The Department of Health has recently created a new training course called Seen and Heard. It has ben designed for NHS workers to help them identify young people who are suffering or are at risk of suffering child sexual abuse and child sexual exploitation. The Department of Health has launched the course alongside the Children’s Society which co-designed the training.

The training has been produced as part of the Department of Health’s Child Sex Abuse strategy, which aims to change organisational culture and practice. I have blogged before on the Children’s Commissioner’s report, which called for more action to be taken across government departments to implement a strategy to prevent child abuse across all departments, which you can read here.

The Need

The training talks of the current position: organisations and agencies are missing disclosures and opportunities to stop children and young people being abused.

In terms of prevalence;

  • 1 in 20 children in the UK have been sexually abused
  • 500,000 children have suffered child abuse in all its forms, including neglect, over the past year
  • 1.3m children have been subjected to child sex abuse or exploitation by the time they turn 18

In around 70% of cases, abuse is not reported to the police, and the training also details the dire statistic that 90% of survivors do not see their abuser brought to justice.

The Format

I recently undertook the e-learning course, which has video and audio of children and young people telling their stories and experiences, as well as interactive quizzes and exercises for the viewer to complete. It aims to help professionals to be aware of how children may be feeling when they try to disclose, how to deal with the disclosure, and what to do next.

Some of the clips of film show how children can engage angrily and defensively with staff and how this can mean that staff react in the same way, without realising that an opportunity to help the child has been missed.

The Content

The training highlights that children may suffer abuse online as well as in person, and that the abuse suffered can be at the hands of friends, relatives or strangers.

The most common reasons young people make disclosures are:

  1. To stop the abuse
  2. To protect others
  3. To seek justice
  4. To receive emotional support

Throughout the training, we see the story of Tyler, who was being abused. Tyler had many appointments and meetings with health professionals, who missed opportunities and Tyler’s attempts to disclose for various reasons. Some of these included lacking time to ask further questions in appointments, being dismissive of the ‘angry’ teenager they had before them and taking what’s being said at face value, rather than questioning the motives or causes of self-destructive and self-harming behaviour.

Videos of other young people describe how they feel when going to an appointment with a health professional, including:

  • Awkwardness about questions and what they would be asked
  • Worry about being in waiting areas with others
  • Feeling sick when they realised the worker was of the opposite gender
  • Confusion about what information will be given to who
  • Embarrassment about if they’d have to show their private parts
  • Distrust of adults

Many of these feelings could be overcome, or at least lessened by professionals being open with young people about what will happen in the process, and how they’ll be dealt with.

The training stresses why it’s so important that professionals ensure that young people are Seen and Heard. 66% of sexually abused children surveyed said that they had attempted to disclose the abuse whilst it was happening, but that their disclosure was not acted upon. For some, the abuse continued for an average of almost six years after the first disclosure. Over 30% of those who had continued to be abused after making disclosures had disclosed to a statutory service such as GP, social worker, doctor or teacher.

Young people say that things that encouraged them to disclose included:

  • How the first person you talk to treats you
  • Staff being friendly
  • Not asking what they’ve come for at reception, in front of others
  • Being spoken to like they’re people – not being belittled
  • Being able to see the human under the uniform – and that they care
  • Professionals being calm and not rushed
  • Understanding what will happen next

I hope that the training will encourage staff to be more open to seeing and hearing what young people are trying to tell them. With small changes to how professionals interact with young people such as those above, I hope that young people will have more confidence to tell workers what is happening to them.

Is the training effective?

I strongly welcome the training which I think most importantly really focuses on, and is formulated by, young people, their actions and their needs. The campaign aims to have 750,000 NHS professionals undertake the training, either through workshops or through the e-learning. There are 1.5 million people employed by the NHS. Whilst I understand that some of these may not work in front line services with young people, I think the training itself shows the need for all staff to be trained to see the signs, and really hear what the young people in front of them are trying to say – and that means workers at all levels.

I really hope that professionals, not just in the NHS, but anyone who works with or may have contact with children undertakes the training, so that they can learn how to help children suffering from or at risk of abuse, be Seen and Heard.

The training lasts for around an hour, and you can find it here.