Following the recent release of the green paper on vulnerable children, nurse practitioner ANGELA BATES and PROFESSOR JENNY CARRYER look at the role of nursing in child protection.
With the release of recent reports like the green paper on vulnerable children, it is becoming more apparent that New Zealand has a major family-based violence problem.
Being almost at the top of the list of OECD countries for youth suicide, family violence and child abuse is concerning and demands answers. Change will only occur when society as a whole owns these problems and seeks ways to change its attitudes and behaviours.
This issue causes many of us to feel huge concern and it strikes deeply to our sense of New Zealand as a safe and desirable place to raise children. Recent public reaction to Sue Bradford’s proposed changes to legislation (to protect children from physical violence as a form of discipline) was both interesting and revealing. Assisted by the media, it was rapidly named the “anti-smacking bill” and became a debate about parents’ rights rather than being about children’s rights to the same protection that adults have against physical assault.
It was troubling to stand back and watch adults vociferously protesting their right to hit small children as a form of control.
Every week in New Zealand we hear of a child who has been abused or killed at the hands of their parents or carers. There is always a fresh public outcry as to how this could have happened and a good deal of talk among well-meaning politicians and professionals as to how it must stop. After a few days, emotions calm and the issue is put on the back burner until the next incident happens.
The cases that make headlines are just the tragic tip of an enormous iceberg. Many children of course are not killed, but they are raised in an environment of physical, emotional or sexual violence and fear. Critical stages of their development as functioning human beings are interrupted and impeded by the constant assaults and the lack of certainty, security and guidance. Many will develop into sad, dysfunctional adults who will make heavy demands on mental health, prison and social services and are likely to repeat the cycle of abuse to the next generation of children.
The vast majority of parents do want the best for their children and they do the best they can even in difficult circumstances. Being a parent is the hardest and most important job in the world, but the only job where we have no formal training and we cop a good deal of criticism if we get it wrong. To parent is hard enough for anyone, but almost impossible in the context of low self-esteem, poverty, susceptibility to alcohol and drugs, and other challenges.
To report or not to report?
In the 2008 to 2009 period, Child Youth and Family services (CYFs) received 110,797 notifications and in 19,596 cases found maltreatment of children. Notifications came from a wide range of people, both professionals and the public, but only 8326 were actually made by health professionals. This is not surprising, given that many professionals find this area of work uncomfortable and are often not confident dealing with issues of child abuse.
Health professionals are often the first to identify when a family is under stress or might be the first to be confronted with a child who is not thriving or is behaving inappropriately. Many express fear that reporting concerns about a family or child to CYFs will ruin their relationship with the family or that the response from CYFs will be punitive. A proposal to introduce mandatory reporting for suspected child abuse will put these issues into a frame of immediacy.
Some key questions need to be considered:
- How many health professionals are fully aware of their organisation’s child protection policy, or have ever referred to it?
- How many have had formal multi-agency child protection training?
- How many know the staff at the local CYFs office, have a professional relationship with them, and know what processes and policies they have in place to support staff with concerns?
Many of you will be reading this and thinking “this is all well and good, but who has the time to do this?” If we are serious about protecting children, making the time is important as no single professional or organisation has the ability to achieve better outcomes for children. Only by sharing concerns and discussing with CYFs what support systems are needed, can we ensure a child’s safety and enable families to stay together.
Is putting a child in care the answer?
As nurses we may perceive the response from CYFs to be inappropriate, resulting in the removal and placement of a child into care rather than providing the family with the right support and help. This may be because CYFs is overwhelmed with the number of notifications being received, social workers are constantly required to be reactive, with little or no time to be proactive.
CYFs has systems and processes which could be seen as potentially detrimental to children. For example, being removed from your family can be extremely traumatic for a child. Often it is the child who is removed and the abuser is left in the home inappropriately, particularly in situations of sexual abuse. This reinforces the child’s belief that they are to blame for what happened rather than their abuser.
Many children received into care will have numerous placements before they leave care. MSD have highlighted that 29 per cent of children in care will end up with a corrections sentence, 30 per cent of youth suicides have occurred in care and 30 per cent of young women leaving care are mothers themselves.
A recent article in the New Zealand Herald (July 11, 2011) suggested that cases of child abuse will fall dramatically over the next two years and claimed that new campaigns and programmes, better collaboration and an increased awareness will enable this. Hopefully this is not just rhetoric.
If we are serious about reducing the rates of child abuse in New Zealand it will take more than campaigns and parenting programmes. Addressing children being raised in poverty is critically important. We need a system where public services collaborate in an open honest way and work in true partnership with each other and the families they serve.
The way funding is allocated also needs to be addressed, as the current process encourages organisations to compete against each other and the result is services that work in silos rather than in an integrated fashion.
Protecting our children is indeed everyone’s business and this needs to be reinforced through child protection training which is developed and delivered from a multi-agency approach. This will ensure professionals are aware of each other’s roles and responsibilities, heighten the importance of multi-agency working and increase confidence in reporting suspected cases of child abuse.
Likewise, child protection policies and procedures also need to be developed from a multi-agency perspective. The Children, Families and Young Persons Act 1989 is now 22 years old and is in desperate need of review.
The latest green paper on vulnerable children offers us all an opportunity to participate in a debate so necessary to tackle this monumental problem belonging to all New Zealanders.