November 2016, Offord Centre McMaster Rounds - SV Youth Rights & Resilience

1. Youth Rights &
Resilience
Christine Wekerle, Ph.D., Associate Professor, Pediatrics,
McMaster University
Email: wekerc@mcmaster.ca or chris.wekerle@gmail.com
Twitter: @DrWekerle
Research Project: Understanding health risks and promoting resilience in male youth
with sexual violence experience. CIHR IGH PHAC Team Grant (TE3 138302)
Follow the project @ https://www.researchgate.net/project/Understanding-health-
risks-and-promoting-resilience-in-male-youth-with-sexual-violence-experience-CIHR-
Team-Grant-TE3-138302

2.  “Where, after all, do universal human rights
begin?
 In small places, close to home—so close and so
small they cannot be seen on any maps of the
world. Yet they are the world of the individual
person…
 Such are the places where every man, woman and
child seeks equal justice, equal opportunity, equal
dignity without discrimination. Unless these rights
have meaning there, they have little meaning
anywhere.
 Without concerned citizen action to uphold them
close to home, we shall look in vain for progress
in the larger world.” —Eleanor Roosevelt

3. Message from Dr. Gregory Taylor,
Canada’s Chief Public Health Officer
Families are the building blocks of our
society and a safe haven to nurture
children and our intimate relationships.
Yet, some Canadians families are in crisis
and the statistics are staggering.
For many, this report may be difficult and
disturbing to read.

4. Presentation Overview
 With half of the world’s population under 25…
 Youth, Prosperity and Security Initiative @ 2012 Clinton Global Foundation by
International Youth Foundation and Hilton Worldwide
 Youth – aged 12 to 25
 Rights (Law)
 Global Partnership to End Violence Against Children
 UN Convention on the Rights of the Child (1989) and optional protocols
 Concept of Duty Bearer – governmental support
 Canadian and Ontario Legislation – Office of the Provincial Advocate
 Rights Rationale: Example of child maltreatment - Need for Protection
 Wellbeing (Status, Predictor)
 Indicators of Wellbeing
 Resilience (Capabilities, Social Ecology, Outcomes)
 Frameworks – Trauma-informed model
 Putting it all together
 Youth Rights & Resilience Knowledge Mobilization
Platform

5. Global Partnership to End Violence Against Children
(http://www.end-violence.org/)
 SAFE, STABLE, SECURE, NURTURING CARE
 (1) Teach positive parenting skills;
 (2) Help children develop life skills and stay in
school;
 (3) Raise access to treatment and support
services;
 (4) Implement and enforce laws to protect
children;
 (5) Value social norms that protect children;
 (6) Empower families economically;
 (7) Sustain safe environments for children

6. Rights Context for Violence
Prevention and Wellbeing -
United Nations CRC Explained
(2016)
Clip: 7:20 to 9:00
https://youtu.be/TFMqTDIYI2U
https://youtu.be/fxlKWPJlkHs

7. What is a duty bearer?
 Duty bearer: Duty bearers are those actors who
have a particular obligation or responsibility to
respect, promote and realize human rights and to
abstain from human rights violations.
 The term is most commonly used to refer to State
actors, but non-State actors can also be
considered duty bearers.
 Depending on the context, individuals (e.g.
parents), local organizations, private companies,
aid donors and international institutions can be
duty-bearers.
https://www.unicef.org/gender/training/content/resources/Glossary.pdf

8. United Nation Convention on the Rights of
the Child (1989)
Duty Bearers:
Rights Actions
Freedom
from Violence Youth Protection
Right to Health Youth Well-Being
w/out Discrimination for all groups
w/Special Needs (gender, disability etc. equity)
Right to Develop Full Youth Resilience

9. Canadian and Ontario Rights-
Relevant Legislation
 CANADIAN CHARTER OF RIGHTS AND FREEDOMS
 CHILD AND FAMILY SERVICES ACT (CFSA)
 EDUCATION ACT
 HEALTH CARE CONSENT ACT
 IMMIGRATION AND REFUGEE PROTECTION ACT
 INDIAN ACT
 ONTARIO HUMAN RIGHTS CODE
 SAFE SCHOOLS ACT (BILL 81)

