sou · GPB372d1 · 2002-01-01 00:00:00 — In this chapter, we also cite the numbers of reports to the concerning child abuse during the year 2000; 938 incidents involving abuse of children aged up to six, and 5,625 incidents concerning abuse of children aged from seven to 14. In nearly three-quarters of cases, the abuse of young children reported to the was committed by an unknown perpetrator , against 45 per cent for the higher age group. Another difference is in outdoor abuse by a person unknown to the child, which makes up 22 per cent of the offences against children aged from seven to 14, against 10 per cent of those against children up to six. It is essential to be aware that abuse of children is a crime that goes unreported to a high degree. Accordingly, crime statistics of offences reported to the are a relatively poor indicator of the actual scope of child abuse. It is also highly probable that a change in peoples propensity to report the matter took place in the 1990s. This makes it even more difficult to draw conclusions about the actual trend. We propose that the Swedish Government commission , and the for Education to jointly draw up a strategy for collaboration in issues relating to children who are in distress or at risk. The strategy would be intended as support for local collaboration in particular, since we deem that the most important work for disadvantaged children takes place in the local community. Agencies concerned should have a statutory responsibility to collaborate. We propose that new concerning collaboration therefore be inserted in the Act, the Health and Act, the Act on professional activities in the healthcare sector, and the Education Act. The Act already contains a corresponding . We propose that the social services be given, by law, special responsibility to work for this collaboration. Based on their ultimate accountability and responsibility for carrying out investigations, the social services have a self-evident role as coordinator and hub of activities. We propose, moreover, that the Swedish Governments Circular (1970:513) concerning cooperation between social welfare committees, schools and the be annulled. The provisions in this circular appear not to have been applied for many years. Local collaboration should take place both on a general level, to draw attention to situations and environments that entail distress or risk for children, and on an individual level for example, in cases of child abuse. It is invariably local conditions and circumstances that govern this collaboration and determine which parties work together. For a child subjected to abuse, for example, we consider that the working methods along the lines of a child conference can be developed. A child conference is a form of joint meeting in complex child-custody cases, where the various principals collaborate with the child as far as the childs age and maturity permit and his or her family, and possibly with all those concerned. The purpose is to develop working methods and offer measures based on the childs needs, in which it is the responsibility of agencies concerned to participate. Development of methods and measures should take place in association with evaluation and research in social work. This chapter poses the question of whether collaboration is a successful approach. Then follows a review of different preconditions for collaboration. Many peoples needs and problems today are so complex that no principal alone can bring about a satisfactory solution. A variety of skills and resources are required for good measures of helping the abused or neglected child, and the childs family, to be identified. When a major accident or disaster takes place in society, various agencies show that collaboration is necessary to help the victims. Reporting to the social welfare committee The results of various surveys show that only a small proportion of children suspected of being in distress are reported to social welfare committees. Reporting rates vary between occupational groups that have an obligation to report such situations, but are low in all groups. Provisions concerning the obligation to report are contained in Section 71 of the Act (1980:620, SoL). On 1 January 2002 a new Act will enter into force (SFS 2001:453). Chapter 14, Section 1 of the new Act contains a provision that, in content, corresponds to Section 71 of SoL. We propose that the word protection in Section 71 of SoL (Chapter 14, Section 1 in SFS 2001:453) be replaced by the words protection or support. People who are obliged to report such matters have difficulty in determining when this obligation comes into effect. In the wording of the Act, the obligation is connected with a childs need of protection. The preliminary legislative material states that a report should also be made when children may be assumed to need support or help. With the wording we propose, it should be easier for the people subject to this obligation to judge when a report should be made. The new wording has other advantages as well. We propose that be commissioned to issue general recommendations concerning information for the person who has reported a matter according to Section 71 of SoL (Chapter 14, Section 1). Various surveys show that the absence of feedback may result in professionals refraining from reporting such matters. It is perceived as frustrating not to know what happens after a report has been made. The provisions of the Secrecy Act (1980:100), it is true, prevent the social welfare committee from freely disclosing information about the personal circumstances of individuals. However, some facts may be provided. We propose that references to Section 71 of SoL be inserted into the Education Act (1985:1100), the Health and Act (1982:763), the Dental Care Act (1985:125), the Act (1998:531) on professional activities in the healthcare sector and the Act (1984:387). Social welfare