When a Psychiatrist, Psychologist or Psychotherapist is a Sexual Predator, Defrauder or Commits any Other Crime, Criminal Sanctions are Necessary

By CCHR International
The Mental Health Industry Watchdog
June 13, 2020

Australia has an inequity in its laws when it comes to psychiatrist and psychologist sexual offenses, for example, against patients, thereby putting potentially hundreds of patients at risk. Citizens Commission on Human Rights (CCHR) International’s therapist abuse database documents that since 2010, at least 54 Australian psychologists and psychiatrists had their licenses suspended or revoked—primarily for patient sexual abuse, but also for fraud. While some of those committing sexual offenses, are criminally prosecuted, the abuse is largely treated as a disciplinary issue, which must change, CCHR says. While compassion, common sense and decency declare that sexual abuse of patients is a serious and criminal act, psychiatrists and psychologists tend to sanitize it as “professional misconduct.”

In other countries, such as the United States, Germany, Israel and Sweden, there are laws specifying it a criminal offense to engage in such abusive contact with a mental healthcare patient. In fact, CCHR has successfully worked to obtain laws that ensure psychiatrists, psychologists, psychotherapists and behavioral counselors are not above the law, with 32 criminal statutes in the U.S. alone that now protect patients from therapist sexual assault.[1] 

The abuse is also prevalent in Australia. The Medical Journal of Australia reported that “an anonymous mail survey of psychiatrists found that 7.6%, almost all male, reported erotic contact with patients during or after termination of treatment.”[2] In 2007, Australian psychiatrist Prof. Carolyn Quadrio’s research found that one in every ten male therapists will have sex with or develop an intimate link with a female patient.[3]  

The rates of abuse are similar to that in the U.S. where a survey of U.S. psychiatrists, published in 2006, found 7.1% of the male and 3.1% of the female responding psychiatrists acknowledged sexual contact with their own patients.[4]

An estimated 3,369 psychiatrists were working in Australia in 2017, of which 60.8% (2,048) were male and 39.2% female (1,321).[5] That potentially equates to an estimated 156 male Australian psychiatrists sexually exploiting patients and using the U.S. 3.1%, 41 female psychiatrists.

Just as concerning, 33% of U.S. psychiatrists who responded to one survey admitted to sexual relationships with multiple patients.[6] In another study, 80% of psychologists who had intimate relationships with patients reported encounters with multiple patients.[7] Quadrio’s published 1996 analysis of data derived from assessments of 40 women who experienced sexual abuse in therapy, also determined that 68% had a history of childhood abuse, and one-half were themselves helping professionals.[8] 

A 1991 study pointed out how abusive this is because, “Like a child depends upon a parent, a patient often depends upon a therapist.”[9]

In Australia, this potentially puts hundreds of patients at risk. While license revocations may prevent a psychiatrist or psychologist from practicing, this can be temporary and they can continue to practice as an unregistered therapist, albeit not likely able to bill insurance companies.  

A study published in February 2020 reinforces that “sexual relationships between psychiatrists and patients are neither a new phenomenon nor particularly rare.”[10] The sexual crimes committed by psychiatrists are estimated at 37 times greater than rapes occurring in the general community, one U.S. law firm stated, estimating that about 150,000 female patients in the U.S. have been assaulted.[11] A Boston Globe article suggested psychiatry is a “hotbed of sexual misconduct.”[12]

Based on NSW Health Care Complaints Commission information, about 4% of male psychiatrists in NSW alone have been reported for sexual abuse of patients. Cherrie A Galletly, writing in the MJA, referred to “predatory doctors” but she also uses a common minimizing term: that doctors who have sexual contact with patients are “boundary crossing” (so-called non-exploitative departures from usual practice).[13] In 1992, Quadrio, who had found a 10% prevalence of sexual relationships arising in and following psychotherapy, described one-half of offenders to be “ruthless” and “exploitative,” but the remaining 50% were said to be “often ‘lovesick.’”[14]

Herein lies the problem: Any lay person accused of sexual assault in a criminal court is unlikely to be able to use “boundary crossing” or they were “love sick” as a defense and get away it. 

