‘Confidential Doctor’ for child abuse

Press, 12 November 1981, Page 19

‘Confidential Doctor’ for child abuse

The serious problem of child abuse and neglect was the subject of a report on this page two months ago. Less known to the public is' what people should do if they believe the child is being ill-treated. On the left, MARIANNE THORPE, a social worker with the Child and Family Guidance Centre, who visited the Netherlands, England, and the United States recently, and attended the third international congress on Child Abuse and Neglect at Amsterdam, writes on the way the subject is dealt with in the Netherlands, in the first of two articles. On the right, GARRY ARTHUR reports on how the cases are treated in Christchurch.

She spread her arms wide and spoke with emphasis: “Madam, here in the Netherlands we simply have a primeval jungle of social services." I was speaking to a social worker employed by a relatively new agency set up to co-ordinate services for abusing families in the Netherlands. “The Confidential Doctor.” In spite of the proliferation of all kinds of social agencies, church or government run, privately funded or hospital based, an attempt has been made to tie them up, so that families desperately in need of help but difficult to treat because they tend to be disorganised, isolated, and nomadic, will be assisted and their children protected. How does it work in practice? To find out I visited several social agencies in the heart of the Netherlands, in the city of my birth, Utrecht, which has a population of about 870,000, in an area a fraction of the size of Christchurch. First, I went to see a social worker, Joop Mei, who works for “The Confidential Doctor,” an agency set up in 1972 and funded by three different government departments. The service is now operating in 10 different cities and employs a total of about 50 people. “We don’t treat people ourselves,” Joop Mei said. “In the Netherlands we do not have to report cases of child abuse and neglect to the police, as people do in the United States. Doctors faced with patients telling them they were abusing their children or becoming aware of

this from seeing children maimed, scarred, and bruised from non-accidental injury, did not really know what’ to do with the information. “The relationship between doctor and patient is confidential so they did not feel they could report this abuse to the police or even to a treatment agency without the family’s consent. Yet they did not know how to help these families themselves and, of course, they felt worried about the safety of the children.” The bureau of “The Confidential Doctor” was set up so that doctors, professional or voluntary workers in any of the health fields, the police, neighbours, friends and relatives, lawyers -- any members of the public in fact — may ring up the agency (there is a 24-hour telephone service) and report cases of (suspected) child abuse. What happens then? “More often now the parents ring in themselves and say they have already abused, or are intending to abuse, their child. If the crisis is serious, the family is

visited at once, even if it is the middle of the night,” Joop Mei said. “When I call, we will talk about what has happened and discuss what needs to be done. With the talking, the tension and stress of the parents already decrease. The child or children may have to be placed temporarily. I find that these people invariably want help. By hurting their child they are crying out that they are not coping and don’t know where to go from there.” While not treating the family herself, Joop Mei will refer them to another agency. She will undertake to contact the family G.P. and social worker (if they have one) and mediate between foster home, hospital, and police where necessary. She will keep in regular contact with them, check on results of treatment, and lend assistance where necessary, acting as a consultant and co-ordi-nator. There are other cases where neglect and abuse are reported to “The Confidential Doctor,” but not by the parents. Then the case is first

Anyone knowing of a case of child abuse or neglect should call the Department of Social Welfare on 897-136. That is a 24-hour service number for dealing with such cases. Social workers are rostered on duty around the clock ready to be called out. After office hours they are reached at their homes by a telephone answering service. In a crisis, however — a real emergency with immediate danger to a child — call the police on the 111 emergency service number. A patrol car will reach the scene sooner. “We hear of a good number of cases of child neglect and abuse,” says Mr Doug Seller, Social Welfare’s senior social worker in charge of community service, “and we investigate them very quickly and fully.” Two Social Welfare officers are dispatched to the scene immediately a case is reported, so that they can take the appropriate action on the spot. First, they try to encourage the parent to accompany them to hospital or other medical care. If that is refused, they can seek a warrant from a Justice of Peace and remove the abused or neglected child under the Children and Young Persons Act. Mr Seller says that when calls are received at night, the department often asks the police to attend. “We’ve

investigated, the family’s G.P. is contacted, and she or he may verify the information. (The name of the G.P. can usually be traced through the National Health Insurance). Other agencies will also be contact d, for example schools and kindergartens, depending on the age of the children. The reporter’s name remains anonymous, but the family where abuse is suspected is named. “Usually, several of the people contacted have already suspected that there could be child abuse but they did not want to ask the parents directly,” Joop Mei said.

Either the area social worker or the G.P. will approach the family and tell them that “The Confidential Doctor” has been informed about mistreatment of the child, or Joop Mei will do so herself, or the two may work together. “The family will usually respond favourably to this invitation to talk about their relationship with their child and about the many other pressures they are experiencing as well, such as marital stress, lack of finance, alcoholism. They are often very glad of the chance to bring things out into the open.” Occasionally the family refuses to have'anything to do with the agency. When there has been no response to either of the two letters written to the parents inviting them to come in and see Joop Mei about the reported mistreatment of their child,

then there is no option left open to her but to write to the family again that she will notify the Child Protection Services under the Department of Justice. The Child Protection Services have legal sanction to start investigation and then recommend to the Children’s Judge that action be taken to safeguard the child. This action may mean that the child is placed in foster care or that the parental rights are removed from the parents, or that they are temporarily suspended.' “Whatever the outcome, the case must always be pursued," Joop Mei said, “even if it is against the parent’s wishes. If the child and its parents cannot be helped through the normal cnannels, we have to find other ways.” Tofnorrow: Services to abusing families carried out by the police and the children’s hospital.