Co-operating to protect children -shifting the thresholds

Abstract

It is now 30 years since Kempe delivered his watershed address to the American Academy of Paediatricians graphically describing the battered child syndrome. In the 30 years that followed elaborate child protection procedures, supported by strong legal powers, have developed not only in the UK and the USA but also in may countries around the world. In the last 5 years or so, however, there has been another great watershed. Independently in both the USA and in the UK, evidence has accumulated which is questioning the efficacy of our elaborate child protection systems. For social workers in the UK the history is familiar; the child abuse inquiries leading on to the Cleveland Inquiry, on going scandals in residential care and concern about the outcomes for children in the public care system, and, finally, the recent message from the Department of Health in 1995 “Child Protection - Messages from Research”. Less familiar will be the concerns which emerged in the USA. There, following the introduction of mandatory reporting which in some states is mandatory even for civil citizens, there was a huge rise in the number of children reported (3 million reported in 1992 of which less than half were substantiated). This largely incapacitated the child protection agencies and led to large numbers of children being admitted into the public care. In 1990 the US Advisory Board on Child Abuse and Neglect concluded that there was an urgent need to develop new approaches. The answer put forward in this country and the USA has been the rediscovery of targeted preventive approaches. Central to these approaches is what we call family support and what is called social support in the USA. Child protection is an important and demanding activity - research and our own limited local information does pose serious questions about the efficacy of the process; - this points to the need for reviews by area child protection committees; - research also tells us important things about the characteristics of families involved especially about their social and economic circumstances. These need to be addressed. Addressing these needs requires several things - a good individual assessment and population assessment to plan appropriate services; - a sound interagency/multiprofessional approach; - maximising all the resource options and taking a broader view of the task - as well as mainstream services as currently arranged, we need to embrace a community development approach and to view die families involved in terms of their inclusion or exclusion from society and address these shortfalls. We are only at the threshold of the implementation of the Order and we need to approach it with a broad vision.