Sunday, May 13, 2012

Mandatory reporting of child abuse not a panacea

OPINION: The best way to achieve effective reporting of suspected child abuse is to restore confidence in the system.

FOLLOWING THE publication of the Ryan report in 2009 there was cross-party political agreement to place the national guidance on child protection and welfare, known as Children 
First, on a statutory footing.

While there is an expectation that services will comply with the provisions outlined in Children First, the guidance has not up to now carried legal force. The intention behind the decision to legislate was to ensure that responsibility for the protection of children was taken seriously by all relevant services. 

However, the Children First Bill 2012, published in late April and currently under consideration in the Oireachtas, has not only missed a unique opportunity to promote collaborative and preventive work, but has proposed measures that are likely to have adverse consequences.

Despite the title of the new Bill, the proposed legislative measures are in fact limited to a small number of sections of Children First, which is a comprehensive document covering many aspects of child protection practice. 

The measures proposed in the Bill are largely confined to the requirement for professionals to report suspected child abuse and for organisations to establish a system for reporting via staff members who are designated with that responsibility. 

A broad range of agencies and professionals come within the ambit of the legislation, including many whose primary function is not related to child welfare.

Irish public opinion has been influenced by revelations of abuse and subsequent cover-up by the Catholic Church. This has understandably led to a preoccupation with the matter of reporting. 

Whether or not legislating for it is the most sensible approach to enhancing child protection services is open to question, however, particularly as it has been well established in other jurisdictions that criminalising failure to report has led to unintended outcomes. 

Among these is the disproportionate level of funding required to manage the intake of reports, with consequent reduction in the resources available to provide services for vulnerable children.

The necessity for such a move is debatable. Most countries that have instituted a legal obligation to report suspected child abuse did so because of a perceived indifference on the part of professionals and communities. 

Irish people, on the other hand, are very aware of and generally quite concerned about child welfare – it has become a major political issue. While there is a public perception that the church is flouting its obligations, the reality is that since the Ferns report in 2005 it has been subject to a greater degree of audit and scrutiny than any other organisation. 

While the disclosure of historic cases may continue for some time, the risk of current or future abuse by priests and religious being hidden is now considerably reduced.

A common consequence of reporting legislation is a significant increase in both “false positive” and “false negative” reports. 

False positives occur when individuals, fearing criminal charges, report indiscriminately and include concerns that fall below the thresholds for statutory intervention. 

This is most likely to occur in organisations whose primary function is not child welfare – for example, schools, local clubs or recreational activities where designated officers have low levels of experience and training, and are not prepared to risk filing a false negative.

False negatives occur when reports are screened out prematurely or erroneously in sectors where the level of reporting exceeds the capacity of the service to respond. 

Inevitably, a higher number of false positives will lead to an even higher number of false negatives and the result is a dysfunctional child protection system. 

A high rate of false positives is undesirable because it means a number of families unnecessarily suffer intrusion and distress. A high rate of false negatives is more dangerous, as it clearly means children who are being ill-treated or abused are being overlooked.

In 2000, the number of cases reported to child protection services was just more than 9,000 and the proportion of substantiated reports – those reaching the “abuse” threshold – was 35 per cent. 

By 2009, the number of reported cases had almost tripled to more than 26,000, and the rate of substantiation had fallen significantly to below 10 per cent. This increase in the proportion of children being screened out could be due to a high rate of of false positives or the use of elevated thresholds on the part of services which resulted in false negatives. 

Either way, it connotes a less than healthy system and suggests measures likely to increase the reporting rate will make matters worse.

The resource implications of the proposed legislation are predictable.

The Health Service Executive (HSE) has acknowledged the need for more sophisticated screening and triage systems, but these are expensive and resource intensive. 

Each report made will activate a process to determine what kind of response is required, which will then trigger other actions, all of which absorb staff time.

Lessons from the Roscommon, Monageer and National Review Panel reports demonstrate that the principal weakness in the system is not failure to report, but a lack of commitment across health, justice and education services to proactively assist vulnerable children in the post-reporting stage of child protection work. 

Weaknesses in multidisciplinary strategic planning have also been highlighted, as well as a shortage of community-based welfare services for children whose situations are worrying, but below the threshold for HSE intervention.

The proposed legislation has missed opportunities to address these serious deficits.

It is interesting to observe the changes currently under way in England and Wales. A major review conducted after the death of baby Peter Connelly (“Baby P”) was published last year. 

The Munro review, as it is known, recommended sweeping reforms which have been accepted by the UK government.

Reporting of suspected child abuse was never mandatory in any part of the UK, and the review made no recommendation to change this, but focused on strengthening the professional skills of the workforce and legally obliging Local Safeguarding Boards to promote child protection at a multi-agency level. 

A review in Northern Ireland in 2007 similarly opted to maintain a voluntary system of reporting, supported by inter-agency protocols and professional training.

In some countries where reporting legislation has been implemented, one in every four or five children in the population is reported to the child protection services each year, and most are screened out again.

The achievement of a similar outcome in Ireland cannot be a worthy aspiration. 

The best way to streamline reporting of suspected child abuse is to restore confidence in the system by implementation of a sound management structure and investment in professional development, alongside measures to promote the notion of child protection as everyone’s business.

Dr Helen Buckley is an Associate Professor in the School of Social Work and Social Policy, Trinity College Dublin, and is the chair of the National Review Panel examining incidents including the deaths of children in care.