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Critics warn on pregnant mother alerts re abuse

Filed under: Boys / Youth / Education,Domestic Violence,General,Sex Abuse / CYF — MurrayBacon @ 10:35 am Sun 12th December 2010

Whilst the public debate about child abuse in NZ has been somewhat distracted by deaths and horrific injuries to a very small number of children, the overall social vandalism of larger numbers of children is perhaps more disabling, in the territory of emotional neglect. Although emotional neglect leaves no bruises or broken bones and a few days of neglect is readily compensated for, months of neglect of babies leaves long lasting social damage, that so far has been extremely difficult to correct later on. Our prison building programme illustrates a small fraction of the total cost. Suicide gravestones illustrates another face of the cost of emotional neglect.

Men’s advocates have been slow to notice this distraction device. In some cases, the fathers would be equally unsatisfactory parents, as humans tend to assortively-mate. In most cases, the father of the emotionally neglected child can offer safer and more effective parenting, rather than remove the child from the parents completely, with all of the hazards and risks that this entails. The CYFs Act already provides for this, but in practice some social workers and “judges” fail to follow through with those clauses, perhaps due to unresolved problems with their own childhoods? Even more worrying, the manner of intervention by CYFs sometimes disables fathers from being able to care for their children, when they would have been capable if the intervention was appropriately sensitive to the situation. Pure vandalism.

Due to the apparent impossibility to rectify the damage done to babies and young children by sustained emotional neglect, rather draconian looking measures are required – to be sure that all children are being protected from this hazard. (Future research might discover methods of helping to correct for effects of childhood emotional neglect, but thus far this seems to be very elusive, Prevention is presently far more effective than trying to later cure.)

Judy Bailey, for Brainwave Trust, spoke on these issues, at the recent Family First Forum on the Family.

The practical reality is unfortunately tempered by the social damage done by stigmatising parents, through possibly well meaning alerts, placed by professionals in healthcare or social work or psychology, who nonetheless are unable to assess accurately and reliably parenting skills and resources. Thus, in our zeal to protect some children, we may be doing serious harm to a larger group of perhaps lower skilled but quite satisfactory parents.

Calls for Starship child unit inquiry

A good example of such a health professional, well qualified in medicine, but I suspect lacking forensic skills, is Dr. Patrick Kelly, who is under investigation by the Health and Disability Commissioner, for acting unethically, outside of legal authority and outside of his established professional medical competence. This investigation has resulted from complaints laid by aggrieved parents. I expect that there are many further parents, who don’t know enough to formulate their complaints and submit them. I feel very sorry for the children of these parents, whom the parents were unable to protect from the actions and interventions of Dr. Patrick Kelly. In many cases the genie cannot be put back into the bottle, serious and irreversible relationships damage has already been done.

I am not suggesting that forensic medicine is easy. On the contrary, it is less well developed than everyday medicine, as it attempts to deal with relatively rare conditions. Most importantly, we need to separate what we know and what may or may not be a shrewd guess. Also, to separate forensic functions from medical practitioner functions, as the necessary mindset and ethics are so different and one person trying to perform both functions is difficult to probably impossible (as well as being unethical). Professor Goodyear-Smith made these points very well and she has years of relevant experience, from all points of interest. Professor Felicity Goodyear-Smith Inaugural Lecture

Our biggest barrier to improving child protection, is the lack of ability to reliably assess parenting skills and resources and report on this, irrespective of the gender of the parent.

Through the present faltering steps taken by MSD, I expect that we will eventually provide better protection for all of our children. I feel very sorry for the children mangled, while we try erratically to improve. On present indications, there will be a decade of more damage done, until we evaluate present child protection performance rigorously, frequently and competently. Presently, Government interventions are poorly researched, poorly designed and even more poorly evaluated after introduction.

Present gender politics driven design of social programmes, with improvement through occasional royal commissions, is a slow, destructive and dismal approach, compared to good quality evidence based design, evaluation and quality improvement.

Too much damage is being done, while we fail to quickly evaluate our performance.

Critics warn on pregnant mother alerts

TONY WALL – Sunday Star Times
Last updated 05:00 12/12/2010

Alerts are being placed on the health files of pregnant women whose unborn children are deemed at risk of abuse — a move critics say could stigmatise and wrongly label parents.

