@article{ref1,
title="Delayed healthcare access among victims of sexual abuse, understood through internal and external gatekeeping mechanisms",
journal="Nordic journal of psychiatry",
year="2021",
author="Rajan, Gita and Wahlström, Lars and Philips, Björn and Wandell, Per and Wachtler, Caroline and Svedin, Carl-Göran and Carlsson, Axel C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Sexual abuse is associated with severe health consequences, and the European Union has, through the Istanbul Convention, urged its member countries to provide specialist care for victims of sexual abuse. <br><br>AIM: This aim of this study was to investigate patient- and abuse-related characteristics among patients seeking help at a specialist clinic in Sweden, with focus on disclosure, mental health and appropriate healthcare access.  Methods: This is a descriptive study where journal data from 100 consecutive patients January 2017 to February 2018 were analyzed. All adult individuals (women n 80, men n ¼ 8) who had taken part in the standardized semi-structured intake interview at the clinic were included (n 88).  Results: At admission, mean age was 40.3 (SD 11.9), mean number of psychiatric diagnoses 6.3 (2.6), and 93% of the patients scored above cut-off (34) on IES-R for PTSD. A majority of the patients (87%) had been exposed to childhood sexual abuse (CSA), and mean time to first disclosure was 15.9 (SD 15.3) years. In total, 82% of the patients had, despite disclosure, experienced difficulties accessing appropriate healthcare before coming to the specialist clinic.  Conclusion: Adult victims of sexual abuse have difficulties accessing appropriate healthcare. This constitutes a gender-based equality problem. A model of gatekeeping mechanisms with two dimensions (external and internal) and three categories (Competence related, Organizational and Emotional) is proposed to understand these difficulties.<p /> <p>Language: en</p>",
language="en",
issn="0803-9488",
doi="10.1080/08039488.2020.1868573",
url="http://dx.doi.org/10.1080/08039488.2020.1868573"
}