition of the different needs of male and female survivors, with skills and staff mix to match. Whilst there are both male and female survivors, it is also true that the majority of perpetrators are male. The shared understanding of gender-based violence set out in the Scottish Executive policies on domestic abuse applies here also.

15. Local partnerships are therefore essential for making an impact in terms of service provision for adult survivors. GPs in particular are a crucial first point of access for survivors seeking help. Pathways of care that connect primary care, non-statutory services and specialist mental health services can help. Again, there are models developing for domestic abuse that can be adapted for adult survivors. Indeed, if integrated services are to be developed, there may be potential for local domestic abuse forums to broaden their remit to cover this area of need.

Improved commissioning and resourcing of services at local level with more specialist and intensive support for those who require it, recognising the fluctuating and long-term needs of many survivors

16. For the vast majority of adult survivors, a warm, open and empathetic service response is all that is required. For survivors accessing support services, there is scope to incorporate these features into quality assurance with survivors themselves helping in the design of systems and their monitoring. Above all is the necessity to avoid re-traumatisation by services. It is also necessary to recognise the impact of abuse on the partners of survivors.

17. Survivors need to be sensitively supported to explore their sexual abuse history at a pace appropriate to them by staff who feel confident and who can offer safe responses to disclosure. It is usually non-specialist frontline services, dealing with issues like substance misuse, homelessness or distressed behaviour, that survivors approach first for help, or to which they are referred. Sometimes staff do not feel equipped to deal with the subject of childhood sexual abuse. Recipients of disclosure should be trained to avoid panic and possible unnecessary referral to specialist services, especially since many survivors do not wish constantly to be referred on.

18. This strategic document emphasises the necessity for better co-ordination of local services, and illustrates the continuing difficulties the voluntary sector faces in being seen as equal partners when decisions are being made on provision of services. However, with the exception of services for men, there remains duplication of effort across Scotland which presents difficulties for local funders in meeting needs effectively. This is compounded in some respects by a lack of clarity on what constitutes effective outcomes. Planning and delivery of local services must remain a matter for local decision, and the Executive's guidance on funding the voluntary sector stresses that the sector must be key players in policy development across sectoral issues like community planning and health strategies.

19. The Scottish Prison Service(SPS) is eager to engage with other stakeholders on planning and delivering services and support across a community. SPS already collects some relevant data on this matter, and proposes applied research. Again, they would wish to collaborate with other developers of information systems and research plans in order to yield the most consistent and durable results.

Clear inclusion of adult survivor issues in mainstream policies

20. It is essential that adult survivors work is integrated into existing areas of policy. Sexual abuse in childhood is a social and cultural phenomenon with potentially damaging effects. It requires above all, a recognition that it happens and that its impact can be lifelong, and not only in childhood, where existing policy focuses.

21. Provision of help and support to children at the time abuse happens will always remain important, but more can be done to recognise and plan for continuing need in later life. To achieve the broad-based shifts in policy requires that it is integrated with policy development and practice around child protection and domestic abuse.

22. There are also important links to be made with mental health policy. Psychological services should be responding explicitly to the needs of adult survivors. This could be brought out in the psychological services addition to the national framework for mental health services. Services need to consider CSA survivors at all levels of service provision. This should become an aspect of performance management of mental health services.

Identification of adult survivors in the prison population

23. At present, little is known about the numbers and needs of adult survivors within the criminal justice system in Scotland. It will be for the Survivors Reference Group to maker recommendations on how best to undertake this work. Generally, the Scottish Prison Service(SPS) is increasingly aware of the relationship between abuse and addiction which, in turn, is a driver of much criminal activity. Psychologists, mental health professionals and addictions specialists are increasingly interested in the full picture of a prisoner's needs in terms of their addiction and mental health problems, and what may underlie them. SPS has an increasing understanding of the effect of abuse owing to the growing partnership with the voluntary sector and its specific skills in this area.