Galletly acknowledges this: “It has been suggested that sexual exploitation by psychotherapists (psychiatrists, psychologists, psychoanalysts and social workers) should be a criminal offence, with penalties including fines and imprisonment…Public pressure for more punitive responses is likely to increase if the profession’s response is seen as inadequate.”[15] However, it’s not a matter of “professional response” (which usually mitigates the offense) but rather a matter or judicial recognition that it is a crime and even more egregious because the abuse is done in the name of “therapy.” The desperate victim has accepted help and is then betrayed by the “benefactor.” Such despicable treachery in the wake of an already serious personal crisis could only burden the victim with further emotional scars and instability. 

All this adds up to the need for Australian state laws to specify that therapist-patient sexual contact should be subject to criminal investigation and prosecution.

In an Atlanta Journal-Constitution investigation culminating in an article headlined, “Licensed to Betray,” journalists noted that while society condemns sexual misconduct when committed by citizens and demands punishment when a physician is the perpetrator, the nation often looks the other way. It further stated that “layer upon layer of secrecy makes it nearly impossible for the public” to know the extent of the abuse.[16] 

The crime can also involve fraud. Mental health therapists have billed insurance companies for their sexual assault as a consultation.  Representative of this, one U.S. patient said her psychotherapist had sexually assaulted her and billed her insurance $85 per hour. In another case, the patient said the psychiatrist had “control of my drugs and whether I could stay out of the hospital. I had to do sexual things to get my medication.”[17]  

But thankfully, some Australian criminal courts are recognizing the inequity and lifting the veil of secrecy. Since 2000, CCHR International has documented more than a dozen publicized convictions of psychiatrists and psychologists, not only for patient sexual abuse, but also possession of child pornography; videoing young boys urinating in public toilets; maliciously wounding and injuring a young, male prostitute and murder.

On 10 June 2020, ABC News reported that the Australian Psychological Society (APS) was under fire for its “disturbing” response to APS’s former president pleading guilty to a charge of child sexual abuse.[18] As a celebrity psychologist, he appeared on the TV show Big Brother as a consultant and was used by the Family Court as an expert in custody disputes. He is being sentenced in the NSW District Court on two counts of buggery, five of indecent assault of a male and one of procuring an indecent act. He faces up to 14 years in prison.[19]

In 2014, the APS had made the psychologist a “new honorary fellow” to recognize his “extraordinary and distinguished contribution.”[20] But that “contribution” involved a hidden history of sexual assault of children.  The psychologist pleaded guilty to abusing 12-year-old boys while he was a scoutmaster in Sydney in the 1960s. The Daily Mail in the UK headlined their story on the conviction, “Big Brother TV doctor preyed on young boys by encouraging them to pleasure themselves in his living room before abusing them on Boy Scout camping trips – as his victims break their silence.”[21]

The case is not an exception to the rule. CCHR’s public database of criminal and disciplinary actions committed by mental health industry personnel, reveals nearly a third of criminal convictions are for sexual abuse committed by psychiatrists, psychologists, therapists and counselors including the sexual assault of children. 

Chelmsford Hospital Psychiatrist-Sexual Manipulation

Awareness of Australian psychiatrists sexually abusing their patients was highlighted when the late Sydney psychiatrist, Dr. Harry Bailey from Chelmsford private psychiatric hospital, sexually abused his patient, Sharon Hamilton in the late 1970s. Bailey developed the now banned “deep sleep treatment” (DST) which induced patients into a coma with a cocktail of psychotropic drugs and subjected them to electroshock treatment. DST was linked to dozens of deaths. A 1990 New South Wales government inquiry accused Bailey of a disgraceful breach of all standards of medicine in his relations with female patients, some of whom were brought to his house in the middle of the night, according to New Scientist.[22]

