Organised abuse: A neglected category of sexual abuse with significant lifetime mental healthcare sequelae

Background: Organised abuse (where multiple adults conspire to sexually abuse multiple children) has been one of the most controversial issues in debates over mental health practice with survivors of child sexual abuse. Aims: The aim of this paper is to summarise and analyse the available prevalence data pertinent to organised abuse and to identify the challenges that organised abuse poses for mental health policy and practice. Methods: Prevalence studies of sexual abuse based on community and clinical samples were reviewed for findings pertinent to organised abuse. Key indicators of organised abuse were selected and summarised on the basis of their association with the known characteristics of organised abuse. The literature regarding the health impacts of these indicators was also reviewed. Results: A minority of people reporting contact sexual abuse in the community report experiences indicative of organised abuse. These indicators are elevated in particular settings and they are associated with poor mental and physical health. Conclusions: Organised abuse is rare but it is associated with poor mental and physical health outcomes. There is currently no source of integrated care for adults with histories of organised abuse. Many survivors end up in prison or homeless, chronically disabled by illness, or dead.