The Sunday Star-Times has learned that health professionals can now place flags on the national medical warning system for children who have been treated for abuse — but also for pregnant women deemed “vulnerable”.

The system attaches the alert directly to an individual’s health index number, so that if they are assessed at hospitals or medical centres throughout the country, medical staff will know their history. An alert stays in place until a child turns 17, and parents may not always be told about them. Siblings of an abused child can also have alerts placed on their files without a medical assessment.

The system, developed by doctors and supported by the Ministry of Health, is aimed at identifying child abuse early and preventing recurrent abuse.

Former health and disability commissioner Robyn Stent, whose stepdaughter was wrongly suspected of abuse at Starship hospital’s child protection unit, says she does not trust medical professionals to make the right calls around the alerts. In her stepdaughter’s case, a note referring to suspected abuse was never removed from the file.

“These are the people who insist on treating parents as criminal suspects in all cases where abuse is `possible’, and who based their abuse suspicions in our family’s case on a non-existent report,” Stent said.

“We would not trust them with the power to denounce families to the medical world as likely abusers, unless they have evidence which satisfies a court.”

The New Zealand College of Midwives has also expressed concern about the alert system. “The consequences for families and babies are great if the guidelines are inappropriate,” chief executive Karen Guilliland said. “So far, the discussion has been largely hospital-focused with little input from mothers and parents, or midwives.” She said the college found out about the system only last week, and while those behind it seemed to have good intentions, any alert system raised issues of privacy, confidentiality and human rights. A senior Auckland midwife, who asked not to be named, said the system had been developed by child abuse “zealots”.

“There are people who will think it’s a good thing and others who will be horrified. They may have made changes and got on with life, changed partners, and they’ve got this tag. It’s like a tattoo saying `I’m a bad mother’.”
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The national child protection alert system is based on one that has been in place in Hawke’s Bay since 2004, and was developed by paediatrician Russell Wills, of the Hawke’s Bay District Health Board, along with other leading child abuse experts, such as Starship hospital’s Patrick Kelly.

Wills said alerts were placed on the national health index number of children treated for inflicted injuries, so if they “presented” at another hospital, the previous incident would come up. Alerts were put on the system only where a referral had been made to Child, Youth and Family, and where there was considered a likelihood of further abuse. A “multi-disciplinary team” of doctors, nurses and social workers made the decision on whether to lodge an alert.

Wills said medical staff were taught that just because a child protection alert was placed on a file, it did not mean that any new injury was non-accidental. “It just means you have to bear in mind that previous injury when you’re assessing this injury, so there’s no stigmatisation or assumptions. The whole training package in the national rules is designed to avoid stigmatising.”

Meanwhile, the Ministry of Social Development is developing another alert system to notify it when a woman who had abused a child, or had her children taken from her, gave birth again. Social Development Minister Paula Bennett acted after a case last year in which a mother, who allegedly killed her child, had previously had children removed from her care, yet the department did not know about the new child.

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  1. Thanks Murray.

    Comment by julie — Sun 12th December 2010 @ 2:43 pm

  2. What’s new? Now mothers are being identified as potential abusers.
    Fathers have always been suspected in this way- part of being a father is dealing with all the ‘officials’ who treat you as an abuser just because you are male.

    Years ago, I was visiting my daughter in Starship hospital, when a staff member pointed out the sign saying “This is a No Hitting Zone” (or something similar)
    He was assuming that because I was a father I might have been there to hit my daughter.
    I replied
    “Oh- have you stopped hitting children here? That’s good”.
    Stupid clot didn’t like that, probably put me on the BLACK REGISTER OF ABUSERS (Oh- I was already on it being male).

    Comment by John Brett — Mon 13th December 2010 @ 7:33 am

  3. The same old discussion is still limping along, without having moved forwards, in terms of better protecting children. NZ still has not satisfactorily addressed the problems caused by having huge files, full of irrelevant and incorrect data….. familycaught$ neither…….