Robert M. Kaplan, author of Medical Murder: Disturbing Cases of Doctors Who Kill wrote of Dr. Bailey setting up DST in 1963, finding doctors to assist. The treatment caused thrombosis, pneumonia, strokes, heart attacks and brain damage, according to Kaplan. “As casualties mounted and the body count rose, Bailey made no attempt to improve the procedure or provide a better care and supervision,” he wrote. Bailey’s undoing, Kaplan said, was his affair with Hamilton. She was a young dancer who was attacked by a prisoner during a performance at a local jail.[23]

Seeking compensation, she was referred to Bailey, who put her under DST and assured her this would assist in her lawsuit. But Bailey seduced her, beginning a torrid affair. Whenever Hamilton became disgruntled or threatened to expose him, she was subjected to more “treatment.” Within five months of Hamilton’s $100,000 award for the knife attack, she handed over control of her finances to Bailey’s accountant, who invested $30,000 in Bailey’s personal private hospital.[24]

A statement from a former Chelmsford nurse provided to CCHR said she once entered Hamilton’s hospital room to find her cutting her pubic hair. When asked why she was doing this, Hamilton replied, “I’m doing it because Harry likes it cut short.”[25]

Hamilton became pregnant and had an abortion at Bailey’s suggestion, a government inquiry heard. He denied that he was the father. Less than a year later, Hamilton committed suicide.

In 1978, CCHR wrote to the NSW attorney-general detailing the evidence of Bailey’s alleged malpractice and misconduct with Hamilton, her suicide and that he was the beneficiary of her estate. An Australian Dictionary Biography of Bailey said he “reveled in the trappings of professional power and exploited the vulnerabilities of those in his care, having sexual relationships with a number of female patients and some employees.”[26]

That vulnerability extends beyond sexual abuse.

Other Crimes in the Mental Health Industry: Fraud

Quite apart from sexual abuse in the mental health field, as documented by CCHR, in a sample of over 1,000 mental health practitioners worldwide, fraud accounted for the greatest number of convictions for psychiatrists and psychologists (around 36%), followed by sexual assault (30%), drug-related crimes (prescription fraud, drug trafficking, illegal and dangerous psychotropic drug prescribing at 16%.)

Separately, CCHR documented, as an example, 18 cases of psychiatrists and psychologists involved in criminal conduct in Australia. Of these, 12 were psychiatrists and six were psychologists. The majority of convictions were for sexual-related crimes (14), ranging from a Melbourne psychologist placed on the sexual offenders register for 8 years for possessing child pornography; psychiatrists and psychologists being sexually involved with their patients and indecent assault to rape.

Of the 18 cases, at least two were fraud-related involving Work Cover and there was also an incident each of maliciously wounding a male prostitute and murder.

Fraud is prevalent in the healthcare and mental health field. In the U.S., Mark Schlein, former director of Florida’s Medicaid Insurance, when investigating massive mental health fraud said that “the extent of the fraud is limited only by the imagination.”[27]

In 2014, Richard Kusserow, who served for eleven years as the U.S. Health and Human Services Inspector General, pointed out: “Many health care fraud investigators believe mental health caregivers, such as psychiatrists and psychologists, have the worst fraud record of all medical disciplines.”[28]

In Australia, substantial healthcare money is involved where potential fraud could exist. The country spends more than $9 billion on mental health services every year but has no coherent strategy for where the money is going and whether the programs actually work, according to news.com.au.[29] 

In 2017, the Australian Federal Department of Health reported that it was pursuing doctors (generally) to repay AUS$30 million in erroneous or fraudulent Medicare claims—a jump of nearly 60% from a year before, recorded as $18.8 million.[30]

In the country’s employee WorkCover workers’ compensation insurance scheme, fraud is rampant and under-reported, much to the dismay of the parties that have to carry the cost of WorkCover fraud.[31]

In 2014, Nilay Patel, a former U.S.-based certified specialist in healthcare compliance and then law tutor at Swinburne University of Technology in Victoria, said Australia was falling behind the United States at preventing, detecting and prosecuting healthcare frauds. “The safeguards [in Australia] are quite inadequate, the detection is more reactive that proactive and whatever proactive mechanisms that are there I think they are woefully underdeveloped,” he said.[32]