10. Global Youth Wellbeing Index (2014)
http://www.youthindex.org/about/

11. Definition of child maltreatment
 “Child maltreatment, sometimes referred to as child
abuse and neglect, includes all forms of physical and
emotional ill-treatment, sexual abuse, neglect, and
exploitation that results in actual or potential harm to
the child's health, development or dignity” (WHO, 2014)
 WHO | Child maltreatment www.who.int/topics/child_abuse/en/
 Public Health – Prevention of premature mortality, directly and indirectly
 Humanitarian – Use of children during conflict (sex, labor, shielding); lone child migrants
 Human Rights – Basic rights to non-violence and well-being
 (14% >likely to be unemployed in adulthood; Currie & Widom, 2010; open access article:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3571659/)
 Legal – Mandatory Reporting; Professional reporting duties; Duty Bearers

12. From reviews of the global literature,
including population surveys
 363/1000 children (emotional abuse)
 226/1000 children (physical abuse)
163-184/1000 children (neglect)
127/1000 children (sexual abuse)
 Indigenous Males 8%, Females 9% report IPV victimization (Brownridge, Tallieu, Afifi &
Elgar, 2016; General Social Survey, 2014)
 Health: 80% of suicide attempters had a history of child abuse, strong link for sexual
abuse (RR=2.65) than physical abuse or IPV, and with all mental health indices (Martine
et al., 2015; Canadian Community Health Survey)
 Resilience: 53% of abused reported good mental health; linked to: Education/Income;
Physical Activity; Supportive Relationships; Good Daily Coping (Afifi, MacMillan, Tallieu,
& Boyle, 2016; Canadian Community Health Survey/Mental Health)

13. In Canada, youth victim stats show…
 2014 General Social Survey on victimization
 32% or 9 million have experienced of Canadians under age 15 have experience physical
and/or sexual abuse with a family or non-family perpetrator
 (32% men; 27% women reported victimization)
 Perreault, S. (2015) “Criminal victimization in Canada, 2014.” Juristat. Statistics Canada
Catalogue no. 85-002-X.
 2014 Incident-based Uniform Crime Reporting (UCR) and Homicide surveys
 About 53,600 child and youth victims (17 years of age and under) of violent crime.
Children and youth represented 17% of all victims of police-reported violent crime in 2014
 Rates of family-related violence were highest for youth between the ages of 12 and 17
 Females between the ages of 14 and 17 were twice as likely to be victimized as their male
counterparts
 Physical assault was the most common type (134.4 per 100,000 population under age 18),
followed by sexual offences (73.9)
 Sexual assault against females were more than 4 times higher than their male
counterparts (121.8 compared to 28.5, respectively)
 From 2009-2014, rates declined for both physical and sexual assault, except sexual assault
Level 2 and 3 (injuries sustained)

14. James Rhodes: Instrumental
 https://www.youtube.com/watch?v=WhjcoZI
RWVE 1:25 to 4:38
 Child sexual abuse leads to, “multiple
surgeries, scars (inside and out), tics, OCD,
depression, suicidal ideation, vigorous self-
harm, alcoholism, drug addiction, the most
f***ed-up of sexual hang-ups, gender
confusion, sexuality confusion, paranoia,
mistrust, compulsive lying, eating disorders,
PTSD, DID [the shinier name for multiple
personality disorder] and so on and on and
on.”

15. The Chief Public Health Officer's Report on the
State of Public Health in Canada 2016: A Focus
on Family Violence in Canada
Key Messages:
 Child maltreatment increases the risk for mental health issues
at any age and for all types of abuse.
 Vulnerable to stress-related physical health problems
 Vulnerable to unwanted pregnancy and STIs
 Some victims are resilient
 “Resilience is when someone is able to cope with or recover
from a negative experience or stressful situation with little
effect to his or her health.”
 Variety of sources used, for example:
 Canadian Centre for Justice Statistics. (2016). Family violence in Canada: a statistical profile, 2014. (Statistics Canada).
 Afifi, T. O., MacMillan, H. L., Boyle, M., Taillieu, T., Cheung, K. & Sareen, J. (2014). Child abuse and mental disorders in Canada. Canadian Medical Association
Journal, 186(9), E324-E332.

