• 96% of abusers have a relationship with the child, 72% being the natural parents. Only 4% fall into the other/stranger category (AIHW, 2000)v
• Ratio of women to men adult survivors who presented to sexual assault services (1997-1980) was approximately five to one, 38% were aged between 16 - 24 years. In over 60% of cases, the time between the assault and presentation is over ten yearsvi
• Monash Study of Hearing in the Family Court found 50% of pre-hearing cases and 30% of full hearing cases involved child abuse, yet in 86% of cases it had not been reportedvii

• One in 3 girls and one in 6 boys are sexually abused before the age of 18vii
• NASASV in a Snapshot Data Collection by Australian Services against Sexual Violence: June 2000, over a three-week period, recorded service user characteristics in 51 participating services. (3837 contacts with a diversity of providers). The report stated that 62% of service users were survivors, the largest single category of over 50% representing contacts related to sexual abuse during childhood, the largest group presenting aged 20 to 29, followed by those between ages 30 and 39.ix

• Research has consistently shown that adult survivors have high rates of mental illness, suicide, substance abuse and poor physical health.xiii
• An established body of knowledge exists, clearly linking CSA with higher rates in adults of depressive symptoms, anxiety symptoms, substance abuse disorders, eating disorders and post-traumatic stress disorders.xiv Clients with substance abuse problems report high levels of exposure to CSA and physical abuse. A review of 12 studies indicates rates of CSA among those in treatment for alcohol abuse varied from 84 % to 20 %.xv
• In a study of pathways between drugs and crime, drug abuse consistently pointed to histories of sexual, physical and / or emotional abuse.xvi
• Suicidality has been associated with CSA in a number of studies.xvii In one community study, 16% of survivors had attempted suicide compared to 6% of their non-abused cohorts.xviii
• Self-mutilation has been consistently described among former survivors.xix
• The National Homelessness Strategy (2000)xx identified several causal factors for homelessness which closely relate to CSA, sexual and physical abuse, mental illness and substance abuse.xxi
• A study found that 80 to 85 per cent of women in Australian prisons have been victims of incest of other forms of abuse.xxii
• A study of 27 correctional centres in New South Wales found that 65 per cent of male and female prisoners were victims of child sexual and physical assault.xxiii It has also been found that maltreated children are more likely to offend in adolescence than those children who are not.xxiv
• A study of risk factors for the juvenile justice system found that 91 per cent of the juveniles who had been subject to a care and protection order, as well as a supervised justice order, had progressed to the adult corrections system, with 67 per cent having served at least one term of imprisonment.xxv
• The Salvation Army estimates that at least 50% of the homeless young people currently being assisted by them have suffered physical or sexual abuse.xxvi
• A survey conducted by Macquarie University amongst Sydney homeless children (1991) revealed very high levels of physical and sexual abuse, particularly of young females. Of the girls interviewed, 73% reported physical abuse, 82% had been sexually abused, the abuse mostly having occurred under the age of 11 (67%), with 26% experiencing their first sexual abuse between the ages of 12 and 15 years.xxvii

• A National report published by the Kids First Foundation (2003) into the cost of child abuse and neglect in Australia identified:
  • a) Human cost of those abused.
  • b) Long-term human and social costs - The long term human and social costs included mental disability, increased medical service usage, chronic health problems, lost productivity, juvenile delinquency, adult criminality, homelessness, substance abuse and intergenerational transmission of abuse.
  • c) Cost of public intervention and costs of community contributions - Public sector intervention involved child protection services including abuse prevention programs, assessment and treatment of abused children, law enforcement and victim support.
  • d) Economic cost - The report estimated that child abuse and neglect costs Australian taxpayers almost $5 billion a year. The long-term human cost and the cost of public intervention accounted for around three quarters of the total cost, with the long-term human and social cost estimated at just on 2 billion per annum.xxviii
• International research also indicates the massive costs involved. United Kingdom National Commission of Inquiry into the Prevention of Abuse estimated that the cost of child protection services, as well as the additional mental health and correctional services associated with child abuse, was over one billion pounds per year in England and Wales.xxix
• An American study, Prevent Child Abuse, conservatively claimed that US$94 billion was spent annually in response to child abuse. Of this amount, 75 per cent was spent on treating all the long term effects, including special education, mental and physical health care, juvenile justice, lost productivity and adult criminality.xxx
• People with all sexual assault and abuse histories present with physical problems with greater frequency than those who have not experienced abuse, and utilise high levels of health care (more physician visits and higher outpatient expenditure.xxxi
• Services in metropolitan and particularly in rural, regional and remote areas lack both the time and resources to undertake outreach work.xxxii
• Adult survivors frequently have no subsidised access to counselling. Services with only limited resources simply cannot meet the demand and are obliged to prioritise services to assist those in crisis for "recent assaults."xxxiii Subsidised services under health funds rarely offer more that 6 or 8 sessions with a psychologist, when long-term counselling is required.
• NCOSS proposed funding for improved support (particularly for rural services) to address sexual abuse issues would result in a reduction of other general health, mental health, substance dependency, and decrease demand on other health services.xxxiv

