Child Protection

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  • Thank you very much Norma for the invitation to speak today about Family Violence & Child Protection. It’s a topic we must not sweep under the carpet, & something that we’ll all come across at some point in our lives & working career. Click Our Team is …
  • Jessica Kimberley – Team Leader (based at Dairy House, Whangarei) Rachel MacKinnon - Family Violence Coordinator (based at Maunu House, Whangarei Hospital) Debbie Gamble-Ward, Clinical Nurse specialist, Child Protection, Specialises in Child Sexual Abuse runs the Villa, at 41 Norfolk St Vickie Rotzel – Child Protection Educator with (PH) Nursing Background based at Villa Andrea Waugh – Child Protection Educator with (CYFS) Social Work Background, based at Villa When discussing child protection, its important to know the definition of child abuse. There are many definitions used, including those Northland District Health Board have used in the organizations' Child Protection Policy. CLICK
  • The policy defines child abuse/neglect as:- Child Abuse/Neglect - The “harming (whether physically, emotionally, or sexually), ill treatment, abuse, neglect or deprivation of any child or young person” (CYPF Act 1989) Emotional/Psychologica l –as any act or omission resulting in impaired psychological, social, intellectual &/or emotional functioning & development of a child or young person. Physical - Injuries are most usefully, as truly accidental (unusual), neglectful, preventable (most common) or inflicted. Sexual - An act or acts that result in the sexual exploitation of a child or young person, whether censual or not. Neglect - Any act of omission that results in impaired physical functioning, injury, &/or development of a child or a young person. – physical neglect – Neglectful supervision – Medical neglect – Abandonment - Refusal to assume parental responsibility Everyone has the right to a healthy, happy life – no matter what their nationality, race, colour, sex, religion or abilities… what ever they think or say, what type of family they come from, their wealth or social position. Back in 1948 – WHO defined Health as “ A state of physical, mental and social wellbeing and not merely the absence of disease and infirmary” – the ability to lead a socially and economically productive life With this definition in mind, there are essential elements required for a balanced, healthy life – such as adequate food, clean water, shelter, clothing There are many models used to demonstrate this – which I’m sure you are all aware of & use… Maslow’s Hierarchy of needs – CLICK
  • Maslow's Hierarchy is a psychology-based theory that says “ … as humans meet their 'basic needs’ (breathing, food, water) , they must satisfy their 'higher needs' (lack of prejudice, morality, acceptance) as human beings. e.g. before a child can develop self-esteem, they need to have the basic needs of food, shelter & safety met as well as their social needs. The role of the parent/ caregiver/ & family is critical in providing not only basic needs for children, but also providing a nurturing relationship for the development of higher level needs. A child who is insecure or threatened in their need for safety, love, belongingness & self-esteem is a child who will show more selfishness, hatred, aggression & destructiveness. Therefore if a child is abused in any way, or witnesses abuse, their psychological needs aren’t being met, they don’t progress on – to a higher level, they stay on the bottom level of Maslow’s pyramid. This has huge implications not only for the child, but everyone around them, including their family, friends, & wider community & NZ. The Maori philosophy towards health is based on a wellness or holistic health model – Mason Durie’s - Te Whare Tapa Wha can be applied to any health issue affecting Maori from physical to psychological wellbeing When discussing child protection & family violence, usually physical violence is what comes to mind first, yet the experience of abuse impacts equally on mental, social & spiritual health. Durie’s Health Model– is a helpful tool to use; it helps to understand that the impact of abuse is holistic. I’m sure you’ve all seen this diagram & are familiar with it. CLICK
  • The whare-nui (meeting house) shows the four dimensions of a Māori view of well-being. Each corner of the house has to be strong and balanced. If one of the corners is not strong, this leads to an imbalance in well-being. The four corners are:- Te Taha Hinengaro (psychological health) – thoughts, feelings and behaviour. The capacity to communicate, think & feel. Te Taha Wairua (spiritual health) – is the most essential requirement for health. The capacity for faith & wider communion Te Taha Tinana (physical health) – The body & things associated with it. The capacity for physical growth & development Te Taha Whanau (family health) - is the prime support system providing care, not only physically but culturally and emotionally. The capacity to belong, to share & care. Mason Durie says the mind & body are inseparable, THEREFORE , when a child is abused or witnesses abuse, they are affected holistically. If children don’t have help overcome the abuse holistically, they won’t progress through Maslow’s psychological stages either. Therefore - their fundamental survival needs (such as safety) aren’t being met. Their psychological & emotional needs, to be loved & belong, their self esteem, to have approval & acceptance – these are all significantly compromised. The child does not progress through to self – actualisation…they won’t become well adjusted adults & fulfill their own unique potential. CLICK
  • As children in school we are always taught about ‘stranger danger’ There was still a misconception that any bad thing that might happen to you would be from someone I had never met before. The reality was then and still is now, the perpetrator in most cases is know to the victim or the victims family and is trusted by either or both.
