It's everyone's job to make sure "I'm alright" Literature Review
Reporting child abuse and neglect
This chapter discusses the ways in which abuse is reported to official agencies and discusses reasons why some professionals may be reluctant to report abuse.
The Council of Europe has urged all countries to have mandatory reporting of child abuse but the UK along with several other European countries does not have laws requiring mandatory reporting. Under UK law only local authority social workers, health and social service board social workers (Northern Ireland) and police have a duty to report suspicions that a child is in need of care and protection. Local child protection guidelines and professional codes of conduct may expect other professionals (teachers, health visitors and other medical staff) to report as part of their professional duty, but they do not have to do so as a matter of law (Madge and Attridge 1996; National Commission of inquiry into the prevention of child abuse 1996).
Gibbons et al (1995) found that:
- education services referred the most cases to the child protection process (23%);
- health visitors, GPs and hospital staff referred 17%;
- household members and other lay people 17%;
- social services professionals 13%;
- police or probation 12%;
- anonymous 6%; and
- other 12%.
Research in Europe, the US and Australia indicates that medical practitioners may be reluctant to report even when they have a legal mandate to do so. Indeed the referral rate by GPs is surprisingly low given the frequency of their contact with families with children. Despite mandatory reporting laws in the US research has shown that medical practitioners still do not report up to a third of what they consider to be possible child physical abuse cases. This is despite the fact that the practitioner only has to suspect abuse or neglect to make a report and is indemnified against prosecution for the making of such a report. There are various reasons for medical practitioners' reluctance to report including ideological and ethical concerns about confidentiality, family privacy, desire for autonomy in practice, and mistrust of state services. Research has also found that doctors may have difficulties delineating accidental and non-accidental injury and defining emotional abuse and neglect and that some express ignorance about reporting laws and procedures (Vulliamy and Sullivan 2000; Thorpe 1996; Haeringen 1998; Buckley 1998). Warner and Hansen (1994) found that cases of physical abuse were more likely to be reported by medical professionals than cases of physical neglect but cases of suspected sexual abuse were most likely to be reported. The type and severity of injury were related to identification. Reporting of physical abuse and cases of physical abuse and/or neglect involving younger children and younger parents were more likely to be reported by hospitals than cases involving older children. African American and Hispanic families and lower income families had a higher probability of being reported.
US and Canadian studies have also demonstrated a poor reporting record amongst teachers. Despite an increase in reporting levels following the introduction of mandatory reporting, teachers' overall reporting rate has been estimated to be at about a quarter of the suspicious cases they encounter. Research has found that many teachers are unaware of standard child abuse reporting procedures and feel unprepared to report cases. The most common reasons cited for not reporting abuse are fear of making an inaccurate report, feeling as though child protective services do not help families and no apparent physical signs of abuse. Cases that do get reported generally involve disclosure, the observation and documentation of a series of bruises over time or one that was sufficiently serious and shocking to stimulate an immediate formal report. Special education teachers have been found to be more likely to report abuse, possibly because they may be more likely to see abused children (Tite 1993; Kenny 2001).
Where doctors, teachers and other professionals are reporting abuse, some commentators believe that mandatory reporting is still not effective in reducing child abuse and neglect. Ainsworth (2002) compared New South Wales which has mandatory reporting with Western Australia which does not. He found that mandatory reporting systems were overburdened with notifications, many of which proved to be unsubstantiated, but which were time consuming and costly. He concluded that mandatory reporting systems were inefficient and ineffective and that the money which was spent on them would be better spent on government and non-government family support and assistance programmes.