It would be easy to feel overwhelmed by the vast, 17-volume final report from the Royal Commission into Institutional Responses to Child Sexual Abuse, handed down on Friday.

But it can be summed up by this single comment, which speaks to the experience of thousands of children whose innocence, future and prospects were taken from them by sexual predators, at institutions where they should have been safe.

This is a comprehensive, once-in-a-lifetime royal commission, one that we should never have to repeat.

Actually, we knew so much already: two decades ago, in the Bringing Them Home report, the horrific extent of institutionalised abuse of Aboriginal children was revealed.

In 2004, we had a national inquiry into the miserable existence of "Forgotten Australians" (children in out-of-home care), and in 2005 the Protecting Vulnerable Children inquiry recommended a royal commission to look at institutional child sexual abuse.

On Friday, the commissioners described child sexual abuse as a national disgrace. And they are right.

Much of the evidence aired during the hearings was difficult to comprehend, and commissioners wrote that they found it hard not to share the anger of survivors.

We should all feel a luminous anger that institutions so comprehensively failed young, vulnerable kids.

But as a nation, we must also acknowledge our responsibility. Institutional child sexual abuse has been occurring for generations. This is not the case of a "few rotten apples".

The greatest number of alleged perpetrators were in Catholic institutions, but child sexual abuse occurred in every place where little boys and girls go: schools, cricket clubs, churches, synagogues, scouts and dance classes.

Our state systems failed. Police often refused to believe children, driving them back to the place from which they had tried to escape.

Child protection ignored abuse when it was disclosed and left children in great danger. And criminal and civil legal systems had multiple barriers that stopped prosecution, and dissuaded survivors from pursuing claims against abusers and institutions.

The Dickensian expectation that children be "seen and not heard" echoed through every residential and religious institution, and moulded a culture that ignored victim's voices, commissioners found.

This mindset protected paedophiles and, somehow, abuse was seen as absolvable through contrition and penance.

The legacy of all this was devastating. Sexual abuse is a profound trauma that affects the chemistry and structure of a child's developing brain.

Victims are often left with profound biological, psychological and physical damage. And this pain spills over in a "ripple effect" through families to the community and wider society.

And it's still happening. More than 250 survivors told commissioners in private sessions they had been sexually abused in contemporary (post-1990) out-of-home-care settings, two-thirds with foster or kinship carers.

Children as young as seven told the commission they had been recently abused, and commissioners noted that sexual exploitation in group homes is a growing concern.

Commissioners have made 409 recommendations in total, including a raft of legal and policy changes to assemble a national system of scrutiny to oversee the safety of children.

These include a national strategy, an independent oversight body, a national office of child safety and a minister dedicated to child safety.

Now our federal and state governments need to be held to account. Any plan will need funding - lots of it - and annual targets.

Preventing abuse, and recognising it early, are crucial. We can't place that burden onto victims, who are often riven with shame and fear.

The commission found the average length of time to disclose abuse is almost 24 years. So a national campaign needs to send a clear signal that abuse is harmful and criminal, and include preventative education to help adults spot the signs a child is being abused.

There is great power in who we commemorate. So the names of perpetrators must be stripped from institutions or memorials. And commissioners recommend a national memorial be created to the many victims and survivors.

The commissioners, on behalf of all of us, thanked survivors for their incredible generosity and resilience, saying it had been a privilege to sit with them and listen. They paid tribute to the parents, spouses and siblings of survivors who died, sometimes by suicide.

As one survivor said: "I want justice for those of my friends who experienced cruelty ... I want to scream that you cannot hide this any longer."

Miki Perkins is Social Affairs Editor for The Age

For support services please visit the commission's website.

If you are troubled by this report or experiencing a personal crisis, you can call Lifeline 131 114 or beyondblue 1300 224 636 or visit lifeline.org.au or beyondblue.org.au