There is a "major deficit in resources" to deal with people who have suffered sexual assault and abuse, a child psychiatrist told a conference in Letterkenny, Co Donegal, yesterday.
Dr Don McDwyer of the North Western Health Board said "all services are under a high degree of pressure".
Population surveys had shown the numbers coming forward for therapy were much lower than the percentage of people who had actually suffered sex abuse.
He was speaking at a conference organised by Letterkenny General Hospital on The Reception, Care and Medical/Legal Aspects of Rape and Sexual Assault.
Dr McDwyer said a new team approach at Letterkenny General Hospital was ensuring victims received therapy immediately and that initial examinations and investigations were done in a therapeutic way.
But he said much remained to be done at later stages in the process to improve the treatment and support services to victims, particularly children, and their families.
"Increased awareness and training are certainly needed but there is also a major deficit in resources to deal with the unmet needs we know are out there," he said.
Dr McDwyer said there was "a wide range of severe and long-lasting effects on child victims" and these may or may not be evident at the time. In some cases problems arise later, often in adolescence.
Mr Tom McGrath, the director of counselling in North West Regional Counselling Services, said a significant number of people who were abused as children were "revictimised" as adults. One study had found 61 per cent of children who had been victims of incest before the age of 14 were revictimised after the age of 14.
This posed challenges for workers as they had to bear in mind that traumatic events in adulthood could trigger memories of childhood abuse.
Mr McGrath said he believed the National Counselling Service, which was set up by the Government in each health board area, as a response to revelations of abuse in institutions, was making a difference. Over the past year, about 200 people had received counselling in the north west and there was no waiting list at present. This service was available to people who had suffered any kind of abuse, either in institutions or elsewhere. He said a review of the service nationally would be published next month.
Assistant State Pathologist, Dr Marie Cassidy, spoke about the role of the expert witness in court cases. She said she had spent "many a long and unhappy hour in the witness box". While she had no specific qualifications in forensic pathology, she had "learned the hard way, on the job". Although getting paid by one side, she believed the expert witness had to be fair and "straight down the middle".
In a talk, which was at times humorous, she said she had got herself in "terrible trouble" because she couldn't lie.
