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| Approximately 2,000 children die every year as a result of abuse and neglect in the U.S. alone |
Nearly 5 Children Die every Single Day as a Result of Abuse and Neglect in the United States
Child abuse and neglect are
topics that do not seem to get a lot of media attention. Perhaps it is the
collective mentality of not wanting to be reminded that such horrific crimes
happen every day, perhaps it is the belief that maltreatment of children is not
‘that’ bad. Sadly, these disbelieves are easily dispelled. Nearly five children
die every day in the United States of America as a result of abuse and neglect
(Every
Child Matters, 2009).
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| Picture of 3-week-old infant ... How could anyone break 18 of her bones? |
On November 4, 2013, The Detroit Free Press reported that a Michigan father is facing life in prison after being charged with abusing his three week old daughter. The newborn infant, who is currently being treated at Children's Hospital of Detroit and listed in critical condition, had a total of 18 broken bones – 15 that appeared to have been newly shattered and 3 that were previously broken. This news report highlights an ongoing cycle of violence, abuse, and neglect. Shockingly, approximately 80% of children that die from abuse are under the age of 4 (U.S. Department of Health and Human Services, 2012).
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| 48-year-old Dutch man arrested after sexually abusing about 300 underage girls |
This most recent article, subsequent news-stories, and many others (see caption to the left for example) showcase that popular media outlets tend to highlight the sensational aspects of child
abuse and neglect: babies abandoned or killed by their mothers, toddlers beaten
by their parents, school-aged children subjected to sexual abuse. And while
these stories attract tremendous interest, outcry, and empathy for the victims,
the attention on maltreatment of children is short-lived. Moreover, these
stories focus on one tragic case while ignoring the estimated 2,000 children
that die from abuse and neglect in the United States every single year (U.S.
Department of Health and Human Services, 1999).
Lack of Interventions, Lack of Research ... Lack of Interest?
At present, Child
Protective Services (CPS) in the U.S. is underfunded, understaffed, and
overburdened. In 1994, investigative researcher Brenda Scott argued that “with
insufficient checks and balances, the system that was designed to protect
children has become the greatest perpetrator of harm." Unfortunately, in
the nearly two decades since this report, CPS continues to deteriorate. But what is the answer to fixing a broken system?
The above mentioned news reports substantiate the argument of experts that we need to focus more on preventing violence and identifying the warning signs before things get out of control. Yet a literature search for ‘prevention of child abuse and neglect’ or ‘strategies for the prevention of child maltreatment’ shows that research is severely lacking, as the majority of articles were published between 1977 and 1999.
The above mentioned news reports substantiate the argument of experts that we need to focus more on preventing violence and identifying the warning signs before things get out of control. Yet a literature search for ‘prevention of child abuse and neglect’ or ‘strategies for the prevention of child maltreatment’ shows that research is severely lacking, as the majority of articles were published between 1977 and 1999.
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| Approximately 6 Million Children are Suffering Abuse and Neglect in the U.S. alone |
Indeed, no recent articles were found, which raises the question – why is there such a vacuum of prevention and intervention strategies when experts agree that prevention of child abuse and neglect is essential in overcoming the state of our collapsing child protective system? This is a question that this article cannot answer. However, continuous emphasis needs to be placed on the fact that approximately 6 million children are suffering from child abuse and neglect in the United States alone. In fact, child maltreatment is increasing at alarming rates, reaching epidemic proportions (U.S. Department of Health and Human Services, 2011).
As such, it is the hope of this author that we as a society, and especially, we as health care providers pay continuous attention to the plight of children that are being mistreated every second of every minute, of every hour, of every day...