    The Lancet

    Implementation of the Child Protection Information Sharing Project (CPIS) in England raises concerns about privacy, data accuracy, and how vulnerable groups will benefit from the initiative. Electronic sharing of information will only help children and young people if health professionals know how to interpret and use the information to intervene effectively. Health professionals might be falsely reassured that there are no underlying problems for the many abused or neglected children below CPIS thresholds (ie, those who are not looked after or subject to a child protection plan),1 and caregivers might be deterred from seeking health care as a result of the initiative. Adaptation of the National Health Service (NHS) number as a personal identifier to enable health-care practitioners to access linked health, education, and social-care records for the direct care of children from vulnerable groups, as recommended by David Low and colleagues (July 25, p 313),2 raises similar concerns.
    We do, however, support the linkage of data for all children for the purpose of anonymised, population-based analyses that aim to improve service provision. For example, out-of-home care during developmentally sensitive periods of life, such as infancy and early childhood, can have lifelong consequences.3 The effect of early social care on educational outcomes cannot be investigated at present, because 22% of looked-after children leave the care system before school age and cannot be identified in education data.4 Linkage of health, education, and social-care datasets would also enable the assessment of service use for all children, including those below CPIS thresholds. Some analyses could be done without NHS number data by the linkage of datasets through the Personal Demographics Service. Collaboration between government departments would be necessary to develop appropriate legal gateways and algorithms for the effective linkage of data.

    Louise Mc Grath-Loneemail, Jenny Woodman, Ruth Gilbert

    Comment by MurrayBacon — Mon 26th October 2015 @ 7:31 am

  4. There used to be a joke – What does a psychologist do? Turn hearsay into evidence.

    I thought it was a bit funny, until I had seen it work in practice. Probably it is true more often of social workers, than psychologists. (I have seen a few psychologists who were careful not to unwittingly do this.)

    A mother makes a comment to a psychologist, who repeats it in her report. (The vast majority of familycaught$ appointed psychologists and MSD social workers are sort of female.) She didn’t have enough time or resources to check it, but repeated it in the report anyway. In a stupid judge’s eyes, it is now hard evidence, unless the other party can disprove it. If they were only supplied a copy of the report at the hearing, they will have little opportunity to be able to access the required evidence.

    This is why familycaught$ performs so poorly, it is swamped with incorrect and misleading information. It cannot work out what is false, what is suspect and what is actually correct information. The blind leading the blind. Its not my fault, my decision was based on “evidence” from xxxx.

    Of course, in the real world, people like to get their facts straight, before rushing in and making decisions.

    Doesn’t actually matter, it is only about children’s development and upbringing!

    Comment by MurrayBacon — Mon 26th October 2015 @ 8:08 am

  5. Murray, I think you are misunderstanding the concept of the Family Court.

    When the psychologist reports what the mother says, it is the point of view of the mother, and this should be accepted without question, as this is the way this woman sees it.

    The Family Court in this respect is not about evidence, but perception – the women’s intuitive judgement, the overriding needs of the mother – which should be accepted by the court as the basis on which a decision should be made.

    The best interests of the child being what is in the best interests of the mother.

    It took me a while to realise that I was trying to quantify their behaviour by male standards (also criminal law standards not civil standards) rather than actually seeing their behaviour for what it was.

    Comment by Downunder — Mon 26th October 2015 @ 11:00 am

  6. I think that we are saying the same thing, in slightly different ways?

    Although similar things happen in criminal caught$ too, they just happen a little less often and perhaps are done with more subtlety…

    Sympathy as a substitute for evidence?

    Comment by MurrayBacon — Mon 26th October 2015 @ 1:02 pm

  7. No, Murray.

    Law of the Individual relies on one person to satisfy the wants of the other, in law, not in nature.

    Comment by Downunder — Mon 26th October 2015 @ 3:38 pm

  8. … and there is n important distinction in terms of the function of law!

    Comment by Downunder — Mon 26th October 2015 @ 5:05 pm

  9. @Murray I’ve been thinking about this.

    The expectation of sympathy is a feminine trait.

    And, yes, that translates into a legal system, but it doesn’t form the basis of that legal system.

    Yes, we’re coming at it from different directions, but which question is it you hope to answer?

