It can be hard enough for anyone to talk about sexual assault, and to get in touch with the services and the support they need. For some groups and communities, it's even harder.

If you've suffered from mental illness in the past you may face a number of extra problems if you've been sexually assaulted.

You may find it hard to get people to believe you-they may say it is because of your medication or your illness.

You might feel guilty about what happened, and wonder if it was your fault. You may also doubt your own judgement and need to gain confirmation from somewhere about what happened. These are common reactions, but everyone is different, and you may feel differently.

If there is a social worker, counsellor, doctor, nurse or relative who you trust, it's a good idea to make sure that they know what has happened. Or contact a sexual assault service.

Abuse in psychiatric institutions
A 1997 report on the sexual abuse of women in psychiatric institutions found far-reaching effects on the women who had been sexually abused, including a loss of trust and faith in the staff and the institution itself. 'A crucial topic was the issue of disbelief of those who disclosed that they had been sexually abused; this was one of the main barriers to provision of safe, effective care' (Davidson, J., Every Boundary Broken: sexual abuse of women patients in psychiatric institutions, Women and Mental Health, 1997, p.97).

Abuse in institutions and community care
Rape and sexual assault in institutions and community care accommodation is often invisible to the rest of society. People can be sexually assaulted by staff, other patients and those sharing accommodation. People in institutions or community care may not tell anyone, fearing that they won't be believed, or that they may be thrown out. Sometimes when they do tell, nothing is done.

If you have been assaulted in a hospital or community accommodation, no matter who did it, you can contact the NSW Rape Crisis Centre or a sexual assault service. They will give you counselling, support and advice, and they will believe you.

Bipolar disorder
If you suffer from a bipolar disorder (manic depression) and you know that during a manic state you become sexually active, this does not mean that people have the right to take advantage of you. If you believe that someone has sexually exploited you during a manic phase and forced you into sex without your full consent, talk to someone you trust about what has happened to you, or contact a sexual assault service.

Childhood sexual assault and mental illness
Research suggests that that there is a strong link between sexual assault in childhood and mental illness in later life. A history of sexual abuse doubles the risk of serious mental disorder in adulthood.

It can also result in symptoms that are labelled as mental illness, including psychosis, without the abuse itself being acknowledged in treatment or therapy.

Mental health workers and psychologists are beginning to work with these facts. If you were abused as a child, or you suspect that you were, and it is not being dealt with, you may seek independent help from the NSW Rape Crisis Centre and sexual assault services. If you have also been raped as an adult, either tell your worker in mental health services that you would like them to contact a sexual assault service, or contact the centre yourself to get counselling, support and advice.

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