Abuse and Neglect in Care – Then and Now

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Looking at the 2004 Forgotten Australians report on people who experienced institutional or out-of-home care as children, it would be very easy to conclude that these events were an historical anomaly which have little bearing on contemporary child welfare policy and practice. And to be sure the state care system has changed considerably since that time, and arguably for the better. But the evidence suggests that some (and perhaps even many) children and young people currently or recently in care have experienced forms of abuse and neglect similar to those described in Forgotten Australians, and that this abuse and neglect is similarly undermining their long-term life chances. So there is no doubt that we need to learn some key lessons from the Forgotten Australians if we are to avoid similar suffering in the future.

Forgotten Australians Report and related Findings

Two key issues were raised by the Forgotten Australians report: the nature of abuse and neglect cited, and the long-term impact of this cruelty. Some care leavers reported positive or at least neutral stories of their time in care. But the great majority of the stories documented experiences of neglect and deprivation, and overt emotional, physical and sexual abuse. Specific reference was made to separation from extended families, separation from siblings, suppression of identity and individuality, sexual and physical assault, cruel forms of punishment, forced adoption of babies, lack of education, unmet health needs, exploitation of children’s labour, medical experimentation, placement in adult mental hospitals, and the lack of any preparation for leaving care or after care support (pp.85-126). The overwhelming consensus was that children in care were not provided with the "love, affection and nurturing" necessary for adequate personal and emotional development (p.xv).

This abuse and neglect had severe long-term implications for former wards including low self-esteem, anger and grief, poor interpersonal and life skills, relationship problems with partners and children, poor literacy and numeracy skills and associated employment problems, depression, substance abuse, prostitution, crime, and contemplated or actual suicide. Ongoing physical and health problems and difficulties with housing and employment were also commonplace (pp.145-170). Reference is made in the report to enormous social and economic costs to society including medical care for injuries, medical care for long-term effects, mental health care, substance abuse treatment, costs to the criminal justice system, and the costs of welfare services and programs (p.166).

Similar findings emerge from the 2008 report by Raman and Forbes for the Centre for Excellence in Child and Family Welfare which was based on a survey of 77 care leavers in Victoria. A number in this group described their lives in care as "brutal, violent, awful, traumatic, cruel and insensitive". Some nevertheless reported significant life achievements in areas such as education and careers, family relationships, upbringing of children, and positions in various community and social groups.

But for others their traumatic institutional care experiences had a long-term adverse impact on many aspects of their lives including education, health, income, employment, and personal relationships with partners and children. Many referred to mental health problems, criminal offences, physical disability, and drug and alcohol abuse.

Implications of Forgotten Australians for Contemporary Policy and Practice

Firstly, it is essential that child welfare services and programs be adequately funded. If governments are to intervene in families and remove children, then they need to be able to provide demonstrably better or more adequate parenting than that offered by natural parents. The state needs to provide not only the care expected of a good parent, but also to actively compensate abused and neglected children for the disadvantages produced by their traumatic pre-care experiences.

Secondly, government and non-government agencies need to employ properly trained and qualified professional child welfare staff. This does not provide a foolproof system in itself, but it does mean that people with sinister motives are more likely to be exposed before they can do any damage.

Thirdly, state authorities need to adequately prepare young people for leaving care, and ensure that they are provided with ongoing support during the long transition from dependence to independence. Most families continue to support their children when they turn 18 years of age. They provide them with ongoing accommodation (often till 21 or even 25 years of age), money, food, clothing, health care, assistance with the cost of education or employment training, and emotional support. At the very least, care authorities should aim to approximate this ongoing support.

Finally, child welfare services need to be accountable to independent external bodies including Children’s Commissioners and consumer groups. It is only because of the intense lobbying that the past abuse of children in care was placed on the public agenda. Equally, it is crucial that consumer groups such as the Create Foundation be adequately funded in order to provide monitoring and advocacy services for children and young people currently in or leaving care.

Abuse and Neglect Today

Now I would like to be able to write that the appropriate conclusions have been drawn from the Forgotten Australians, and that the child welfare system has been reformed to prevent further abuse and neglect. There is no doubt that the out of home care system has changed considerably in the last two or three decades with most children now residing in home-based care rather than residential or institutional care, most services now being professionalised, and workers being subject to police background checks.

However, recent reports by researchers and state and territory governments and authorities cite continued significant examples of the physical, sexual, and emotional abuse, and neglect, of children in care. For example, Cashmore & Paxman’s 1996 study of care leavers in NSW found that a significant number had experienced physical abuse, sexual assault or emotional abuse and neglect whilst in care (pp.43-49). Ditto, the 1999 study by Maunders et al (pp.58-60). Similar concerns were raised by the second Senate inquiry into children in institutional our out-of-home care (pp.95-97), and by a number of state-based inquiries.

A recent study by Badal Moslehuddin at Monash University based on interviews with 20 care leavers in Victoria aged 18-26 years also found significant evidence of continued abuse and neglect in the care system.

