ROME—On the last day of his historic visit to the United States, Pope Francis excoriated American bishops and cardinals with him in Philadelphia for their handling of child sex abuse by clergy, one of the most damaging issues the American Catholic Church has ever faced.

Earlier Sunday morning, Francis had gone to St. Charles Borromeo seminary, where he received five adult survivors—three women and two men—who were sexually abused as minors, and his unscripted remarks to the bishops were fraught with emotion.

“I have in my heart these stories of suffering of those youth who were sexually abused,” he said. “And it continues to be on my mind. The people who had the responsibility to take care of these tender ones violated that trust and caused them great pain. God weeps for the sexual abuse of children.”

While the television cameras did not focus on the faces of any of the bishops in the audience, there were several there, including Cardinal Justin Rigali the retired archbishop of Philadelphia, who retired in 2011 amid accusations about his mishandling of known pedophile priests in his parishes. Also in attendance was Cardinal Roger Mahony, the former archbishop of Los Angeles, who was stripped of his duties in 2013 for his role covering up abuse allegations.

Francis was absolutely steadfast in his criticism of the American clerical crimes. “For the sexual abuse of children,” he said, “these cannot be maintained in secret. And I commit to a careful oversight to ensure that youth are protected and all responsible will be held accountable,” he said. “Those who have survived this abuse have become true heralds of mercy…. we owe each of them our gratitude for their great value.”

During the pope’s earlier meeting with abuse survivors, each was accompanied by a family member or support person, according to Vatican spokesperson Father Federico Lombardi. Also at the meeting with Francis were Cardinal Seán Patrick O'Malley, Archbishop of Boston and chair of the commission set up by the pope for the protection of minors; Archbishop of Philadelphia, Charles Chaput and Bishop Michael Fitzgerald, head of the Diocese of Philadelphia Office for the protection of minors.

“The Pope spoke with visitors, listening to their stories and offering them a few words together as a group and later listening to each one individually,” Lombardi said. “He then prayed with them and expressed his solidarity in sharing their suffering, as well as his own pain and shame, especially in the case of injury caused them by clergy or church workers.”

Just when and how Francis would focus on the sordid history of rampant clerical sex abuse in the American Church had been of great interest to support groups for victims, who had not been impressed with his handling of the issue. When he met with American bishops on his first day in the United States, he seemed almost to praise them for their work. “I realize how much the pain of recent years has weighed upon you and I have supported your generous commitment to bring healing to victims, in the knowledge that in healing we too are healed, and to work to ensure that such crimes will never be repeated,” he said.

David Clohessy, the director of the Survivors Network of Those Abused by Priests, known as SNAP, said the pope didn’t do enough. “He is an innovator in other ways, but this pope is a throwback on sexual violence. He talks and acts like the church hierarchy is the real victim in this crisis,” Clohessy, himself a victim, said after those first comments to bishops. “He seems humble and preaches service, but like so many other clerics, Francis seems to put church officials above the rest of us.

After Sunday’s address, Clohessy called the comments another “feel good, do nothing” moment. “Is a child anywhere on earth safer now that a pope, for maybe the seventh or eighth time or ninth time, has briefly chatted with abuse victims? No,” he said in a statement. “A smart public relations move. That’s what this meeting is. Nothing more.”

Clohessy had earlier predicted that the pope would address American clerical abuse in terms of the past, while he says there is credible evidence that while abuse has greatly diminished, it is still going on.

“It fits church officials’ carefully-crafted narrative,” he said. “Years ago, prelates pretended the abuse and cover up weren’t happening. That no longer works. So now they pretend it’s not happening now, that it’s all ‘in the past’ and only healing remains to be done,” Closhessy said in his statement. “They know, however, this is deceptive and dangerous.”

Instead he says that studies show that priests continue to abuse children at an alarming rate. “If you do the math,” he says, “There are more than 1.5 million men and women on this planet who have been raped, sodomized or molested by Catholic priests.”

“That’s where Francis should focus,” he says. “Stopping abuse and cover up now and in the future, not conveniently implying that only healing is needed now. He could meet with a thousand victims. But that wouldn’t safeguard a single child.”

Perhaps. But when the pope says that God weeps, there would seem to be little question he is calling on his bishops to repent, to make amends, and to be sure that nothing like this every happens again.