Child abuse is one of the most serious problems facing society. Each year, the Ministry of Children and Family Development reportedly receives approximately 30,000 calls from concerned citizens that a child or youth might be in need of protection. Under BC law, all citizens have a moral and ethical duty to report any concerns if they have reason to believe that a child has been, or is likely to be, abused or neglected.
In my message in last month’s College Connector, I wrote about the challenges in accessing mental health services for children and youth. This month my focus is on children who live with domestic and family violence. These are children who are experiencing trauma, including trauma which is ongoing and long-lasting. Domestic and family violence disrupts attachment to the primary caregiver, and it severely disrupts, even prevents, the ability of the primary caregiver to administer care.
This may cause diminished mental health and exhaustion for both the caregiver and the child, and triggers numerous emotional, behavioural, cognitive and physical issues for those trapped in the cycle. Children may be forced to have an ongoing relationship with someone they fear. Alternatively they may be coerced to join in with verbal abuse and contempt, or risk being victimized for supporting the caregiver.
On June 1, 2014, the domestic violence amendments to the Child, Family and Community Service Act came into force and the Ministry of Children and Family Development amended its handbook, Responding to Child Welfare Concerns: Your Role in Knowing When and What to Report. The handbook can be accessed online at http://www.mcf.gov.bc.ca/child_protection/pdf/child_welfare_your_role.pdf. Significantly, the handbook clarifies reporting requirements of domestic violence when witnessed by children, citing that the likelihood of physical and emotional harm to a child increases when the child is living in a situation where there is domestic violence by or towards a person with whom a child resides. This handbook is available in five different languages including Chinese, French, Punjabi, Spanish and Vietnamese at http://www.mcf.gov.bc.ca/child_protection/translated.htm.
Physicians play a significant role when identifying child abuse or neglect. It is our collective responsibility to report any such concerns, and there may be a requirement to remain involved in cases where the child is removed from current care followed by court actions and decisions. In this situation, physicians will be expected to cooperate with the Ministry for Children and Family Development and/or the local Delegated Aboriginal Child and Family Services Agency, while maintaining their ethical responsibility to their patient, the child, and to the child's parents or legal guardians. Physicians are encouraged to take a collaborative approach where possible, acquiring consent from parents or guardians to share a child's relevant information and medical records, unless this interaction jeopardizes a situation where a child requires protection.
Currently there are five child protection teams in BC:
- Child Protection Service Unit, BC Children's Hospital, 604-875-3270
- Northern Health SCAN Clinic, Prince George, 250-565-2120
- Health Evaluation, Assessment and Liaison (HEAL) Team, Surrey Memorial Hospital, 694-585-5634
- Vancouver Island Suspected Child Abuse and Neglect Team, Nanaimo, 250-755-7945
- Kamloops Suspected Child Abuse and Neglect Clinic, Royal Inland Hospital, 250-314-2775
Other sources of support are available after hours at the Helpline for Children at 310-1234. I quote Franklin D. Roosevelt, “We may not be able to prepare the future for our children, but we can at least prepare our children for the future.” Children are our future, and how we protect them and provide for them will in essence shape the next generation of leaders, thinkers and physicians. We cannot afford to let them down.
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