Child abuse: role played by police

Press, 13 November 1981, Page 13

Child abuse: role played by police

Many abusing families in the Netherlands are not in the first instance reported to “The Confidential Doctor” (the organisation discussed in yesterday’s article). They are reported, or report themselves, to the police. While in Utrecht, I went to see Dr Anneke Visser, head legal consultant to the police department dealing with matters related to “children and morals.” “We aim to do preventative work rather than lay complaints,” she told me. “The question is, how can we best help children outside the public legal system?” A dynamic and enthusiastic young woman, Dr Visser is a well-known authority in the Netherlands on violence in the family. She has helped to instigate a co-ordinated service for women who have been raped, a model which could well be applied in other parts of the world. “Some people will contact the police first rather than a helping agency; and, as many crisis situations arise during the week-ends, when most agencies are closed, the police are left holding the baby, sometimes literally.

“So many, and such severe crises, were occurring that we' got a number of representatives from various helping agencies to spend the week-end at the police department, so they could see what we had to deal with. “The result was that a lot of people got a fright and realised they had to help us cope with these situations of domestic violence. Now we have a much better working relationship with the various agencies around the town. “We have four social workers working for us fulltime. When a case of child abuse is reported one will go and visit at once, if the case is not acute; if severe, a police officer will accompany her. She will investigate what has happened and usually refers the family either to ‘The Confidential Doctor’ or to a helping agency from where treatment will be instigated. We only supply first-aid.” If the case is very serious, the child and its parents are taken to the police station, and the parents questioned. Usually the child is taken to the children’s hospital. If the situation is dangerous, the

police are always involved, for example where it is not safe for children to be left at home with psychotic parents. “We have to decide whether to refer the case to the Child Protection Services, a body with legal sanction, which will instigate complaint action against the parents and recommend that protective action be taken to ensure the safety of the child, or to pass the case on for treatment with one or other of the social agencies. “We usually choose the latter course,” Dr Visser said. Work with victims of family violence has led to cooperation between police, hospital, lawyers, doctors, and social agencies. Now victims of violence and those to whom they turn know better what course of action to take, who to approach, and where to go for help. This information has been widely disseminated among the public in general and the health professionals in particular. In addition, there are at least eight 24-hour telephone services available in crisis situations, one specific-

ally for young people and children. To find out what happens to the abused child once she or he is admitted to hospital, I went to see Miss A. van der Leurs, social worker with the psychosocial department of the Children’s Hospital in Utrecht. Situated centrally in the city, this modern building has 120 beds with approximately .a thousand young patients using them annually. About 3000 to 4000 people are seen yearly at the hospital’s busy outpatient department, where emotional problems are frequently presented as medical ones. “All abused children and their families are referred to the Psychosocial Department as a matter of course,” Miss van der Leurs said. She emphasised that par-

ents must be. seen. “The child cannot be returned home until and unless the parents are willing to receive help with the problems they are facing. The child will not be discharged until we are satisfied there is hope for improvement. “Of course, if the parents don't want help, then the hospital can’t force the situation and neither can we keep the child for ever.” But Miss van der Leurs, herself a paraplegic, is a very forceful lady. “I never give up,” she said. “The child must not be neglected. "I will always make sure the child is ’helped, even when it means I have to visit the parents and bang on the door until they finally let me in. I have to motivate them, because often they are not motivated themselves. First

outreach, then treatment.” If she cannot make any headway, she too refers the family to the Child Protection Services who will instigate legal action to protect the child. A young ward sister showed me around her ward. She was not in uniform and explained that everyday clothes were the normal form of dress for all ward staff. “Hospitalisation is already so threatening to children, why should we make it worse by wearing uniforms?” she asked. It was a small ward, with about 10 to 12 beds placed in separate rooms, some in groups, some singly, all situated around the periphery of the area. The ward sister’s office and a little laboratory were placed in the middle of this space, with a walkway around. Everyone could see into every room, all the central walls being glassed in. This made it all seem very open, spacious, and practical. The doctor’s room, on one side near the entrance, stood open so people were free to walk

in and consult whoever happened to be there. It was a mixed ward, with children of all ages. Parents visited freely and there seemed a lot of coming and going. I saw a young girl sitting on her bed. The ward sister explained that she had been a patient for several weeks. She and her mother were receiving treatment from the psychologist as the child had consistently refused to eat. “They are sometimes here for months,” the sister said. “A close working relationship between the staff of the different disciplines is very important and we have weekly consultations with everyone involved in the case,” she added. All severely abused children seen by the police are referred to the hospital, which then undertakes treatment for the family. A variety of agencies will usually be called in — the G.P., the Confidential Doctor, the Child Protection Services, the Society for Therapeutic Family Care, Therapeutic Daycare Centres, or any of the many other social agencies.

MARIANNE THORPE, a social worker with the Child and Family Guidance Centre, completes her account of the manner Dutch cities deal with reported cases of child abuse and neglect. The first article was published yesterday.