1 / 23

Definition of Family Violence?

Early Detection of Family Violence Kevin Browne, PhD. Louise Dixon, PhD Centre for Forensic and Family Psychology, University of Birmingham, UK k.d.browne@bham.ac.uk. Definition of Family Violence?.

eliora
Download Presentation

Definition of Family Violence?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Early Detection of Family ViolenceKevin Browne, PhD.Louise Dixon, PhDCentre for Forensic and Family Psychology, University of Birmingham, UKk.d.browne@bham.ac.uk

  2. Definition of Family Violence? • Any act committed within the framework of the family by one of its members that undermines the life, the bodily or psychological integrity or the liberty of another member of the same family or that seriously harms the development of his or her personality (Gil, 1978). This definition was put forward by the Council of Europe (1986)

  3. Dangers of Family Violence are Commonplace • “People are more likely to be killed, physically assaulted, hit, beat up, slapped or spanked in their own homes by other family members than anywhere else, or by anyone else, in our society…...” • “This statement applies not only to American families but it is also an accurate assessment of family life in England, Western Europe and many other countries and societies around the globe.” From Gelles, R. J. (1997) Intimate Violence in Families 3rd edition – Page1. Sage Publ: Thousand Oaks, CA.

  4. Forms of Abuse and Neglect(From Browne, K & Herbert, M 1997. Preventing Family Violence, Wiley -Page 9)

  5. Types of Family Violence (From Browne, K & Herbert, M 1997. Preventing Family Violence, Wiley -Page 7) Violence by adults in family Spouse Maltreatment Child abuse and neglect Sibling Maltreatment Parent Maltreatment Elder Abuse and Neglect Violence by Children in the Family

  6. Links between Spouse and Child Abuse • D.V often escalates during pregnancy. • 80% of children who live in violent families will witness an assault at some time or other (Sinclair, 1985). • Children who witness abuse between adults in their home become secondary victims. • Strong link between Spouse abuse and child abuse: • In 70% of cases of recorded domestic violence children had also been abused (BCC 1999) • Walker (1984) - USA - 53%, • Browne and Saqi (1988) - UK Community - 52% • Browne and Hamilton (1999) – UK Police cases – 46%

  7. USA Costs of Family Violence: 192,000 incidences of family violence resulted in: • 21,000 hospitalisations. • 99,800 days in hospital. • 39,000 visits to a physician. • 28,700 emergency department • visits. • $44 million in health care costs • alone during 1987. (Gelles, R. Family Violence, Sage Publ. 1987)

  8. Patterns within Domestic Violent Families (From Browne K & Dixon L 2003. The Heterogeneity of Spouse Abuse,Aggression and Violent Behavior, 8:107-130) F M C Reciprocal Family Violence – 30% F F M M C C Hierarchical Family Violence – 46% F F M C M C Paternal Family Violence – 24%

  9. Consequences of maltreatment Death / injury Physical and mental disability Low self-esteem / poor self-worth / educational failure Mental health problems / sleep disorders / PTSD Substance misuse Stress and physical health problems Emotional and behavioural problems Eating disorders and self-injury Increased vulnerability to further victimisation, Antisocial and criminal acts (Victim to offender)

  10. Financial Costs of child abuse and neglect (WHO, 1999) • Medical Care for Victims • Mental Health Provision for Victims • Legal Costs for Public Child Care • Criminal Justice and Prosecution Costs • Treatment of Offenders • Social Work Provision • Specialist Education UK Total Economic Cost 1996 = $1,470 million, p.a. USA Total Economic Cost 1996= $12,410million, p.a.

  11. LEVELS OF PREVENTION • Primary Prevention with Universal Services offered to the whole population on a routine basis -peri-natal care, promotion of good feeding practices, immunisation, safety measures. • Secondary Prevention with Targeted Services directed at ‘high risk groups’ and offered intervention before health and developmental problems in the child become severe. • Tertiary Prevention with Specialist Services for treatment of families where parents/caregivers are failing to care for the child. Intervention is offered only after “significant harm” has occurred.

  12. Abuse No abuse (No=106) (N=14146)% % 30.2 1.6 31.1 3.1 48.1 6.9 70.8 12.9 34.9 4.8 19.8 1.8 21.7 6.9 12.3 3.2 29.2 7.7 27.4 6.2 16.0 7.5 2.8 1.1 Risk Factors *Violent Partners *Indifferent Parents *Single Parents *Socio-Economic Problems *Mental Illness *Parent abused as a Child *Infant Premature *Separated at Birth *Teenage parent *Step-Parent *Less than 18 mos between births Disabled Child English Families in Five-Year Prospective Study on Child Maltreatment * Significant difference between abusing and non-abusing families (P<0.05)K. Browne & M. Herbert, Preventing Family Violence. Wiley, 1997. P120

  13. 12.4 7.0 5.0 3.9 5.2 7.6 2.3 2.8 2.8 3.2 1.6 1.9 0.7 Violent Partners Indifferent Parents Single Parents Socio-Economic Problems Mental Illness Parent abused as a Child Infant Premature Separated at Birth Teenage parent Step-Parent Less than 18 mos between births Disabled Child Parent with a Child under five Factors associated with maltreated children: Conditional Probabilities from 5year prospective study on English families (N=14,252)* *K. Browne & M. Herbert, Preventing Family Violence. Wiley, 1997. P120