In the 1980s, because of the fraud and abuse CCHR found in private psychiatric hospitals, the group was instrumental in obtaining the establishment of a healthcare complaints unit, first in NSW and then in other states. A federal registry now exists of those healthcare professionals, including psychologists and psychiatrists convicted or disciplined for crimes.  Between 2019 and 2020, 8,023 complaints were assessed, up from 7,735 in 2018-19, with a 98.6% success rate in prosecutions.[33]

Generally, complaints against mental healthcare practitioners in Australia are generally higher than for physical physicians, according to a study published in BMJ.  This was a study of the “complaint risk among mental health practitioners” (psychiatrists and psychologists) compared to physical health practitioners (physicians, optometrists, physiotherapists, osteopaths and chiropractors) in Australia for the period 2011-2016. In total, 7,903 complaints were lodged with regulators over the 6-year period. Patients or their relatives lodged the majority of these complaints (83.4% for psychiatrists; 60.3% for psychologists).  Findings from the analysis included:

• Mental health practitioners had a complaint rate that was more than twice that of physical health practitioners.
• The complaint rate among psychologists was nearly treble than among other allied health practitioners.
• Psychiatrists had five times the risk of being subject to a complaint about a breach of confidentiality compared with physicians, and for psychologists, the risk was nearly eight times higher than for other allied health practitioners.
• Mental health practitioners had more than three times the risk of complaints about interpersonal behavior, such as disrespect, discrimination, threats, or bullying, compared with physical health practitioners. The reason for this is unclear.
• Alleged breaches of sexual boundaries accounted for 4.4% of complaints about psychiatrists and 6.7% of complaints about psychologists )

• A small number of complaints resulted in formal regulatory action such as a caution, reprimand, conditions or suspension (7.8% of complaints about psychiatrists, 12.0% about physicians, 23.9% about psychologists and 28.7% about other allied health practitioners).[34]

There are reports of suspected fraud in the mental health system. In 2021, the Victorian government launched an inquiry into a mental health organization alleged to have falsified suicide helpline data so it could receive state government funding. The organization delivers counselling and mental health services throughout Australia via outsourced telephone and digital counsellors for hotlines.[35] (The outcome of the inquiry is not known at the time of writing)

In March 2022, a Queensland psychologist of more than 20 years, used the names of patients’ family members to receive almost $110,000 from bogus bulk bill claims. She made 1,381 false Medicare claims for more than 18 months up to May 2017.  She was sentenced to three years in jail, to be released after six months, on one count of obtaining a financial advantage by deception.

Whether it is fraud, sexual abuse or other crimes, patients deserve better.

Taking a 2019 case as an example, Independent Australia referred to a convicted psychiatrist as “Dr. Predator” who had committed a “huge abuse of power.” It took “a brave survivor” with the courage to speak out that helped take him down, according to the report.[36] Laws should respect that bravery.

The term “boundary crossing” should be abolished as an excuse or defense in any psychiatrist, psychologist or mental health therapist sexual contact with a patient. Therapist sexual abuse is sexual abuse. Therapist rape is rape. They will never constitute therapy. Until this is widely recognized, with prosecutors treating every incidence of this as criminal offenses, many psychiatrists, psychologists and psychotherapists will remain a threat to anyone, including children undergoing mental health therapy.

Anyone sexually abused by a mental health professional also has the right to seek recourse for damage incurred. If you or anyone you know has been sexually abused or knows of a patient who has been sexually assaulted by a psychiatric or psychological counselor are encouraged to report this to CCHR Australia: https://cchr.org.au/report-psychiatric-abuse

Anyone who has been defrauded or otherwise abused in the mental health system should also report this to CCHR Australia: https://cchr.org.au/report-psychiatric-abuse

The NSW Healthcare Complaints Commission has a much needed service for patients, families, health insurers, etc.  It has a database of practitioners whose name can been inserted and any criminal or disciplinary actions that may have been taken is available. Anyone who wants to search if a healthcare professional in NSW has been disciplined or convicted, search the NSW Health Care Complaints Commission.