Creation of change programmes targeted at prevention of further sexual offending to take forward the Cosgrove Report Recommendation 26

24. Lady Cosgrove's report on sex offending recommended that the Executive must give priority to putting systems in place which will reduce the risk for those who might become victims of sexual abuse in the future, on the basis that prevention is better than cure. None of this detracts from the need to work with the current survivors of childhood abuse, but works on the premise that some perpetrators, or those who think they may become perpetrators, may also have suffered from sexual abuse and need access to ongoing support and intervention while they are in the community- to reduce the risk they present to the public. We are committed to addressing this as part of the strategy through education programmes targeted at changing the behaviour of perpetrators and potential perpetrators as well as to look into other strands and behaviours that can be linked to abuse. This will go beyond education to include projects that give perpetrators as well as survivors better access to more sensitive and responsive support services.

Research - Underpinning and ongoing evaluation

25. In terms of what works, the evaluation of services and provision for survivors of childhood abuse are less developed than services and policies in related areas, such as domestic violence. Again, it will be for the Survivors Reference Group to define research priorities and the means to have these addressed.

26. There is a clear clinical and mental health emphasis in the available literature, and studies of sexual abuse outnumber those that look at childhood abuse in general or those that focus on physical or emotional abuse or neglect. Studies tend to focus more upon the mental health conditions for which survivors are at greater risk than on the high risk group itself. Indeed, it may be the case that survivors are not recognised per se, but as people who suffer from particular mental health problems such as depression or borderline personality disorders. Many studies focus on a particular sub-group of survivors. The general theme of the literature is to document the adverse consequences in later life of childhood abuse, and clinical interventions. There is less research evident on the long-term consequences for physical health of childhood abuse.

27. There is also less research evidence on the social and familial consequences in adult life of childhood abuse but the dominant theme from such studies is that the legacy of childhood abuse in adult life is a much higher risk of problems in social functioning, in forming and sustaining intimate partnership relationships, and in parenting. Studies of services for survivors also have a clinical and mental health emphasis. Research on informal support networks and on services giving information and support that are provided in the voluntary sector is also sparse.

28. It will be important, in developing policies and provision for adult survivors of CSA that undue emphasis is not given to treatments, short term interventions and recovery programmes such as cognitive behavioural therapies, at the expense of other forms of provision that address the longer-term support needs of both survivors and members of their families.

Useful Contacts

return to top

EDINBURGH

Beyond Trauma Team
Health in mind
EH2 4RTTel: 0131 225 8508
Fax: 0131 220 0028
Email: contactus@health-in-mind.org.uk
www.health-in-mind.org.uk
Offers a range of services for survivors of sexual abuse, including: confidential counselling for adult survivors of childhood sexual abuse, emotional and practical support for women, group-work, a young people's project and a national training programme.
Edinburgh Women's Rape and Sexual Abuse Centre
PO Box 120
Brunswick Road
Edinburgh, EH7 5XX
Helpline: 0131 556 9437
Email: EWRASAC@aol.com
www.rapecrisisscotland.org.uk
Support for women who have been raped or sexually abused.

Gay Men's Health
10a Union Street
Edinburgh, EH1 3LU
Tel: 0131 558 9444
Fax: 0131 558 9060
Email: counselling@gmh.org.uk
Counselling for gay and bisexual men.

Sexual Abuse Survivors Support in Edinburgh (SASSIE)
7b Randolph Crescent
Edinburgh, EH3 7TH
Telephone: 0131 220 4722
Support groups for sexually abused women.
sassie@homecall.co.uk

Saheliya
10 Union Street
Edinburgh EH1 3LU
Tel: 0131 556 9302
Fax: 0131 556 9302
Email: saheliya@connectfree.co.uk
www.saheliya.org.uk
Counselling and support for Black and Minority Ethnic women.

Rivers Centre
Tel : 0131 537 6874
Support for people experiencing Post-traumatic Stress Disorder.

Royal Edinburgh Hospital
Morningside Place, Edinburgh, EH10 5HF.
Tel: 0131 537 6000
The Royal Edinburgh Hospital provides two services with dedicated space for sexual abuse survivors:
Adult Psychotherapy Dept
Young People's Unit.

GLASGOW

Breakthrough for Women
4/1, 30 Bell Street
Glasgow, G1 1LG
Tel: 0141 552 5483
Fax: 0141 552 7982
Support for women who have been raped or sexually abused.

