This article is in follow-up to the recent email message sent to all registrants about their legal and ethical duty to report a child in need of protection to the appropriate authority. I want to personally thank those of you who took the time to share your concerns with the College about access to mental health services for children and youth. There is no doubt that the challenges of addressing complex issues of poverty, violence, mental health and addiction are significant in BC.
I hope you had a chance to read the Representative for Children and Youth’s investigative report, Lost in the Shadows: How a Lack of Help Meant a Loss of Hope for One First Nations Girl. It is a powerful review that details the repeated failure of health professionals, and in particular a number of physicians, to identify and report a child in need of protection. This is not the first time this issue has been identified in BC. The Gove Inquiry into Child Protection in 1995 concluded that medical examinations of Matthew John Vaudreuil were seen as isolated interventions and physicians were found to have not paid sufficient attention to the young boy’s medical and social history, and did not make a report to the ministry as they should.
Difficulty accessing services for children and youth is not an excuse for failing to report a child in need of protection. It is clear that the failure to report this child was systemic in nature, given the number of health professionals involved. Our collective task as physicians is to understand the reasons behind this failure, and take steps to eliminate these shortfalls. It bears repeating that just because a child or family is receiving services from the ministry doesn’t mean that the ministry is aware that the child is in need of protection. When assessing/certifying an adult psychiatric patient, physicians must make inquiries about the patient’s possible role and capability as parent/caregiver.
Some physicians have already identified opportunities to improve child protection reporting compliance, such as revising mental health certificates to include a question about the detained adult psychiatric patient’s role as a parent or caregiver. I welcome your specific suggestions as to how to improve reporting compliance under the Child, Family and Community Service Act. Together with the College of Registered Nurses of BC, this College will be collaborating with the Ministry of Children and Family Development, the Ministry of Health, the provincial Director of Child Protection, and the Representative for Children and Youth to ensure children in need of protection are appropriately reported. It takes a community to raise a child and we all have a professional duty to protect them from harm.
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H.M. Oetter, MD
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