Opinion: Sweden's healthcare system lets down victims of sexual violence

That’s why we want to highlight the question of healthcare and create a dialogue between the #MeToo movement and politicians.

Petitions like #bortabrahemmavärst ('Away is good, at home is worst' – relating to sexual violence at home), #intedinhora ('Not your whore' – relating to sexual violence against people in prostitution), #underytan ('Under the surface' – victims of honour-related violence), #utanskyddsnät ('Without a safety net' – sexual violence against those suffering from substance abuse or other social problems) and #vårdensomsvek ('Care that let us down' – women subjected to sexual trauma and harassment by health professionals) testify of traumatized people who received substandard care and, in the worst cases, were subject to assault and violations from healthcare staff.

In the petition #omniberättarlyssnarvi (if you talk, we’ll listen), 1,299 psychologists attested to their patients’ and clients’ vulnerability – at least 39,500 narratives of assault in total.

Talking about assault is still closely linked with shame. Many don’t talk about what they experienced, and healthcare professionals are often bad at asking. But the biggest problem is that access to effective treatment is lacking.

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Without treatment, there’s a significant risk of long-term mental health problems, for example post traumatic stress disorder (PTSD), depression and anxiety – with reduced quality of life and, in the worst instances, suicidal tendencies, as a result. There’s also a higher risk of suffering from physical health problems, substance abuse, or long-term sickness requiring time off work.

One of seven suggestions for political measures put forward by the coordinators of the #MeToo petitions is about increased efforts when it comes to treatment. In Almedalen, Equality Minister Lena Hallengren and the Moderate Party’s equality spokesperson Jessica Polfjärd showed engagement in the issue, but throughout the entire election campaign, we’ve not had any proposals of concrete investment.

Approximately just five percent of patients with mental health issues receive psychological assessment and treatment, according to national guidelines. Those who seek treatment after assault are rejected or have to wait much too long, despite the fact there are effective psychological treatments.

Would we accept so few getting the right care for any physical condition? Imagine that only five percent received care for cervical cancer. That would never be accepted.

In the case of cervical cancer, the healthcare sector has received resources to work with information campaigns, screenings at a national level, and extensive routines so that as many people as possible get treatment at an early stage.

When hundreds of thousands attested to harassment and abuse, we listened – but it’s not enough just to listen. There’s a need for concrete efforts and special measures for the relevant group.

We want to see a healthcare sector that works proactively and uses outreach to identify people early on who are developing mental health problems as a result of sexual assault. It should be as obvious to screen for this as it is to carry out smear tests for those at a risk of cervical cancer.

Sex-workers, people with substance dependencies, and those who are at risk of honour-related violence seek care less frequently. Therefore, they should be asked about any vulnerability through contact with the social services and other facilities, and they should be helped to receive further care as needed.

Care must be scaled based on the number of those affected. A large increase of psychological treatment requires primary care as well as specialist care, both for children and adults.

Within the #MeToo movements there is important knowledge both from the perspective of patients and those treating them. Within #omniberättarlyssnarvi (If you talk, we’ll listen), there is psychological expertise in trauma and care development, which are completely necessary in the work that needs to happen.

We are now inviting the responsible politicians (including Minister for Social Affairs Annika Strandhäll and the social policy spokesperson for the Moderates, Camilla Waltersson Grönvall) to a meeting in August. That’s when we will sit down together and discuss the solutions which give the best possibility of change.

Article by the undersigned, originally published in Swedish in Aftonbladet and translated into English for The Local by Catherine Edwards. Read the original version here.

#omniberättarlyssnarvi ('If you talk, we'll listen')
Amanda Simonsson
Charlotte Ulfsparre
Kristina Bondjers
Maria Bragesjö
Erica Mattelin
Johanna Ekdahl
Kerstin Bergh Johannesson
Maria Sandgren
Sveriges Kliniska Psykologers Förening
Olof Molander
Gustav Jonsson

#allmänhandling ('Public records)
Ingrid Mårtensson

#bortabrahemmavärst ('Away is bad, at home is worse')
Hanna Kaiser Barnes
Karin Tennemar

#ickegodkänt ('Not approved')
Ulrika Konstig
Anna Hermelin

#intedinhora ('Not your whore')
Gabriella
Ida
Ida
Juliana
Amanda

#lättaankar ('Cast anchor')
Cajsa Fransson
Frida Wigur
Linda Svenson

#metoobackstage 
Anna Velander Gisslén

#nödvärn ('Self defence')
Kerstin Dejemyr

#sistabriefen ('The last brief')
Elin Ahldén
Maja Stridsberg
Mimmi Sköldberg

#slutvillkorat ('Final terms')
Denise Cresso

#underytan ('Under the surface')
Galaxia Elias

#utanskyddsnät ('Without a safety net')
Birgitta Johnsson
Lotten Sunna

#virivermurarna ('We tear down walls')
Katarina Risberg
Malin Isaksson
Mia Blomberg

#vårdensomsvek ('Care that let us down')
Natalia Valiente Vecchio

Coordinators for the #MeToo petitions
Emmy Lilliehorn
Elin Andersson