  • In fact the number of children uplifted from their families is very small. CYFS tries to encourages alleged perpetrator to leave the home rather than the child. If child needs to be uplifted, placements within the family/whanau are the first priority (need to undergo caregiver assessments)
  • These statistics continue to rise on a yearly basis, this year alone there has been extensive media coverage like never before that identifies a fast growing trend in child abuse and as a result child deaths in NZ. We have all heard about the Kahui twins, Nia Glassie and the countless other children in our communities that are suffering abuse everyday. It is a real problem in a real world
  • At a conference in May 2007 Dr Patrick Kelly presented his research and opinions on Child Abuse
  • Is Child abuse a health issue do you think (open up for a show of hands) in what way? Child abuse is a health issue in the fact that left untreated or unrecognised it can result in, mental health issues, drug and alcohol abuse, reckless behaviours causing injury or death, sexualised behaviours resulting in unwanted pregnancies and STD’s and the list goes on The economical & social impact of child abuse & cruelty to children in NZ is staggering! There is a $5.32 billion fiscal & economic cost to NZ on the long term effects of childhood abuse
  • As a reminder the DHB Policy Quotes and defines Child Abuse as: “ the harming (whether physically, emotionally, or sexually), ill treatment, abuse, neglect or deprivation of any child or young person ” Children Young Persons and Their Families Act 1989, We are in a unique situation here in Northland, while we have clear identification that child abuse is indeed occurring in this region we have not had a fatal incident in the headlines. The importance of identifying abuse, and reporting it is so significant and can literally save the lives of many children and young people including the unborn that may be entering into a home with a history of abuse. Policies are in place to keep children safe and staff safe. CLICK
  • The policy provides ALL NDHB STAFF A framework to identify & manage actual and/or suspected child abuse & neglect Recognises the important role & responsibility ALL staff have with early identification of actual abuse & neglect identifying children & young people who might be at risk of being abused or neglected CLICK
  • STEP 1 – Recognise Abuse Any situation when abuse is disclosed, diagnosed or suspected It is better to refer on suspicion - if you wait for proof serious harm could occur. STEP 2 – Consultation Cultural Consultation: Whenever possible involve a staff member with same ethnicity of child/young person If child is Maori contact the Takawaenga Collegial Consultation: i.e. Line manager, Paediatrician, Social worker, Child Protection Educator… Never make the decision about suspected child abuse on your own! STEP 3 – Involve Family/Whanau The family should be informed of referral, however child’s safety is paramount Other factors to consider: - Safety of staff - Takawaenga Service - Call Police for assistance if required STEP 4 - Referral to Statutory Authority Whenever child abuse and/or neglect is disclosed, diagnosed, or suspected a referral to CYFS MUST be made for consultation and/or assessment Complete referral form: Fax to CYFS Call Centre (if urgent call CYFS directly 0508 FAMILY ) Fax to Child Protection Team Put copy of referral into patient notes Call Police if child is in immediate danger or presents with severe or fatal injuries STEP 5 - Ensure Safe Plan Safety of child is paramount However you can’t physically prevent parents from taking their children home Liaise with CYFS and Police if required STEP 6 – Documentation Document conversations and observations thoroughly Ensure all relevant information is passed onto CYFS and Police if required Keep copy of documentation in client file DON’T interview the child about suspected abuse Listen to the child Document well what the child is telling you CLICK
  • At the end of the day, we are professionals working in an organisation that has a policy relating to the welfare and safety of children and young people. It is a must that we perceive Children and young people as gifts and that they are heard and acknowledged. We are in a preventative mode in Health we have a unique opportunity to recognise signs of abuse and refer them on to the appropriate agencies for the safety of children and young people. If you have any suspicion at all that a child or young person may be at risk of harm then don’t hesitate to make that call. At the end of the day it is always better to be safe than sorry and current research shows that all children in NZ who have been killed at the hands of abusers were all known to health in some way, and often the signs were present. There are no barriers or areas within our society that violence does not affect, it occurs in all ethnic & social groups. Family violence & child abuse impacts on the whole family, community & country, with massive costs – not just in financial terms, but the huge effects on the child, siblings, family, community & country . Child abuse has detrimental effects on children’s physical, cognitive, emotional, behavioral & social development (again it’s the holistic approach - effecting the “whole” being of the child, which lasts a lifetime) Therefore, children must be protected. Family violence & child protection - must be treated as a health issue, with all governmental departments, interagencies & communities networking, communicating & working together – to prevent these atrocities continuing in NZ. CLICK