  14. Effects of Screening a Population to Predict Child Maltreatment in England Screened Population = 14,252 births 7 per 1000 Incidence 106 Abusing Families 14,146Non Abusing Families 68% Sensitivity at Birth 94% Specificity at Birth 72 abusers identified(Hits) 34 false negatives(Misses) 892 false positives(Alarms) 13 254non abusers identified From Browne & Herbert (1997) Preventing Family Violence p. 121 964 HIGH RISK 13 288 LOW RISK

  15. The Build up of Health Services that Children and their Families Receive Hospital Teams Specialist Services - 1/10 of targeted families Targeted Services - 7% of population Universal Services To all Primary Care Teams

  16. Consider Maltreatment When Child Trauma or Injury Is Presented Accident Does explanation match trauma? 1. Mechanism 2. Severity 3. Timing Eg:Shaken Baby Syndrome Neglect Abuse

  17. A 15-month-old was said to have climbed into a bath of hot water whilst his mother briefly left the bathroom to get some clothes. Symmetrical immersion scalds to both arms extended circumferentially about four inches above the wrist with clear line of demarcation from non-scalded skin, below the elbow, with no splash marks. The child was aggressive and had nightmares for many months after the incident. (From Hobbs, C and Wynne, J. (2002). Predicting sexual abuse and neglect. In K. Browne, H.Hanks, P.Stratton and C. Hamilton (Eds). Early Prediction and Prevention of Child Abuse: A Handbook. Wiley)

  18. Tertiary Prevention by Reactive Surveillance Children and caregivers/parents attending health service facilities are classified by doctors and nurses at the clinic into red, yellowandgreen from physical and behavioural symptoms which maybe associated with child abuse and neglect, for referral and intervention. (i.e.development for IMCI)

  19. Integrated Management of Child Abuse and Neglect • Evidence of suspicious physical condition/injury OR • Delay in seeking help OR • Lack of agreement between story and injury CHILD ABUSE AND NEGLECT LIKELY • URGENT referral to hospital with specialist services. • NOTIFY child protection team and/or social services • Inadequate physical care of child OR • Abnormal child behavior OR • Abnormal parent/caregiver behavior OR • Risky family circumstances CHILD ABUSE AND NEGLECT POSSIBLE • Schedule a follow-up clinic or home visit within 10 days • Refer to community health and social services for prevention work • Counsel parents to reinforce positive parenting skills • Inform parents about the developing child and appropriate safety measures • No signs consistent with the possibility of child abuse and neglect CHILD ABUSE AND NEGLECT NOT LIKELY • Counsel parents to reinforce positive parenting skills (availability and attention, sensitive interaction, cooperation and consistency) • Inform parents about the developing child and appropriate safety measures Does the Child have a condition associated with child abuse and neglect? IF; evidence of physical injury or unusual genital discharge, OR low weight and/or malnutrition, OR developmental delay and/or disability, OR not immunized OR delay in seeking health care. THEN CHECK FOR SIGNS OF CHILD ABUSE AND NEGLECT • OBSERVE AND CHECK • Evidence of suspicious physical condition/injury from likely child abuse (e.g., multiple bruises of different ages, unusual discharge, lesions or scars on genitals or anus, whip marks, immersion scalds and fractures in children less than one year). • Delay by parent/caregiver in seeking help for any injury with no valid reason. • Lack of explanation or story inconsistent with injury or genital discharge. • Inadequate physical care of child: illness ignored, not-immunized, poor condition of skin, teeth, hair and nails, child unsupervised. • Abnormal child behavior: sexualized behavior, aggressive hyperactivity, frozen hypervigelance, avoids visual contact with caregiver. • Abnormal parent/caregiver behavior: careless, punishing, angry, defensive, insensitive, over-anxious, low self-esteem, depressed. • Risky family circumstances: history of family violence, alcohol/drug addiction, mental illness, social isolation, child disability, neglect/abandonment. Classify signs of child abuse NB: LISTEN TO WHAT THE CHILD SAYS Browne, K., Leth, I., Lynch, M., Mangiaterra, V. and Ostergren, M. (2002)

  20. Multi-sector Referral Pathways Social Service Teams Police Units Hospital Teams – Specialist Services Primary Care Teams - Universal & Targeted Services

  21. References • Browne, K. Hanks, H. Stratton, P. and Hamilton, C. (2002) Early Prediction and Prevention of Child Abuse: A Handbook.Chichester: Wiley. • Browne, K. Douglas, J. Hamilton, C. and Hegarty, J. (2006). A Community Health Approach to the Assessment of Infants and their Parents.Chichester: Wiley. July 2006 • Browne, K. et al (2006) Training and Information Pack on the Prevention of Child Abuse and Neglect.Copenhagen: WHO Regional Office for Europe. Sept 2006

  22. Conclusions of Breakout Session on Early Detection of Family Violence • What successes can be reported? • Existing resources and opportunities? • Overcoming barriers to progress? • Role of international organisations? (eg: WHO, UNICEF, EC, EUROSAFE) • Activities to be taken • International (European) • National

More Related