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[1] https://www.globenewswire.com/news-release/2019/10/17/1931441/0/en/CCHR-Warns-Psychiatric-Sexual-Assault-of-Patients-is-all-too-Common-Occurrence.html

[2] Cherrie A Galletly, “Crossing professional boundaries in medicine: the slippery slope to patient sexual exploitation,” Med J Aust., 4 Oct. 2004; 181 (7): 380-383. https://www.mja.com.au/journal/2004/181/7/crossing-professional-boundaries-medicine-slippery-slope-patient-sexual

[3] A tenth of therapists crossing the sex lines,” Sydney Morning Herald, 29 Nov. 2007. https://www.smh.com.au/national/a-tenth-of-therapists-crossing-sex-lines-20071130-gdrpu9.html

[4] “Psychiatrist-patient sexual contact: results of a national survey. I: Prevalence,” The American Journal of Psychiatry, 1 Apr. 2006, https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.143.9.1126?journalCode=ajp

[5] https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/mental-health-workforce/psychiatrists

[6] Michael R. MacIntyre and Jacob M. Appel, “Legal and Ethics Considerations in Reporting Sexual Exploitation by Previous Providers,” Journal of the American Academy of Psychiatry and the Law Online February 2020, http://jaapl.org/content/early/2020/02/12/JAAPL.003911-20

[7] Michael R. MacIntyre and Jacob M. Appel, “Legal and Ethics Considerations in Reporting Sexual Exploitation by Previous Providers,” Journal of the American Academy of Psychiatry and the Law Online February 2020, http://jaapl.org/content/early/2020/02/12/JAAPL.003911-20

[8] Carolyn Quadrio, “Sexual Abuse in Therapy: Gender Issues,” Aust. & NZ Journ. Of Psychiatry, 1 Feb. 1996, https://www.researchgate.net/publication/14478763_Sexual_Abuse_in_Therapy_Gender_Issues

[9] Linda Jorgenson, et al., “The Furor Over Psychotherapist- Sexual Contact: New Solutions to an Old Problem,” William & Mary Law Review, Vol 32, Issue 3, May 1991, https://scholarship.law.wm.edu/cgi/viewcontent.cgi?article=1936&context=wmlr&sei-redir=1

[10] Michael R. MacIntyre and Jacob M. Appel, “Legal and Ethics Considerations in Reporting Sexual Exploitation by Previous Providers,” Journal of the American Academy of Psychiatry and the Law Online February 2020, http://jaapl.org/content/early/2020/02/12/JAAPL.003911-20

[11] “Doctor Sexual Assault Cases: Capable Philadelphia Medical Malpractice Lawyers Fight for Justice,” https://www.beasleyfirm.com/medical-malpractice/doctor-sexual-assault/

[12] https://www.bostonmagazine.com/2006/05/15/head-games/

[13] Cherrie A Galletly, “Crossing professional boundaries in medicine: the slippery slope to patient sexual exploitation,” Med J Aust., 4 Oct. 2004; 181 (7): 380-383. https://www.mja.com.au/journal/2004/181/7/crossing-professional-boundaries-medicine-slippery-slope-patient-sexual

[14] Carolyn Quadrio, “Sex and Gender and the Impaired Therapist,” Aust. & NZ Journ. Of Psychiatry, 1 Sept. 1991/2, https://journals.sagepub.com/doi/10.3109/00048679209072058

[15] Cherrie A Galletly, “Crossing professional boundaries in medicine: the slippery slope to patient sexual exploitation,” Med J Aust., 4 Oct. 2004; 181 (7): 380-383. https://www.mja.com.au/journal/2004/181/7/crossing-professional-boundaries-medicine-slippery-slope-patient-sexual