16. Key Message: Maltreated youth tend to
function day-to-day (adaptation)
 Order of Canada, ex-NHL’er Sheldon Kennedy adolescent interview YouTube
 2016 Documentary: “Swift Current”
 CLIP: https://www.youtube.com/watch?v=sP3z8KVttro (1.03 minutes)
 “Graham asked me questions about my life that nobody ever
asked me. He asked me how I got along with my father, how I
liked playing on my team, how I felt about school. I opened up to
him immediately, especially…I wasn’t used to being asked about
my feelings and opinions about things, and I sure wasn’t used to
being listened to with so much interest and attention.” (p.33,
Why I didn’t Say Anything, 2011)

17. Key Message: Definitions may vary by locale;
Duty over-rides confidentiality
 For Ontario, Canada: http://www.cpso.on.ca/policies-publications/policy/mandatory-
and-permissive-reporting
 Ontario’s Child and Family Services Act (CFSA) goal is to promote the best interests,
protection and well-being of children (<16 or <18 if under protection order)
 Reasonable grounds (“the reasonable man test”) – need to provide this information
 Suspicion of maltreatment = risk of maltreatment (not maltreatment per se)
 Receiver or Observer of the information = the report to child welfare, police, CPS
 CPS informs police re: criminal offense
 Special awareness or opportunity to note signs or receive disclosures – same duty as the
general public
 PHYSICAL HARM OR ABUSE (including via NEGLECT ); REQUIRES MEDICAL TREATMENT but does not
obtain (lack of consent, neglect etc.) – CPA AND NEGLECT
 SEXUAL HARM OR ABUSE, MOLESTATION, EXPLOITATION (including failures to protect) - CSA
 EMOTIONAL HARM (via neglect) linked to serious mental distress, aggression, delay - PM
 ABANDONMENT – Not providing care - NEGLECT
 CHILD is UNDER 12 and committed serious CRIMINAL ACTS against persons or property; FAILED to seek
services for said child

18. Target Resilience Capabilities: Strategies for
Mental Health, Wellbeing Among Adolescents and
Youth Adults

19. Trauma-informed framework
 Trauma-informed Mental Health (Butler, Critelli & Rinfrette, 2011)
 Developmental context for adverse childhood events
 Need for youth empowerment in decisions to or not to receive information, how
to receive information, and time to consider resilience strategies
 7 components:
 (1) Physical and Psychological Safety
 (2) Trust in Service and Service-Provider
 (3) Appropriate Choice and Voice
 (4) Distress and Impairment Minimization
 (5) Positive Events & Resilience Maximization

20. Crafting A Daily Resilience Practice
(1) Reducing everyday experience/perception of overwhelming stress (rumination;
impulsive sensation-seeking);
(2) Increasing positives and regulation actions
Sleep Quality
Exercise/Fitness/Healthy Fun
Social Connectedness
Self-compassion/Mindfulness
Resilience Mindsets (Realistic optomism, growth, hope,
awe)
Interpersonal Resilience
Mattering Clip: 2:47 – 5:00
https://www.youtube.com/watch?v=oHv6vTKD6lg
Publication: http://in-
car.ca/ijcar/issues/vol3/2015/Flett_et_al_pp_4-33.pdf

21. Pulling rights, protection, wellbeing,
resilience together for youth
 UNICEF (2013) defines child welfare as “certain formal or informal structures,
functions, and capacities that have been assembled to prevent and respond to
violence...” (p. 3).
 Already have support for UN CRC
 Focus on youth (12 to 25)
 Support SDG/Global Goals – wellbeing, peace & strong institutions
 Opportunity to integrate child welfare, health/mental health, university, citizenry initiatives
 Identify common ground; commission systematic reviews; emphasis e-learning for youth; achieve
standardization in common ground training of duty bearers (best interests, reporting)
 The Caring Campus Project (targeting intoxication) http://caringcampus.ca
 First priority is safety and protection from violence – gap area male sexual violence
victimization
 Support Kmb on Global Partnership to End Violence Against Children (and Youth)
 Support Kmb on youth health, wellbeing and engagement with International efforts
 Support Youth Prosperity and Security Initiative (International)
 Focus on Youth Needs and being Trauma-informed
 INTEGRATED KMB FOR RESILIENCE IN YOUTH PLATFORM – PRODUCT DEVELOPMENT

22. Thank you for your attention!
Questions or Comments?