committees have an obligation to inform the public of their obligation to report these matters. Nevertheless, various facts show that these committees have difficulty in getting their message across in all quarters, and other measures are therefore also required to enhance awareness of the obligation and its implications in detail. The Social Services Act covers the work of social welfare committees. People who work with children in pre-school and youth education, child health services, dental care, etc may be assumed to be more familiar with their own legislation, and perceive that it affects them more, than other occupational groups. We also deem it likely that issues relating to the reporting obligation may be given more attention from executive management if the reference provisions are introduced. We propose that a special inquiry be initiated to address the issue of a counterpart to official misconduct for people working in the private sector who fail to submit a report under Section 71 of SoL (Chapter 14, Section 1). The fact that many professionals fail to fulfil their reporting obligation is a grave problem. The view is often expressed that increased scope is needed for society to react in these cases. Today, at any rate, certain people obliged to report such matters who fail to submit such reports run the risk of being adjudged liable for official misconduct under the Penal Code, or incurring a disciplinary sanction under provisions of labour law. However, it is probably not possible to cite official misconduct when staff in privately run activities fail to report a case. We propose that the reporting obligation under Section 71 of SoL (Chapter 14, Section 1 of the forthcoming Act) be extended to apply explicitly to prison and probation agencies and their employees. Prison and may have reason to react to childrens circumstances in several different situations. We also propose that a reference to Section 71 be inserted in the Act (1974:203) on correctional treatment in institutions and the Ordinance (1998:642) on the execution of non-institutional correctional sanctions. We propose measures to enhance skills in the social services. The overall objectives of the Degree Ordinance for training in social work and public administration should, we propose, be supplemented by a requirement that the students must have acquired knowledge of childrens life conditions and of the situation and circumstances of disadvantaged children. Staff who handle complex child-custody cases should have special skills. We propose that a programme for developing skills supplementary training, for example be drawn up within the framework of national support for development of knowledge in the social services. We assume that the cornerstones of social work include staff skills, good reception and collaboration. Bearing in mind the quality that the social services inputs must be of good quality, and that the work should be carried out by staff with suitable training and experience we recommend skills-enhancing Special knowledge is required for taking a child into custody and successfully tackling the complex problems this entails, and the crisis that the child and the family are in. year, the county administrative boards examine the municipalities social work. comments, and issues a report, on these observations. In its supervisory report for the year 2000, the Board states that the child perspective in the municipalities inquiries has become more prominent, that comprehensive solutions to childrens and families problems are aimed at, and that quality development and collaboration have improved. Local resources for non-institutional care have been developed, often in collaboration with other care providers. However, there are still shortcomings in administration and documentation. The municipalities have a tendency to tackle complex problems with local non-institutional care initially, but such measures do not always suffice. The supervisory authorities deem it worrying that the social services have difficulties in recruiting and retaining competent staff. This, in turn, may have adverse repercussions on the individual, who is often in a disadvantaged situation. We propose that, for two years, government funds of million be granted in each year for work to devise working methods and measures for children subjected to abuse or neglect, and work involving their families. This development work should be carried out jointly by the social services, schools, , healthcare services and possibly other parties. The activities concerned should contribute funds corresponding at least to the amounts of project funds applied for. The projects should be linked to a research and development unit or an academic department of social work and public administration. When a report is received by the social welfare committee there may, in some cases, be reasons to talk to the child without his or her guardians knowledge. The Commission on the Compulsory Care of pinpointed this need in the course of its inquiry. We concur with their assessments and we propose that this matter be investigated. In cooperation with the county administrative board in and this countys 13 municipalities, we have conducted a study of cases of child abuse reported during 2000. The intention of this study was to clarify not only the social services work in response to these reports, but also their assessments and interaction with other principals that take place in connection with the reporting of a case. Our report includes a survey of measures taken in cases reported, who filed the reports, consultations, etc. reports (20 per cent of the total) come from schools than from any other source. Child-health centres are the authority from which only a few cases are reported. The contributions of the and prosecutors are included. Although the give priority to cases of child abuse, decisions were taken during the