For example, six (30 per cent) of the 20 young people interviewed reported having been subjected to overt abuse including physical, emotional, sexual abuse and neglect during their period in care. Another four young people reported having experienced other mild forms of abuse including harsh treatment, scapegoating, verbal abuse, exploitation, discrimination and inappropriate discipline.

This study also found evidence of poor quality care including multiple foster care placements for children. All of the 20 respondents in this study reported experiencing multiple placements while in care with the minimum placements being two and the maximum being 100 plus, as alleged by two care leavers. These two young people lost count after they had been to numerous placements and hence were only able to give an estimate. One other young person reported having lived in too many placements to remember.

A number of these young people reported that due to these constant changes in placements they were unable to connect with their carers, and consequently felt unsettled and insecure. In addition, harsh treatment by some carers resulted in them feeling unwanted, unwelcome and even rejected.

Poor Outcomes Today

As with the Forgotten Australians, contemporary care leavers are not a homogeneous group, and some have enjoyed significant success including professional qualifications. But for others their poor in-care experiences have contributed along with pre-care experiences of abuse and neglect to poor outcomes including:

  • -A high correlation between state care and later homelessness;
  • Involvement of some care leavers in drug and alcohol abuse;
  • Poor physical and mental health including psychological disruption, depression and suicide;
  • Poor educational outcomes which then contributes to unemployment and poverty;
  • Poor social support systems;
  • Involvement of some care leavers in prostitution;
  • Over-representation in the criminal justice system, and particularly in juvenile detention facilities;
  • Early pregnancy and parenthood including some women experiencing protective intervention with their own children.

For example, the care leavers interviewed in the Moslehuddin study reported;

  • Multiple accommodation following discharge from care;
  • About half experienced drug and alcohol problems including five who required professional intervention due to heavy drinking;
  • Over half suffered from some form of depression or other mental illness warranting prescribed medications and/or counselling, and 16 had significant physical health problems;
  • Most did not progress their education past Year 10;
  • Most were unemployed, and experienced related financial difficulties;
  • The majority had few social or emotional supports;
  • The majority had faced criminal charges;
  • Six had given birth at an early age, and three had experienced child protection interventions with their own children due to substance abuse.

The above findings suggest that much still needs to be done to improve the outcomes for young people leaving state care. At the very least, we need to act on the recommendations of the international research as summarized by the UK researcher Mike Stein.

The first is improving the quality of care as positive in-care experiences are essential in order to overcome damaging pre-care experiences of abuse or neglect. This involves providing stability and continuity, felt security in care in terms of being loved and belonging, a positive sense of identity, assistance to overcome educational deficits and holistic preparation. But to use a football analogy we can’t just measure children’s progress at the age of 15 or 16 years and then stop there because if we do it is a bit like a football team which plays two quarters of a Grand Final, but fails to play the last two quarters which actually decide the outcome.

The second component is the transition from care which includes both preparation for leaving care, and the actual moving out from the placement into transitional or half-way supportive arrangements from approximately 16-21 years. This transition needs to be less accelerated, and instead become a gradual and flexible process based on levels of maturity and skill development, rather than simply age. Care leavers need to be given the same psychological space as all young people to explore a range of interpersonal and identity issues well into their twenties.

The third component is ongoing support after care till approximately 25 years of age. This may involve a continuation of existing care and supports and/or specialist leaving care services in areas such as accommodation, finance, education and employment, health, and personal and family support networks. These services have been introduced in most Western countries as a result of a number of factors including the influence of the United Nations Convention on the Rights of the Child, and also hard economic evidence of the costs of failing to support care leavers given that they will otherwise (as I have documented today) make significant and on-going demands on income security, housing/homeless support, health and welfare, criminal justice, and other crisis intervention systems.

 

Further Reading

Cashmore, J. and Paxman, M (1996) Longitudinal Study of Wards Leaving Care. Sydney, Social Policy Research Centre.

Community Affairs References Committee (2004) Forgotten Australians: A report on Australians who experienced institutional or out-of-home care as children, Commonwealth of Australia, Canberra.

Community Affairs References Committee (2005) Protecting vulnerable children: a national challenge. Canberra, Commonwealth of Australia.

Maunders, D., Liddell, M., Liddell, M. and Green, S (1999) Young People Leaving Care and Protection. Hobart, National Youth Affairs Research Scheme.

Mendes, Philip (2007) "A structural analysis of young people leaving state care" in Communities, Children and Families Australia, Volume 3, No.1, pp.69-79.

Moslehuddin, Badal & Mendes, Philip (2008) "Graduating from the state care system: An analysis of experiences of young people leaving out-of-home care’, Paper presented to XVIITH ISPCAN International Congress on Child Abuse and Neglect, September 7-10, Hong Kong SAR, China.

Raman, Sunitha & Forbes, Catherine (2008) It’s Not Too Late To Care: Report on the research into life outcomes for people brought up in institutional care in Victoria. Centre for Excellence in Child and Family Welfare: Melbourne.

Stein, M. (2008). Transitions from Care to Adulthood: Messages from Research for Policy and Practice. In M. Stein & E. Munro (Eds.) Young People’s Transitions from Care to Adulthood (pp.289-306). London: Jessica Kingsley.

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