Can we do better preventing child maltreatment?

The cost of child maltreatment isstaggering, yet our willingness to live with the consequences suggests that weremain in a state of denial.   The consequences of child maltreatment include:

  • Human costs to victims: child fatalities, child abuse relatedsuicide, medical costs, lower educational achievement, pain and suffering.
  • Long term human and social costs: medical costs, chronic healthproblems, lost productivity, juvenile delinquency, adult criminality,homelessness, substance abuse, and intergenerational transmission of abuse.
  • Costs of public intervention: child protection services,out-of-home care, child abuse prevention programmes, assessment and treatmentof abused children, law enforcement, judicial system, incarceration of abuseoffenders, treatment of perpetrators, and victim support.
  • Costs of community contributions by volunteers and non-governmentorganisations.

Translating overseas estimates of the costs of child abuseand neglect to the New Zealand context suggests that it imposes long term costsin the vicinity of $2 bn per year, ie in excess of 1% of GDP every year.  Roughly one third of this cost relates to dealing with immediate consequences(eg health care, child welfare service, and justice system costs).   Anotherthird relates to ongoing health, education, and criminal consequences for childabuse victims in later life.   The final third results from a decline inproductivity as victims fail to meet their potential.  

Reducing the incidence of child maltreatment would notonly have a profound impact on the quality of life for potential victims but,by reducing our need to support victims, it will also materially improve thewellbeing of the rest of society.  

Prevention is more effective than correction.   The mainreason for this is that maltreatment has lifelong impacts on the victims.   Thetrauma of maltreatment can inhibit brain development in ways that marsintellectual, communication, social, and emotional abilities.   Victims of childabuse face a greater risk of failing at school and of being emotionallyalienated from society.   That so many victims of maltreatment go on to leadessentially normal productive lives is a testament to the general resilience ofhuman nature.   But these victims have done it tough.   Life could have been somuch better and productive if their formative years had been less stressful.   Andthen there are the walking disaster areas who go on to impose huge costs on themselvesand the rest of society.

Abusive behaviour is not constrained by socio-economicstatus, but research has identified a number of risk factors that increase thepotential for child abuse.   Key markers of child maltreatment include:

  • Parental age and education, eg young or uneducated parents mightnot be naturally as well equipped to deal with the stresses of parenthood.
  • Parental mental health problems such as depression.
  • Social deprivation, in particular a lack of wider family support.
  • Alcohol or other drug dependency issues.
  • Past exposure of parents to interpersonal violence or abuse.

Poverty might exacerbate these pressures, but it is notclear that it is a root cause.  

In New Zealand, agencies such as Barnardos, Plunket,Preventing Violence in the Home and many others play a critical role insupporting families to do their best for children.  

Also the government’s commitment to preventing childmaltreatment has increased considerably in recent years.   Child, Youth andFamily’s appropriation for education and preventative services for childrenincreased from $16m in the 2004 Budget to $166m in the 2008 Budget.   Thisincreased spending has the potential to reduce the incidence and therefore thefuture cost of child maltreatment.   But is it sufficient? Will servicesprovided be effective?   And what guarantee have we that the current commitmentwill be maintained?  

A common problem with government sponsored programmes istheir top-down, planned design.   Large-scale programmes may miss the factorsthat made small-scale programmes a success or have difficulty obtaining successin different environments.   Large programmes also have a propensity fordiverting resources away from children and their families into running thebureaucracy and creating an overarching infrastructure.

Large-scale programmes can succeed if they have thefollowing three features:

  • The programmes focus on at-risk children and encourage directparent involvement.
  • There is a long term commitment to reducing the incidence ofchild maltreatment, including changing attitudes about physical punishment.
  • The programmes reward successful outcomes in order to encouragehigh quality and innovative practices.

A way of maintaining commitment would be to create apublic endowment that would fund the provision of child and parent supportservices.   A fund would clearly signal an ongoing commitment to reducing theincidence of child maltreatment, a focus on service rather than bureaucracy, areassurance to service providers that there will be consistent demand for theirservices, and a willingness to fund effective, specialised and innovativeservices.

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