year in only two-thirds of the cases, while information is lacking for the other cases. The study also demonstrates the need for a system of continuous statistical documentation. The statistics must be monitored over time to become an instrument for follow- up and analysis. In this study, too, the county administrative board cites the municipalities heavy workload for caseworkers in child and youth care. The report conveys a picture of childrens disadvantaged situation. Pre-schools, schools and after-school recreation activities The introduction to this chapter discusses the importance of a comprehensive approach to pre-schools, schools and after-school recreation centres. We share the Pupil Welfare Committees view that health and learning go hand in hand. The Education Act (1985:1100) cites the category of children in need of special support. However, this phrase is not defined. We propose that consider, in its work, the group of children to which this expression refers and decide to include children subjected to abuse or other forms of assault as well. Moreover, we propose that head teachers responsibility for these children be clarified. We propose that the for Education be commissioned to carry out national surveys of childrens influence and participation in pre-school and school education. Under the Education Act and the curriculum, children are entitled to participate and exert influence in their pre-schools and schools. We consider that pupils who exert influence on the everyday running of their schools develop good relationships with and attitudes towards the adult staff. This can also result in improved scope for detecting and remedying the situation of children in distress. school where pupils meet many adults in the course of the day and where procedure for adult-child dialogue is not highly developed, it is relatively difficult to detect children in distress. We propose that the for Education be commissioned to issue general recommendations on the obligation to report to the social welfare committee. Our contacts with pre- school and school representatives have indicated the need for a plan or routine, devised for each particular school, for dealing with cases where a child is in distress or at risk. The plan should be designed to support and help staff who encounter disadvantaged children. In our view, each pre-school and school should have a plan of this kind. We propose that, in their annual evaluation of the quality reports submitted to them, municipalities should examine how schools deal with children in distress. We propose that special examinations concerning childrens needs and development, with particular attention to children in distress, be inserted in teacher training, in the descriptions of aims contained in the Degree Ordinance. In our view, good skills are the precondition for detection of, and provision of help to, children in distress or at risk. We propose that the municipalities attention be drawn to their responsibility for developing the skills of staff in pre-schools, schools and after-school recreation centres concerning such matters as children in distress or at risk. The healthcare services come into contact with child abuse in many different ways. Staff in some categories have reason to be aware of issues relating to children and child development although they do not even meet children. Examples of such activities are adult psychiatry and treatment of alcoholism and drug addiction. In all such activities, there should be routines to guide the staff in situations where it may be suspected that a child is being abused or neglected. Staff in the healthcare services that involve children are subject to other requirements. Besides the actual and nursing care provided, the way in which staff receive and respond to children is crucially important. We propose that provisions concerning the best interests of the child be inserted in the laws that regulate activities in the sphere of healthcare, i.e. the Health and Act (1982:763), the Dental Care Act (1985:125) and the Act (1998:531) on professional activities in the healthcare sector (LYHS). When measures relate to children, particular attention should be devoted to what taking the best interests of the child into account entails: these interests must always be ascertained, but need not be decisive. Although the various categories of health professionals encounter child abuse in widely varying ways, they have one thing in common: the difficulty of detecting which children are in distress and of reporting to the social welfare committee that a child presumably needs the committees protection. A statutory child perspective is one way of drawing more attention to children and their needs and conditions. By the same token, scope for identifying children in distress is increased. We propose, moreover, that LYHS be supplemented with a provision that acknowledges childrens right to express their views. This kind of provision may be seen as part of the work of ascertaining what is best for the child. We propose that the question of a guardians sole right to decide on a childs care and treatment be dealt with in the overview, announced by the Government, of the 1998 custody reform. A perpetrator of child abuse is often one of the childs parents. It has come to our attention that the legislation on joint custody has had repercussions on childrens scope for obtaining psychiatric care and treatment: if one of the guardians is opposed to the child receiving care or treatment, it is not unusual for the child to be turned away. We propose that special examinations concerning children and the situation of disadvantaged children be inserted in training for midwives, doctors, psychologists, nurses and dentists according to the descriptions of aims contained in the Degree Ordinance. A good reception of children who are abused requires that healthcare staff possess knowledge