The trauma caused by childhood sexual abuse (CSA) often persists into adulthood, with many survivors remaining silent about what happened. Globally, trauma is common, with about 70% of people exposed to at least one traumatic event (Kessler et al., 2017), yet CSA remains among the most damaging and pervasive forms of developmental trauma (Mathews & Collin-Vézina, 2019). In England and Wales alone, around 1 in 13 adults report experiencing CSA before the age of 16 (Office of National Statistics, 2025), with long-term impacts including PTSD, depression, anxiety, and substance misuse (Hailes et al., 2019).
There’s strong evidence that psychological therapies, such as trauma-focused CBT and EMDR can help adults who have experienced CSA (National Institute for Health and Care Excellence [NICE], 2018). But evidence alone does not mean everyone affected by trauma will reach out for support or receive equitable care. Previous Mental Elf blogs remind us that cultural context, stigma, language barriers, and trust can all shape whether people seek help in the first place (Taylor, 2021; Tong, 2020; Qiu, 2019).
For adults of South Asian heritage, help-seeking may be further influenced by concepts of honour, shame, family reputation, and silence around sexual abuse (Begum, 2018; Gill & Harrison, 2019). Despite South Asians being the largest ethnic minority group in the UK (Office of National Statistics, 2022), their experiences remain underrepresented in trauma research.
A new qualitative study by Chen and colleagues (2025) at UCL helps address this gap by asking a crucial question: what do UK mental health professionals and key stakeholders think South Asian adult survivors of CSA need, and where are services falling short?
Childhood sexual abuse affects South Asian communities, but their needs are often overlooked.
Methods
Chen and colleagues (2025) conducted a qualitative study using semi-structured interviews to explore professional perspectives on the support needs of South Asian adult survivors of childhood sexual abuse (CSA). Participants included UK-based mental health professionals and key stakeholders with relevant experience, recruited through purposive and snowball sampling. Interviews were conducted online or face-to-face, audio-recorded, and transcribed word-for-word. Data were analysed using reflexive thematic analysis. Ethical approval was obtained, and careful procedures were put in place to support participants during discussions of this sensitive topic.
Results
Four overarching themes were identified from interviews with seven participants (five mental health professionals and two key stakeholders). These themes highlight barriers to care and priorities for improving support for South Asian adult survivors of CSA.
1. Barriers to accessing professional support
Participants described multiple practical and structural barriers that made accessing mental health support difficult. These included long NHS waiting lists, financial barriers associated with private therapy, and limited availability of language-appropriate services. A lack of South Asian representation within mental health services was also seen as a barrier, with some survivors potentially struggling to feel understood or comfortable engaging with predominantly White services.
Alongside these practical challenges, participants highlighted culture-specific barriers, including an “extra layer” of shame associated with CSA, concerns about family honour and reputation, and fear of community judgement. Worries about confidentiality, particularly when interpreters were involved, were also thought to discourage help-seeking.
2. Challenges when engaging with professionals
Participants highlighted possible mismatches between survivors’ expectations and the way therapy is typically delivered in UK services. Western models that emphasise open emotional expression and individual identity could be unfamiliar or uncomfortable for South Asian clients. Professionals noted that some survivors found it hard to express emotions, carried self-blame, or delayed disclosing abuse.
It was also highlighted that unhelpful responses to disclosure, such as feeling dismissed or not believed by professionals or community members, often reduced trust in services and discouraged survivors from seeking help.
3. Reliance on informal sources of support
Many South Asian survivors may not know that professional support is available, so they often turn to informal sources such as family, community networks, faith-based support, or online spaces. Strong family ties can offer emotional and practical help, but they can also reinforce silence and discourage disclosure. Online platforms were described as helpful for providing anonymity and easy access to information.
4. Improving support for South Asian CSA survivors
Based on the participants’ accounts of the current care provided to South Asian survivors of CSA, the researchers identified several priorities for improving care:
- Cultural humility, characterised by openness to learning about survivors’ cultural, familial, and spiritual contexts
- Raising awareness and mental health literacy within South Asian communities, including understanding of CSA, trauma responses, and available support
- Increased diversity among service providers, to improve representation and therapeutic trust
- Targeted, language-accessible resources, clearly explaining confidentiality, treatment processes, and routes to care
- Adapting Western-based interventions and assessment tools to better reflect cultural norms and expressions of distress.
Barriers to care, reliance on informal support, and priorities for improving trauma services for South Asian childhood sexual abuse survivors.
Conclusions
While evidence-based trauma therapies are effective, they are not enough on their own to ensure equitable care for South Asian survivors of CSA. Practical barriers, cultural stigma, and mismatched therapeutic norms can all prevent survivors from accessing support.
Researchers emphasised that closing this gap requires cultural humility from professionals, greater diversity among service providers, and language-accessible resources. They also highlighted the importance of raising awareness and improving mental health literacy within South Asian communities, alongside adapting Western-based interventions and assessment tools.