    Comment by Downunder — Wed 28th October 2015 @ 4:32 pm

  10. I am not trying to be academic legal.

    On the contrary, I am just trying to describe the everyday reality of citizens wandering into a caughtroom and then finding that the evidence that they put together had astonishingly little impact on the decisions of a judge.

    I am trying to warn everyday citizens, so that with forewarning, they will approach gathering evidence, in the awareness that they might get a sympathetic hearing and it is likely that they will get a rather unsympathetic hearing.

    By being forewarned, they are more likely to get a knowledgeable friend to look over their evidence in a Devil’s Advocate mode and point out to them whatever weaknesses might lie in their evidence. By having their evidence challenged well before any hearing, hopefully they are then in a position to gather further evidence, to fill in any possible gaps or weaknesses.

    Evidence is like a chain, one missing link allows scope for “judgement”, or for sympathy or the lack of sympathy. If all missing links, or ambiguous factors have been addressed, then you might have evidence that doesn’t allow sympathy to enter into the equation – ie the judge has to accept your evidence and your conclusion.

    Another way of saying this, is that there are many paths that the judge might choose to follow. But a complete set of relevant evidence shuts all doors, except the one that you want the judge to go through.

    Another way of saying the same thing, is that by showing sufficient evidence that there was only one possible conclusion, you have shown that if the judge doesn’t follow your interpretation, he/she can see that you are in a strong position to appeal and succeed. This is quite embarrassing to the judge, so they are unlikely to risk it. If there were several possible interpretation of the evidence, then you cannot succeed on appeal.

    Some people say just throw a bit of evidence together and see how it goes. If it fails, then appeal and sort it out then. As described above, this doesn’t usually work. You have to get it right first time, as it is extremely difficult to sort out problems after the first hearing.

    I have heard women complain about weighing of evidence, almost as much as men.

    Either way, just put together your evidence, so that it can pass unsympathetic weighing and still succeed.

    Then you can relax and not have to overstress.

    Comment by MurrayBacon — Thu 29th October 2015 @ 6:08 pm

  11. A high-flying Wellington lawyer has received a rare diversion after assaulting and kicking his wife, a decision slammed by Women’s Refuge for sending “the wrong message”.

    On Friday, Law Society spokesman Geoff Adlam said while he could not comment on the particular case, domestic violence was a “serious crime”.

    Excuse me – Is there a crime called ‘Domestic Violence’ – Legal Wanker.

    Comment by Downunder — Fri 30th October 2015 @ 6:48 pm

  12. Dear Downunder,

    I am a little concerned that you might be taking the legal workers too seriously?

    Remember that it is only your money that they are after.
    Certainly, respect their power to do harm, especially if you trust them!.

    I hope you are not doing yourself any harm, by taking them too seriously?

    Murray – revolting axe murderer.

    Comment by MurrayBacon — Sat 31st October 2015 @ 6:15 am

  13. What really does my head in, Murray, is trying to work out whether they are a comedy or a tragedy.

    Comment by Downunder — Sat 31st October 2015 @ 7:05 am

  14. We need to take into account what those intimate to the actions of the couple have decided.
    “The decision to deal with the offence by diversion was supported by the police family violence team, with the approval of his wife.”
    I can imagine that if he did it again.
    He would be punished with vigour.
    The relationship could survive.
    With the communities support it could even be stronger.

    Comment by DJ Ward — Sat 31st October 2015 @ 8:17 am

  15. What really does my head in, Murray, is trying to work out whether they are a comedy or a tragedy.

    It looks like a comedy, if you aren’t worried for the welfare of the real people involved. Just a fishing game, of pulling in the suckers, letting out the line and pulling them in again… Milking them while the money is coming out and then dropping them like hot cakes when the money and borrowing capacity has run completely out.

    If you have some integrity and feeling for the welfare of vulnerable people, then the familycaught$ is a tragedy of relationship vandalism, of proportions so huge, that most people can’t see it. The wasted money is a small issue, compared to the unnecessary social damage.

    Remember that if dealing with familycaught$ isn’t fun, you aren’t doing it right. Maybe you hadn’t protected yourself properly, before dealing with them?

    Just business as usual….

    Comment by MurrayBacon — Sat 31st October 2015 @ 7:26 pm

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