• Mental disorders account for almost 30% of the non-fatal burden of disease in Australia. Depression is the most common mental disorder reported, both recent and long-term and has been identified as one of the most pressing priorities.xxxv
• In 2001 -2002, total spending on mental health services was $3.1 billion. Specialised mental health services accounted for 6.4% of Australia's recurrent health expenditure. AIHW analysis shows that the proportion of mental health expenditure rises to 9.6% if substance abuse and dementia are included. Substance abuse accounts for 11.5% of the costs of mental health in Australia.xxxvi
• Those who suffer a continuing mental illness have lives shortened on average by as much as 20 years, 23 per cent of this is due to alcohol. Dependency on alcohol at least doubles and perhaps even triples the risk of depression and other substance abuse, it also increases vulnerability to other mental disorders and physical disease.xxxvii
• Up to 23 per cent of suicides in Australia are caused by alcohol and between 30 and 50 per cent of people who commit suicide have had a previous history of an alcohol use disorder. Suicide is the commonest cause of death in alcohol dependent people. Alcohol misuse penetrates family life, the workplace and the community at large.xxxviii

i(AIHW) Australian Institute of Health and Welfare. (2006). AIHW Child Protection Australia 2004- 2005, Cat. No. CSW: 26. Canberra: (Child Welfare Series No: 38).

ii(AIHW) Australian Institute of Health and Welfare. (2006). AIHW Child Protection Australia 2002- 2003, Cat. No. CSW: 26. Canberra: (Child Welfare Series No: 34).

iii(AIHW) Australian Institute of Health and Welfare. (2006). AIHW Child Protection Australia 2003- 2004, Cat. No. CSW: 26. Canberra: (Child Welfare Series No: 36).2001-2 No.32

ivAustralian Childhood Foundation. (2006). Out of Sight - Out of Mind. .

v(AIHW) Australian Institute of Health and Welfare. (2000).

viNSW Health. NSW Health Sexual Assault Services Data Collection, 1997/ 1998: Initial Contact at Sexual Assault Services. Available: http://www.health.nsw.gov.au/pubs/s/sas/tables.html

viiAustralian Domestic and Family Violence Clearinghouse. (2005). Issues Paper 10.

viiiRussell, D. E.H. (1988). The Incidence and Prevalence of Intrafamilial and Extrafamilial Sexual Abuse of Female Children. In: Handbook on Sexual Abuse of Children (eds) L. E.A. Walker. Springer Publishing Co.

ixNASAV. (2000). National Data Collection Project: Report on the Snapshot Data Collection by Australian Services against Sexual Violence, June 2000. .

xIbid.

xiNSW Health. NSW Health Sexual Assault Services Data Collection, 1997/ 1998: Initial Contact at Sexual Assault Services. Available: http://www.health.nsw.gov.au/pubs/s/sas/tables.html Accessed: 06.07.05.

xiiAustralian Institute of Family Studies. (2003) Statistical Information. International Violence Against Women Survey: the Australian Component. Available: www.aifs.gov.au/acssa/statistics.html

xiiiNCOSS. (2004). Better social results for NSW. Social and economic priorities for a fair and sustainable community: 2005 - 2006.State Budget.Council of Social Services NSW, p. 69.

