Interventions to halt child abuse in Aboriginal communities
Authors: Fiona J Stanley, Dorothy A Scott and Melissa O’Donnell
Published online: 15 October 2007
To the Editor: The recent editorial by Ring and Wenitong1 about interventions to prevent child abuse in the Northern Territory highlights the importance of treating the causes as well as the symptoms. This is true not only for children in remote Aboriginal communities, but for all children across Australia.
Child abuse and neglect is not a “new” national emergency. In 1966, Bialestock2 wrote in the Journal:
This situation should be considered as a national emergency as lethal to the lives of potential Australians as is a war. Immediate allocations of revenue to prevent this situation should be made if the[se children] . . . are to be allowed to grow into adults able to live in dignity and to work to contribute to our economy. We must not sentence these children to a lifelong need for State support.
There are no reliable prevalence data, but Australian Institute of Health and Welfare data indicate that there were 266 745 notifications of suspected child abuse and neglect in Australia last year, double the number 6 years ago. About one in five of these notifications were “substantiated”. Over 25 000 children are in state care at any one time, an 82% increase in the past decade.3 Our child protection systems are at risk of imploding under the strain. These systems are also potentially dangerous, with high levels of multiple placements contributing to the very high prevalence of mental health problems among children in care.4
The contributory factors are well known. Children with disabilities, chronic health problems, difficult temperaments and externalising behaviours, families where there is domestic violence and parental mental health or substance misuse, and communities characterised by poverty, unemployment, higher residential mobility, and a low adult to child ratio are at much greater risk.
We must close the gap between what we know and what we do. A public health approach is needed to reduce the risk factors, using population-based measures of child abuse and neglect, and tapping the potential of universal health, welfare and education services as platforms for primary and secondary prevention.
In relation to health services, the adequate provision of universal maternal and child health services, including sustained nurse home-visiting programs, is vital. General practitioners and mental health and drug treatment services using child-sensitive and family-centred approaches also have a major role to play. These interventions have also been shown to improve overall outcomes for children in education, health, and social and economic participation. Hence, economists have suggested that they are the most cost-effective intervention for a nation.5
Now is the time to ask whether governments are really serious about preventing child abuse and neglect.
References
- Ring IT, Wenitong M. Interventions to halt child abuse in Aboriginal communities [editorial]. Med J Aust 2007; 187: 204-205. Epub ahead of print 1 Aug 2007. 0_CBBEAEAD
- Bialestock D. Neglected babies: a study of 289 babies admitted consecutively to a reception centre. Med J Aust 1966; 2: 1129-1133. 0_pgfId-1429595
- Australian Institute of Health and Welfare. Child Protection Australia 2005–06. Canberra: AIHW, 2007. 0_pgfId-1429603
- Rubin, D, O’Reilly, A, Luan, X, Localio, A. The impact of placement stability on behavioural well-being for children in foster care. Pediatrics 2007; 119: 336-344. 0_pgfId-1429608
- Heckman, J. Skill formation and the economics of investing in disadvantaged children. Science 2006; 312: 1900-1902. 0_pgfId-1429708
Watchful Waiting Compared With Immediate Antibiotics for Urban Aboriginal and Torres Strait Islander Children With Uncomplicated Acute Otitis Media (WATCH): A Non-Inferiority Randomised Controlled Trial
Jennifer S. Reath, Hasantha Gunasekera, Sanja Lujic, Amanda J. Leach, Letitia Campbell, Robyn Walsh, Tim Usherwood, Geoffrey K. Spurling, Claudette A. Tyson, Deborah A. Askew, Kelvin Kong, Chelsea J. Watego, Peter Morris, Wendy Hu, Penelope A. Abbott
A Rare Case of Storage Mite Anaphylaxis in Infancy
Eliza Kluckow, Katie Frith
Beds Still Burning: Suicide Should Not Be in the Vocabulary of Children
Rudi Louis Taylor-Bragge
Progressing Cross-Sector Collaboration for People With Eating Disorders and Higher Weight: Priority Actions From an Expert Roundtable Using a Modified Nominal Group Technique
Hiba Jebeile, Leah Brennan, Tracy Burrows, Xochitl de la Piedad Garcia, Angelique F. Ralph, Supreet Saluja, Evan Atlantis, Sarah P. Garnett, Carmel J. Harrison, Eve T. House, Natalie B. Lister, Lisa Moran, Milan K. Piya, Elizabeth Rieger, Evelyn Smith, Phillipa Hay, Sarah Trobe
Intergenerational Child Protection Contact and Child Development Outcomes: A Whole Population Linked Data Study
Meredith Forsyth, Alicia Montgomerie, Kathleen Falster, Deepa Jeyaseelan, Paul Hotton, John Lynch, Rhiannon M. Pilkington
Impact of the 2025 New South Wales Respiratory Syncytial Virus Prevention Program on Infant Notifications and Hospitalisations: A Population-Based Analysis
Janaki Amin, Sally L. Ellis, Christopher Lambeth, Jessica Gugusheff, Christine Selvey