  • Any questions or comments are welcome
  • Child Protection

    1. 1. CHILD PROTECTION Northtech Nursing Students
    2. 2. Our Team <ul><li>Jessica Kimberley – Team Leader (RN) </li></ul><ul><li>Rachel MacKinnon – Family Violence Coordinator (SW) </li></ul><ul><li>Debbie Gamble-Ward – Clinical Nurse Specialist (RN) </li></ul><ul><li>Vickie Rotzel – Child Protection Educator (RN) </li></ul><ul><li>Andrea Waugh – Child Protection Educator (SW) </li></ul>
    3. 3. Definitions <ul><li>Child Abuse/Neglect </li></ul><ul><ul><li>The “harming (whether physically, emotionally, or sexually), ill </li></ul></ul><ul><ul><li>treatment, abuse, neglect or deprivation of any child or young person” (CYPF Act 1989). </li></ul></ul><ul><li>Emotional/Psychological </li></ul><ul><ul><li>Any act or omission resulting in impaired psychological, social, intellectual &/or emotional functioning & development of a child or young person. </li></ul></ul><ul><li>Physical </li></ul><ul><ul><li>Injuries are most usefully, as truly accidental (unusual), neglectful, preventable (most common) or inflicted. </li></ul></ul><ul><li>Sexual </li></ul><ul><ul><li>An act or acts that result in the sexual exploitation of a child or young person, whether censual or not. </li></ul></ul><ul><li>Neglect </li></ul><ul><ul><li>Any act of omission that results in impaired physical functioning, injury, &/or development of a child or a young person. </li></ul></ul><ul><ul><li>(Northland District Health Board Child Protection Policy & Guidelines Sept. 07) </li></ul></ul>
    4. 4. Maslow’s Hierarchy of Needs
    5. 5. A Māori Health Model Te Whare Tapa Wha Mason Durie 1984
    6. 6. Myths <ul><li>Biggest myth is: </li></ul><ul><li>- Dangers to children come from strangers. </li></ul><ul><li>In most cases the perpetrator is someone known to the child or parents, and is often trusted by the child and/or family </li></ul>
    7. 7. Myths cont… <ul><li>All children and young people referred to Child Youth and Family for concerns of abuse will be removed from their homes </li></ul>
    8. 8. Statistics <ul><li>It is estimated each year in NZ: </li></ul><ul><li>Every month one child is killed through physical abuse </li></ul><ul><li>9,800 children are hospitalised with preventable injuries, </li></ul><ul><ul><li>193 hospitalised for deliberate injuries in 2006 </li></ul></ul><ul><li>CYFS referrals rise 15,000 annually. </li></ul>
    9. 9. Stats cont… <ul><li>From 48 children admitted to Starship Hospital </li></ul><ul><li>in 2006 with suspicious head injuries only 20% were known to CYFS. </li></ul><ul><li>All 48 children had prior visits by health professionals </li></ul><ul><li>Research from Dr Patrick Kelly, Clinical Director, Starship Hospital, Auckland </li></ul><ul><li>“ In 2003 NZ rate of child deaths from maltreatment was third - worst of 27 developed countries”. </li></ul><ul><li>UNICEF league table 2003 </li></ul>
    10. 10. <ul><li>So… </li></ul><ul><li>As Health Professionals what can we do </li></ul><ul><li>to change this? </li></ul>
    11. 11. NDHB CHILD PROTECTION POLICY <ul><li>Quotes and defines Child Abuse as: </li></ul><ul><li>“ the harming (whether physically, emotionally, or sexually), ill treatment, abuse, neglect or deprivation of any child or young person ” </li></ul><ul><li>Children Young Persons and Their Families Act 1989, </li></ul>
    12. 12. Executive Summary/Rationale <ul><li>The policy provides ALL NDHB STAFF </li></ul><ul><li>A framework to identify & manage actual </li></ul><ul><li>and/or suspected child abuse & neglect </li></ul><ul><li>Recognises the important role & responsibility </li></ul><ul><li>ALL staff have </li></ul><ul><ul><li>early identification of actual abuse & neglect </li></ul></ul><ul><ul><li>identifying children & young people who might be at risk of being abused or neglected </li></ul></ul>
    13. 13. Child Protection Flow Chart <ul><li>Step 1 </li></ul><ul><li>Recognising Abuse </li></ul><ul><li>Step 2 </li></ul><ul><li>Consultation </li></ul><ul><li>Step 3 </li></ul><ul><li>Involve Family/Whanau </li></ul><ul><li>Step 4 </li></ul><ul><li>Referral to Statutory Authority </li></ul><ul><li>Step 5 </li></ul><ul><li>Ensure Safe Plan </li></ul><ul><li>Step 6 </li></ul><ul><li>Documentation </li></ul>
    14. 14. SUMMARY <ul><li>Healthy attitudes towards Child Protection from Health Professionals is essential </li></ul><ul><li>Together we can support & educate families for a safer environment for our children and young people </li></ul><ul><li>Nia Glassie 2004 - 2007 </li></ul>
    15. 15. <ul><li>Thank you </li></ul><ul><li>Vickie Rotzel 021-817-291 </li></ul><ul><li>Andrea Waugh 021-354-171 </li></ul>
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