of childrens normal development. Only those who have such knowledge can be expected to react to deviations from normality. We propose that negotiations be commenced with the healthcare principals at the earliest opportunity regarding the development of routines in healthcare services. It is essential for the healthcare principals to devise routines of these kinds and train the staff in the Child-abuse cases are not particularly common in the healthcare sector, and staff are therefore unable to acquire specific experience of managing them. At the same time, it is for the right measures to be taken and the case to be dealt with promptly. Good case management therefore presupposes routines at the workplace whereby the employee is given clear directives on which measures should be taken, and in which order, in response to child abuse. Psychological reactions and treatment in the event of child abuse Access to prompt and expert support and treatment measures may be crucial to disadvantaged childrens future quality of life. The injuries they have incurred can then heal, leaving scars, instead of always remaining open wounds. Support and treatment measures for a child subjected to abuse are essential because they give healing processes a chance, and sustain and assist the childs further development. A child who has suffered physical abuse has not only visible bodily injuries but also inner, psychological damage. Abuse is a traumatic experience that can affect a childs whole personality, play and learning, and capacity to form relationships, and can also give rise to behavioural disturbances. Witnessing violence or being subjected to mental abuse, too, is a traumatic experience that may have repercussions on the childs further development. Nowadays professionals in every field agree that preventive efforts are important, in both human and economic terms. In our view, measures of this kind should play a more prominent part in everyday work with children. The studies carried out by us and others show the complexity of the background to abuse, neglect or other forms of maltreatment of children. The complex nature of background variables means that work to prevent abuse of children requires a wide-ranging approach. The introduction to this chapter is therefore a rationale of the value of general inputs. One point made is that the category of children in the risk zone is variable over time; another is that if measures are restricted to fewer children the majority of children affected are missed, even if the work is effective. There follows a rationale of the value of social-policy measures and legislation that also performs an educational function, and the importance of influencing societys norms and values and continuing to implement the UN Convention on the Rights of the Child. We propose that the scope for setting up a national centre for children at risk be investigated. In a country with high ambitions to improve conditions for children and families, it is reasonable to have a national research centre at an academic department, with advanced interdisciplinary skills relating to disadvantaged children. A national centre for children at risk should be associated with clinical work at regional level by professionals with expertise concerning children in distress or at risk. This would afford an opportunity for an dialogue between research and clinical practice. A centre of this kind should also engage in close cooperation with higher education institutions and keep up with current research relating to disadvantaged children. A national centre for children at risk could assume responsibility for epidemiological research; carry out expert evaluations of action requirements and of both short-term and long-term treatment measures; and collect data on cases of abuse and other forms of maltreatment that are particularly complex and unusual. The ultimate purpose of the centre would be to support and help children in distress. The existence of a national centre would enhance the research value of the issues concerned, and attract the best researchers in the field. A centre of this kind would also find it relatively easy to get key issues added to both a national and a European agenda. We propose that the Government resolve to explore the scope for setting up parental-support centres. We have found that child- health centres, schools and other authorities are in a position to support and help parents in many ways by means of their respective knowledge, but we consider that there is at present no official body with wide-ranging skills to which parents experiencing problems relating to children and adolescents can turn for help. We discuss forms of preventive work involving prompt measures and support for children and adolescents, and also for families. We consider that pre-schools, schools and after-school recreation centres, just like the social and healthcare services, can play a key part in this work. Regarding the latter, we lay particular emphasis on maternal and child healthcare. In our view, the staff engaged in these activities have special responsibility for monitoring the parent-child bonding process, but also for mobilising parents resources when necessary. We are concerned to emphasise the valuable role of pre-school play groups and family centres in preventive efforts, and also the inputs of voluntary organisations. Good support and treatment measures for children subjected to abuse and other maltreatment, and also rehabilitation of perpetrators, are in various ways important components of preventive work. We propose that Statistics (SCB) be commissioned to survey, every three years, school pupils experience of violence in the home, at school and in leisure activities. In our view, knowledge of childrens and adolescents own experience and perceptions of abuse and other forms of maltreatment should be used in both preventive and remedial work.