Routes out of Prostitution Intervention Team
73 John Street
Glasgow, G1 1JF
Tel: 0141 287 5768
Fax: 0141 287 5022
Support for women wanting to leave prostitution.

Thrive
2-6 Sandyford Place
Sauchiehall Street
Glasgow, G3 7NB
Tel: 0141 211 8130
Email: thrive@glacomen.scot.nhs.uk
Counselling for men who have been sexually abused.

Say Women
3rd Floor, 30 Bell Street
Glasgow
G1 1LG
Tel: 0141 552 5803
Fax: 0141 552 9751
Email: say-women@globalinternet.co.uk
Housing and support for young women who have been raped or sexually abused.

Glasgow Women's Aid
4/2, 30 Bell Street
Glasgow, G1 1LG
Tel: 0141 553 2022
Fax: 0141 553 0592
Email: gwa@ginawade113.fsnet.co.uk
Support for women who have experienced domestic abuse.

Greater Easterhouse Women's Aid
0/2 5 Kildermorie Path
Easterhouse, Glasgow
G34 9EJ
Tel: 0141 781 0230/773 3533
Fax: 0141 771 4711
Email: collective@gewa.org.uk
Support for women who have experienced domestic abuse.

Rape Crisis Centre
PO Box 53
Glasgow, G1 1WE
Tel: 0141 552 3201
Helpline: 0131 552 3200
Fax: 0141 552 3204
Email (for workers): info@rapecrisiscentre-glasgow.co.uk
Support for women who have been raped or sexually abused.

Women's Support Project
31 Stockwell Street
Glasgow, G1 4RZ
Tel: 0141 552 2221
Fax: 0141 552 1876
Email: info@wsproject.demon.co.uk
Support for women who have been raped or sexually abused.

Men Against Sexual Abuse (MASA)
44 Bathgate Street
Glasgow,
G31 1DU
0141 550 2048
Support for men who have been sexually abused

FIFE/KIRKCALDY/FALKIRK

Safe Space
4 Victoria Street
Dunfermline, Fife, KY12 0LW
Tel: 01383 739084
Fax: 01383 622261
Counselling and support for adult survivors of sexual abuse. Support for partners and families.

Kingdom Abuse Survivors Project (KASP)
29 Townsend Place
Kirkcaldy, KY1 1HB
Tel: 01592 644217
Helpline: 01592 646644
Email: info@kasp.org.uk (for workers)
Email: volunteer@kasp.org.uk (for support)
Counselling and support for survivors of sexual abuse. Support for partners and families.

Open Secret
9 Callendar Road
Falkirk, FK1 1XS
Tel: 01324 630100
Fax: 01324 635650
Email: info@opensecret.org
Web: www.opensecret.org
Support for survivors of sexual abuse and non-abusing parents of children.

Fife Rape & Sexual Abuse Centre
29 Townsend Place
Kirkcaldy
Fife
KY1 1HB
Tel: 01592 642 336
Email: frasac6@hotmail.com
Individual and group counselling for people who have experienced sexual abuse.

DUNDEE

M-LINE (Male Survivors of Sexual Abuse)
(c/o Eighteen and Under)
Helpline: 01382 809 111
Support for male survivors of sexual abuse.

Tayside Ritual Abuse Support and Help (TRASH)
Helpline: 01382 207 667
Support for people who have experienced ritual abuse.

Dundee Women's Aid
61 Reform Street
Dundee, DD1 1SP
Tel: Helpline/Office 01382 202525
Fax: 01382 202525
Email: dundeewomensaid@freenet.co.uk
Support for women who have experience domestic abuse.

Women's Rape and Sexual Abuse Centre
PO Box 83
Dundee, DD1 4YZ
Tel: 01382 205556 (office)
Helpline: 01382 201 291
Minicom: 01382 226 936
Fax: 01382 205556
Email: wrasac@btconnect.com
Support for women who have been raped or sexually abused.