xivBriere & Runtz. 1988; Winfield et al.: 1990; Bushnell et al., 1992; Mullen et al., 1993; Romans et al., 1995:1997; Fergusson et al.: 1996; Silverman et al.: 1996.

xvFleming, J., Mullen, P. E., Sibthorpe, B., Bammer, G. (In press). The long term impact of child sexual abuse in Australian women. Australia: Child Abuse and Neglect.

xviJohnson, H. (2004). Drugs and crime: a study of incarcerated female offenders. Research and public policy series, no. 63. Canberra: Australian Institute of Criminology.

xviiBryer, J. B., Nelson, B.A., Miller. J.B., Krol, P.A. (1987) Child sexual and physical abuse as factors in adult psychiatric illness. American Journal of Psychiatry. (144) pp. 44-68. Briere. J., Zaidi. L.Y. (1989). Sexual abuse histories and sequelae in female psychiatric emergency room patients. American Journal of Psychiatry, 1989; 146: 1602-1606. Bagley C, Ramsay R. (1986). Sexual abuse in childhood: Psychological outcomes and implications for social work practice. Journal of Social Work and Human Sexuality. (4) pp. 33-47. Briere J, Runtz M. (1987). Post-sexual abuse trauma: Data and implications for clinical practice. Journal of Interpersonal Violence. (2) pp. 367-379. In: Nurcombe, B. (2005). Paper Presented at Ausinet Workshop. Brisbane. Online.

xviiiSaunders, B. E., Villeponteaux. L. A., Lipovsky, J. A. et al. (1992). Child sexual assault as a risk factor for mental disorders among women: A community survey. Journal of Interpersonal Violence. (7). pp.189-204.

xixLindberg, F. H. and Distad, L. J. (1985). Posttraumatic stress disorders in women who experienced childhood incest. Child Abuse and Neglect. (9) pp. 329-334.

xxCommonwealth Government of Australia. (2000). Department of Family & Community Affairs. National Homelessness Strategy - A Discussion Paper.

xxiAustralian Bureau of Statistics. (2003). Australian Social Trends : Housing and Homelessness.

xxiiEasteal P. (1994). Don't talk, don't trust, don't feel'. Alternative Law Journal, 19(2), pp. 185-89.

xxiiiT.Butler et al. (1999). Childhood sexual abuse among Australian prisoners. Venereology, 14(3), pp.109-15.

xxivA. Stewart, S. Dennison & E. Waterson. (2002). Pathways from Child Maltreatment to Juvenile Offending. Australian Institute of Criminology: Trends & Issues, No: 241, October 2002.

xxvL. Lynch, M.J. Buckman & L. Krenske. (2003). Youth Justice: Criminal Trajectories. Australian Institute of Criminology: Trends and Issues, No: 265, September 2003, p.2.

xxviSmith, J. (1995). Being Young & Homeless. Analysis and discussion of young people's experiences of homelessness, The Salvation Army Youth Homelessness Research Project. Australia. Available: http://www.salvos.org.au/SALVOS/NEW/me.get?SITE.sectionshow&FFFF446#reasons

xxviiHoward, J. (1991). Dulling the Pain: Two Surveys of Sydney Street Youth. Paper presented to the 9th National Behavioural Medicine Conference. The University of Sydney.

xxviiiKids First Foundation. (2003).The Cost of Child Abuse and Neglect in Australia.

xxixNational Commission of Inquiry into the Prevention of Child Abuse, 1996, Childhood Matters: Report of the National Commission of Enquiry into the prevention of Child Abuse.

xxxIbid.

xxxiKeel, M., Fergus, L. and Heenan, M. (2005). Home Truths: A Conference in Review. ACSSA Issues (3) March 2005.

xxxiiIbid.

xxxiiiIbid.

xxxivNCOSS. (2004). Better social results for NSW. Social and economic priorities for a fair and sustainable community: 2005 - 2006 State Budget. Council of Social Services NSW, p. 69.

xxxvMathers, C. , Yos, T. & Stevenson, C. (1999).The Burden of Disease and Injury in Australia. Australian Institute of Health and Welfare (AIHW): Canberra.

xxxviIbid.

xxxviiIbid.

xxxviiiIbid.