[16] http://doctors.ajc.com/doctors_sex_abuse/

[17]  https://www.cchrint.org/2018/02/07/when-your-psychiatrist-or-therapist-is-a-sexual-predator-metoo-in-the-mental-health-industry/

[18] https://www.abc.net.au/news/2020-06-10/australian-psychological-society-bob-montgomery-child-sex-abuse/12334420

[19] “Brother psychologist, Bob Montgomery, pleads guilty to child sex abuse,” ABC News, 1 Jun. 2020, https://www.abc.net.au/news/2020-06-02/bob-montgomery-family-court-report-writer-guilty-child-sex-abuse/12308246

[20] https://www.abc.net.au/news/2020-06-10/australian-psychological-society-bob-montgomery-child-sex-abuse/12334420

[21] “Big Brother TV doctor preyed on young boys by encouraging them to pleasure themselves in his living room before abusing them on Boy Scout camping trips – as his victims break their silence,” Daily Mail, 18 June 2020, https://www.dailymail.co.uk/news/article-8438115/Big-Brother-psychologist-Bob-Montgomery-abused-four-young-boys-scoutmaster.html

[22] https://www.newscientist.com/article/mg12917500-400-nightmare-on-chelmsford-sydney/#ixzz6R5Xevd1k

[23] https://books.google.com/books?id=-4DYxI65nAUC&pg=PA194&lpg=PA194&dq=Sharon+Hamilton+suicide&source=bl&ots=1yjhphTybE&sig=ACfU3U1AREgWx4jHqa_m8tL9fQEawubgeA&hl=en&sa=X&ved=2ahUKEwjWoKjj76_qAhVGrZ4KHbCUDGcQ6AEwBHoECAoQAQ#v=onepage&q=Sharon%20Hamilton%20suicide&f=false

[24] http://www.cchrstl.org/documents/rape_EN.pdf

[25] Statement on file with CCHR International

[26] http://adb.anu.edu.au/biography/bailey-harry-richard-12162

[27] Andrea Orr, “Big Move to Uncover Health Care Fraud,” Reuters Business Report, 20 Aug. 1997.

[28] Richard Kusserow, “Kusserow’s Corner: Mental Health Ranks High on Fraud Scale,” 23 Sept. 2014, http://health.wolterskluwerlb.com/2014/09/kusserows-corner-mental-health-ranks-high-on-fraud-scale/

[29] Charis Chang, “Australia’s $9 billion investment in mental health may not be effective,” news.com.au, 21 Oct. 2019, https://www.news.com.au/lifestyle/health/health-problems/australias-9-billion-investment-in-mental-health-may-not-be-effective/news-story/561f05c4ce11b429c8de759dc49a5379

[30] Julie Lambart, “Medicare fraud claims jump to $30m,” The Medical Republic, 8 Nov. 2017, https://medicalrepublic.com.au/medicare-fraud-claims-jump-30m/11770

[31] “The Darker Side of Workers’ Compensation in Australia,” In Depth Investigations, https://www.indepthinvestigations.com.au/darker-side-workers-compensation-australia/

[32] Sophie Scott and Alison Branley, “Australian Medicare fraud revealed in new figures, 1,116 tip-offs so far this financial year,” ABC News, 6 Mar. 2014, https://www.abc.net.au/news/2014-03-06/australians-defrauding-medicare-hundreds-of-thousands-of-dollars/5302584?nw=0

[33] Healthcare Complaints Commission, https://www.hccc.nsw.gov.au/

[34] Benjamin G. Venus, et al., “Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia,” BMJ Open, https://bmjopen.bmj.com/content/9/12/e030525

[35] Melissa Davey, “Mental health service investigated over allegedly falsifying suicide helpline calls,” The Guardian, 13 Jun. 2021, https://www.theguardian.com/society/2021/jun/14/mental-health-service-investigated-over-allegedly-falsifying-suicide-helpline-calls

[36] https://independentaustralia.net/life/life-display/standing-up-dr-predator-and-a-huge-abuse-of-power,12521