Eighteen and Under
1 Victoria Road
Dundee, DD1 1EL
Tel: 01382 206 222
Helpline: 0800 731 4080 (for young people)
Website: www.18u.org.uk
Email: lormac1053@aol.com
Support for young people who have experienced any form of abuse.

PERTH & KINROSS

Perthshire Womens Aid
49 York Place
Perth
Tel : 01738 639 043 (helpline)
Support for women and girls who have been raped or sexually abused.

Perth Association for Mental Health
Caladh Centre
6 Milne Street
Perth
PH1 5QL
Tel : 01738 631 639
Counselling, support and groups. Includes MindSpace, a counselling service for young people.

ABERDEEN

Rape & Abuse Support
1-3 Little Belmont Street
Aberdeen
AB10 1JG
Tel : 01224 620 772 (helpline)
Tel : 01224 639 347 (admin)
Email (admin): info@rasane.wanadoo.co.uk
Email (clients): rasane@btinternet.com
Support for women and girls who have been raped or sexually abused.

Aberdeen Womens Aid
66 The Green
Aberdeen, AB11 6PE
Helpline: 01224 591577
Support for women who have experienced domestic violence.

DUMFRIES & GALLOWAY

South West Rape Crisis & Sexual Abuse Centre
93 Irish Street
Dumfries, DG1 2PQ
Tel: 01387 253113
Support for women who have been raped or sexually abused.

Dumfriesshire & Stewartry Women's Aid
12 Whitesands,
Dumfries, DG1 2RR
Tel: 01387 263052
Helpline: 07710 152772 (24-hour)
Email: admin@dumfrieswomensaid.org.uk
Support for women who have experienced domestic violence.

NORTH / SOUTH LANARKSHIRE

The EVA Project
Coathill Hospital, Hospital Street
Coatbridge, ML5 4DN
Tel: 01236 707767
Fax: 01236 707739
Email: lily.greenan@lanarkshire.scot.nhs.uk

Counselling and support for women who have experienced rape, sexual abuse or any other form of violence.

The Moira Anderson Foundation
29 Alexander Street
Airdrie, ML6 0BA
Tel: 01236 602 885
Fax: 01236 602 877
Email: info@moiraanderson.com
Support, information and training on sexual abuse.

Lanarkshire Rape Crisis Centre
Tel: 01698 527 006 (admin)
Admin: 01698 527 003 (helpline)
Email: info@lrcc.org.uk
Emotional and practical support for women who have been raped or sexually abused.

HIGHLANDS
Rape and Abuse Line
PO Box 10, Dingwall,
Rosshire, IV15 9LH
Tel: 01349 865316 (office)
Helpline: 0808 800 0123
Telephone support for men and women who have been raped or sexually abused.

Safe, Strong and Free Project
PO Box 5610, Inverness
IV1 1ZU
Helpline: 01463 712669
Information to reduce risk of child abuse.

OTHER

Survivors UK
PO Box 2470,
London SW9 6WQ
Tel: 0845 122 1201
E Mail: info@survivorsuk.org.uk
Website: www.survivorsuk.org.uk
Tel : 0845 122 1201
Telephone support for men who have been raped or sexually abused.

Respond
3rd floor, 24-32 Stephenson Way, London NW1 2HD
Tel: 0207 383 0700 (admin)
Helpline: 0808 808 0700
E Mail: admin@respond.org.uk
Services for victims and perpetrators of sexual abuse with learning disabilities.

Bristol Crisis Service for Women
PO Box 654, Bristol BS99 1XH
Tel: 0117 927 9600
Helpline: 0117 925 1119
E Mail: bcsw@womens-crisis-service.freeserve.co.uk
Provide information on self-harming for women.

BASPCAN
10 Priory Street York YO1 1EZ
Tel: 01904 613605
E Mail: baspcan@baspcan.org.uk
Professional network for workers on preventing child abuse and neglect.

Breathing Space
Tel: 0800 83 85 87
Free and confidential telephone advice and signposting service for people experiencing low mood and depression.
Victim Support Scotland
15/23 Hardwell Close
Edinburgh, EH8 9RX
Tel: 0131 668 4486 (office)
Helpline: 0845 603 9213
Support for people who have experienced crime.