Thanks for sharing, Dani. I agree with all of your points. Unfortunately, I think CPS is often overburdened, understaffed, and often does not have better homes to place children in. Our country has very little resources for new parents compared to others. I found this article about the maternity packages that expectant parents receive in Finland (http://updatednews.ca/2013/06/03/why-finnish-babies-moslty-sleep-in-cardboard-boxes/). I think that this support system is a great way to help new parents start out on the right foot. I think that excessive parental stress often leads to child abuse. Having support systems like this in place is one simple way to slightly decrease the stress that many new parents face.
ReplyDeleteGreat point, Mary. I don't think there are any valuable resources for new parents in the US. I recall the high school 'exercise' of having to take care of a baby to simulate who overwhelming being a new parent might be ... but I just don't think that this really gets the point across. At our OBGyn rotation, I remember having a mom that was interested in giving her newborn up for adoption because she was living on the street - yet the hospital did not give her any support or even contacted CPS to help her out... she was discharged. I remember talking to our preceptor about this who did not seem to understand why I was as outraged as I was.
DeleteWow, Dani. I'm so sorry to hear about your experience during your OB rotation. It is really disheartening to see patients with such difficult situations not just "slip through the cracks" but be willfully ignored.
DeleteI recently worked with a patient at my current clinical site who was formerly in a very similar situation, but, with the help of a new partnership, has a much different outcome. The hospital is participating in a grant that Meridian Health Plan, Michigan's largest Medicaid HMO, received through CMS to provide extra prenatal support to at-risk pregnant women in the hopes of reducing overall costs through pregnancy, delivery, and the child's first year of life. This mom, who is a type 2 diabetic and, obviously, pregnant, was living in a tent until she was identified as high risk and enrolled in the program, which is called Strong Start. A Strong Start liaison for Meridian helped her find housing and financial support, helped the baby's father find employment, and scheduled her transportation for the weekly Strong Start support groups and all of her prenatal appointments. It was great to see that kind of support available to women who need it and the recognition from CMS that investing in those preventative measures can save a lot of cost down the road.
Here's some more information on the Strong Start in the news (http://online.wsj.com/article/PR-CO-20130226-913462.html) and on the CMS website (http://innovation.cms.gov/initiatives/strong-start/)
I agree with everything you are saying Dani. I found a more recent article that discusses how the CPS in Texas is trying to fix their broken system related to foster children (Scott, 2013). So far 9 children have died in foster care in Texas which is an increase from 2 the previous year. In order to reform, CPS is going to try and increase their unannounced visits, increase scrutiny in cases involving special needs children, and examine the other adults more closely who are around the children. Although this is focused on foster children, hopefully this is a small step towards reforming CPS to better prevent abuse and maltreatment towards children.
ReplyDeleteDani, Mary, and Megan: I agree with all of your points! Unfortunately, I think it's not just CPS, but the foster care system as a whole that's overloaded and overworked. There is only so much that CPS can do if there is no space in a foster home for an abused child. I also think that this post ties in well with an early post about safe surrender of infants. If a parent feels unready for a child and does not want their child, they are far more likely to abuse or neglect them. If they have the option to safely surrender their child, the abuse could be prevented. Unfortunately, it is also much easier to place babies for adoption than older children.
ReplyDeleteWow, thanks for sharing Dani! Those statistics are heartbreaking and I think we can all agree that as health care professionals, more initiative must be taken in this area. As Mary mentioned, many of these abuse cases are a direct result of something the parents are dealing with. While it's not feasible to prevent people who are unprepared or unequipped from having babies, it's our responsibility as nurses to provide education and resources. This summer in one of my clinicals, I had an infant patient who was being treated for a "non-accidental" fracture to both of his femurs. It was a very emotional and complicated case but the health care team did a great job of involving other disciplines and coming up with a solution to keep the baby safe. I agree that CPS can only do so much, which is why social workers and case managers in the hospital are key players especially in these abuse cases. Unless the child is removed from the home, I think the only way to prevent abuse from happening again is to address the heart of the issue, which usually involves something the parents are struggling with. If the parents are willing to receive help, educational materials and resources must be provided.
ReplyDelete