As he has for the past several years, President Obama recently proclaimed April 2013 National Sexual Assault Awareness and Prevention Month, citing that “too many women, men, and children suffer alone or in silence, burdened by shame or unsure anyone will listen.“
April is also National Child Abuse Prevention Month. The U.S. Department of Health and Human Services website declares this “a time to recognize that we each can play a part in promoting the social and emotional well-being of children and families in communities.”
In both cases – whether speaking of sexual assault or child abuse (which includes sexual assault on children), two commonalities surprise me:
- The numbers: More than 2 million cases of child abuse in 2011; 1 in 5 women will be sexually assaulted in college.
- The silence factor: The fact that the staggering statistics do not reflect the myriad assault and abuse cases that go unreported, unnoticed, untreated.
Hence the emphasis on awareness. In an attempt to increase mine, I turned to the place I work, UVA Health System. I was completely ignorant and definitely curious: Do we see a lot of cases of child abuse here? What do we do about them? And what, if anything, can someone like myself, not a social worker or healthcare provider but a member of the general public, do to help prevent abuse cases in our community?
Insights from Inside a Hospital
What I learned from Noel Dianas-Hughes, MSSW, LCSW, C-ASWCM, head of social work and child protection coordinator at UVA Medical Center, surprised me, despite what I knew about national statistics.
“We see hundreds of cases,” she says. Not only that, but in her 24 years on the job, Dianas-Hughes says she’s seen “a pretty steady increase. Perhaps,” she suggests, “because of the added stress of our economy. When you don’t have your basic needs met, it adds a whole other level of stress and anxiety.”
Incidents of child abuse, she explains, increase with stress. Parents worried about money, job security, housing and food are at high risk for acting out. “Adult timeouts are very important. Walk away for a couple of minutes until you regain your composure. People lose it. That’s oftentimes when abuse happens.”
Dianas-Hughes shakes her head at the lack of education and stress management available to parents, caregivers. “As a country we could do a lot better in heightening awareness for everyday people. It’s not taught in schools or anywhere outside of professional educational programs.”
Did you know?
A nationally estimated 681,000 children were found to be victims of child abuse or neglect.
Of these unique victims:
- 78.5 % were neglected
- 17.6 % were physically abused
- 9.1% were sexually abused
Whatever the causes, the high numbers of abuse reports require the social workers at UVA to have a comprehensive set of policies and an extensive mechanism for response and support.
Healthcare providers and social workers at UVA, like teachers and police officers, are mandated reporters, meaning they are required by law to report any suspicion of abuse they see. To make a report, a UVA healthcare provider fills out a form or makes a call. “We have social workers at all the main clinics at the medical center,” she says. “And outlying clinics can call either myself during weekday hours or the emergency department social worker, 24/7.” Once reported, the case becomes the responsibility of the social worker, who then performs a thorough assessment of the situation.
Medical Neglect and Cultural Differences
So, do they mostly see physical abuse at the hospital?
“Mostly physical or sexual, and a fair number of medical neglect cases,” Dianas-Hughes says, using a term I don’t quite understand.
Dianas-Hughes explains that medical neglect “can include myriad things: Not following through on appointments, not following doctors’ orders, not seeking medical treatment when needed, like if a child has lethargy and starts seizing and the parent waits 2-3 days when it’s clearly obvious the child had something wrong.”
She points out that sometimes assessing and determining actual neglect can become quite tricky due to variations in religious and cultural beliefs about medicine or corporal punishment.
Some patients who end up at UVA practice leeching, bloodletting and cupping for the treatment of disease. Dianas-Hughes cites a family who “believed in letting the children have minimal boundaries, no supervision, all ages, not just older, two, three, four years old…they didn’t understand why we were so concerned.”
When these more complicated situations arise, social workers perform a psycho-social assessment to get the details about family background, history, beliefs.
The hospital social workers then turn over cases to local social services departments, with whom they have an “excellent and collaborative relationship,” for further evaluation and follow-up.
What You Can Do to Help
How can you help prevent child abuse?
The most important thing, according to Dianas-Hughes: Educate yourself about the signs and symptoms. “Don’t hesitate to intervene by calling social services,” she urges. “It can be anonymous. Call the hotline. You can’t be compelled to identify yourself to the hotline or the Department of Social Services. You’re protected by law. And listen and pay attention to children. It’s best, I believe, to err on the side of caution than take a chance that a child is abused or neglected and in danger. As long as your report is in good faith, that’s all that matters.”
Need to Report Child Abuse?
Call the Childhelp® National Child Abuse Hotline at 1.800.4.A.CHILD (1.800.422.4453).
When you call to make a report, you will be asked for:
- The child’s name and location
- The name and relationship (if known) of the person you believe is abusing the child
- What you have seen or heard regarding the abuse or neglect
- The names of any other people who might know about the abuse
- Your name and phone number (voluntary)