Without these changes, many survivors may continue to live with trauma in silence.
Trauma care must prioritise the needs of South Asian childhood sexual abuse survivors.
Strengths and limitations
This study had some clear strengths. It addressed an important gap in UK trauma research by focusing on the support needs of South Asian adult survivors of CSA. A qualitative design was well-suited to exploring professional perspectives, and semi-structured interviews allowed participants to share detailed views on complex and sensitive issues. Participants were purposively recruited based on relevant experience, and the analysis followed recognised guidelines for reflexive thematic analysis, with evidence of reflexivity and team discussion to strengthen rigour.
However, there are also some limitations. The sample size was small (seven participants), and while depth rather than breadth is expected in qualitative research, the limited number of stakeholders may restrict the range of perspectives captured. It is possible that professionals most engaged with cultural issues may have been more likely to participate. In addition, most participants were based in England and largely practised in London, limiting the transferability of findings to other regions or service contexts.
Crucially, the study did not include the voices of survivors themselves. While professionals and stakeholders offer important insights into service provision and perceived barriers, their accounts cannot fully capture survivors lived experiences or preferences for support. This means the findings reflect what is visible to services, rather than the full range of needs that may remain hidden due to stigma, silence, or disengagement from care.
Finally, while the researchers’ expertise in trauma and cultural issues is a strength, it may also have shaped interpretation. Overall, while the study provides credible and thoughtful insights, its findings should be considered exploratory rather than definitive, highlighting the need for further research that includes survivor perspectives.
This study provides a thoughtful and credible exploration of professional perspectives on supporting South Asian adult survivors of childhood sexual abuse, but the absence of survivor voices limits insight into lived experience and multivocality.
Implications for practice
This study has clear implications for mental health practice in the UK. For South Asian adult survivors of CSA, practical barriers, cultural stigma, and mismatches between therapeutic norms can all limit engagement. Therefore, services must pay closer attention to how care is delivered.
The findings also highlight the importance of cultural humility rather than cultural competence as a static skillset. Clinicians may benefit from ongoing reflective practice that encourages curiosity about family dynamics, honour, shame, spirituality, and community context. Small adjustments, such as explicitly addressing confidentiality concerns, checking for comfort with interpreters, or being flexible about emotional expression, may make a significant difference in whether survivors feel safe enough to engage.
Importantly, this study also sets a helpful tone for how we approach ethnicity in mental health research and practice. Rather than treating ethnic minority communities as a single, homogeneous group, it demonstrates the value of focussing on the needs of specific communities. This more nuanced approach allows us to move beyond broad generalisations and opens the door to further work exploring differences within South Asian communities themselves and other ethnic minority groups (e.g., Afro-Caribbean, East Asian, etc).
From my perspective as a mental health practitioner who has worked across a range of services and as someone from an ethnic minority background, this research resonates deeply. I have often witnessed people from ethnic minority communities being misunderstood, having their distress minimised, or being expected to fit into therapeutic models that do not reflect their cultural realities. Studies like this matter because they validate those experiences and show that being heard is a therapeutic act.
This study has meaningfully shaped how I think about service development in my own practice. As part of my clinical psychology training, I will be undertaking a service improvement project within an eating disorder service, where trauma histories are common. The findings have helped me think more about what it means to widen accessibility for people from different ethnic minority backgrounds, and how services might better recognise and respond to various barriers to engagement. Rather than expecting individuals to adapt to existing models of care, this study has reinforced the importance of designing services that can adapt to the communities they serve.
Supporting South Asian survivors of childhood sexual abuse requires more than evidence-based treatments and understanding of the cultural context.
Statement of interests
Andie Ashdown has no conflicts of interest to declare and was not involved in the study or related projects. AI tools were used at a minor level to support drafting and copy editing.
Edited by
Dr Dafni Katsampa.
Links
Primary paper
Yuqian Chen, Eugenia Drini, Rebecca Appleton, Jo Billings, Shivangi Talwar. (2025) Support needs of South Asian adult survivors of childhood sexual abuse in the UK: Perspectives of UK mental health professionals and key stakeholders. PLOS Mental Health 2(10) e0000454. https://doi.org/10.1371/journal.pmen.0000454
Other references
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Gill A.K., Harrison K. (2019) “I am talking about it because I want to stop it”: Child sexual abuse and sexual violence against women in British South Asian communities. British Journal of Criminology 59(3) 511–529.
Hailes H.P., Yu R, Danese A, Fazel S. (2019) Long-term outcomes of childhood sexual abuse: An umbrella review. Lancet Psychiatry 6(12) 1039–1050.
Kessler R.C., Aguilar-Gaxiola S, Alonso J, Benjet C, Bromet E.J., Cardoso G. et al. (2017) Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology 8(Suppl 5) 1353383.
Mathews B, Collin-Vézina D. (2019) Child sexual abuse: Toward a conceptual model and definition. Trauma, Violence & Abuse 20(2) 131–148.
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