Today a Scottish Parliament Members’ debate led by Johann Lamont will pay 10th anniversary tribute to the pioneering SurvivorScotland Strategy. Also to be heard during the debate will be the serious concerns of some MSPs, the cross-party group for adult survivors of child sexual abuse, many survivors and their agencies about the direction, awareness, commitment and future of this government strategy and team.

Following the launch of Scotland’s historical, in-care abuse inquiry in December 2014, SurvivorScotland now relates all but two of its 10 listed priorities to in-care and institutional abuse. That work is very important, but about 80 per cent of Scottish survivors of child sexual abuse were abused in their families or communities. There is great concern about the future of funding and support for the majority of abuse survivors.

SurvivorScotland used to support a range of partnership projects through its service development fund while staff and advisers did wide-ranging work with a survivor-informed ethos. The key principle of mutual support and confidence-building among survivors was seen as important to recovery for abused women and men.

The original strategy called for public awareness-raising, staff training and prevention work to combat ignorance, stigma and discrimination. But such work has almost disappeared, while SurvivorScotland’s “innovation and development” funding has narrowed to a medical model of assessment, interventions and psychological therapies aimed at “brokering” health and wellbeing services for individuals’ care and recovery.

But few NHS trauma services even exist in Scotland to meet the needs of those survivors who do have mental health issues after abuse in institutions or the community. These have long waiting lists. Besides, survivors widely distrust most psychiatric and psychological services through long experience of medical models that ignore abuse issues.

There is growing concern that the skills and experience of voluntary sector support agencies, in health and wellbeing work they have developed with survivors, are being disparaged and downgraded.

SurvivorScotland’s website is the government strategy’s public face. This includes textual errors and broken web links; two contradictory sets of texts about abuse, its effects and approaches to recovery; and some sections have not been updated for years, though updated materials have been offered.

It’s unthinkable that politicians or civil servants would tell support organisations funded by Scotland’s Violence against Women and Girls strategy that their main task was to facilitate individual recovery and “improved personal outcomes”, with therapies approved under National Institute for Clinical Excellence (in England) or Scottish Intercollegiate Guidelines Network guidelines. If they did, they would be told they neither understood nor addressed an unacceptable crime.

Scottish governments have instead had a longstanding, three-fold strategy of prevention, protection and provision against domestic abuse.

Yet SurvivorScotland’s client group overlaps considerably with service users of Women’s Aid and Rape Crisis centres. It has only about £0.8 million to spend in 2015-16, while there is, justifiably, about £12m for the Violence against Women fund). Unlike SurvivorScotland, this also core-funds hard-pressed support agencies.

Could equalities funding help support victims of abuse? The only significant difference is that SurvivorScotland supports both female and male survivors. But increasing numbers of women’s and children’s support projects work with men and boys too, while work with both genders can be accommodated within a broad feminist framework of understanding, planning and commitment. Even if this issue proves a sticking point, other funding streams than Violence against Women can be drawn upon within equalities. Its total for 2015-16 is given as £20.3m.

As a former professional adviser to the strategy team, my view is that Scottish Government ministers should:

• Move most of SurvivorScotland’s work from its base in health into the equality, human rights and third sector division, where progressive, well-funded initiatives for people facing social exclusion, stigma and injustice are encouraged. All organisations working against sexual violence would be asked to collaborate on funding applications that brought mutual benefit, while on other applications they would still need to protect particular priorities of their client groups.

• Declare that a narrow medical model is neither appropriate nor respectful to survivors. Abuse is not a disease; it is a crime. The health division could instead valuably host a genuine collaboration and mutual learning process among professionals, voluntary sector support agencies and survivors to develop excellence in meeting mental and physical health needs. Survivors themselves could help define what those excellent services should be.

• Reinstate, and demonstrate, policy and funding commitment to the majority of Scottish survivors who were not abused in care as well as those who were.

Sarah Nelson was a professional adviser to SurvivorScotland for five years