Experts don’t know the exact number of children who die from abuse or neglect each year, but they estimate over 2,000. Nearly 82 percent of this number are under the age of four. The issue is so complex that reported statistics are often thought to underestimate the true numbers.
For Congressman Lloyd Doggett, honing the statistics is of secondary concern.
“Whatever the precise numbers are, it’s clear that too many are dying,” Rep. Doggett said before the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) on June 2.
In 2012 Rep. Doggett and Sen. Max Baucus of Montana introduced a piece of legislation that would confront the issue and empower those on the front lines of prevention. The Protect Our Kids Act became law, creating CECANF. The 12-member commission will spend two years exploring the causes of child abuse, and best practices for combating it nationwide.
On June 2, CECANF made its debut in San Antonio, part of which is within Doggett’s congressional district.
Leaders from local public health, child protection, law enforcement and healthcare sectors went before the commission on June 2, and are scheduled to continue presenting on June 3. Over 20 local experts will explain the causes of child abuse in this area. They will also share what they have learned about how to respond.
Unfortunately, the home town debut wasn’t the only reason that CECANF came to San Antonio. In 2012 and 2011 Bexar County had more reported cases of child abuse than any other county in the state – even those with far more children.
Laurie Charles serves on the Texas Child Fatality Review Team. In her work with forensic nursing at Children’s Hospital of San Antonio, Charles works with a collaborative team of professionals to assess and intervene in cases of suspected abuse.
According to Charles’s report, Bexar County statistics are bleak, but our resources are strengthening. In 2013 the forensic nursing staff of Children’s Hospital of San Antonio saw 518 suspected sexual assault cases and 217 physical abuse cases. These numbers are roughly the same as years prior.
To elevate their level of response, Children’s Hospital of San Antonio instituted the Center for Miracles where forensic nurses, social workers, and child abuse pediatricians work together to detect and treat victims of abuse.
“I can’t say enough about the importance of child abuse pediatricians,” Charles said.
The hope is that the commission will help local agencies move from response to prevention.
Joseluis “Jose” Morales, investigation supervisor with Texas Department of Family and Protective Services, explained that responding to cases of child abuse or neglect fatality is far more tragic than most of us can imagine. Even case workers and law enforcement are often unprepared for the emotional weight. It leaves responder wracked with guilt, wishing that prevention had been possible.
A common hurdle to preventing child abuse fatalities is what many of the presenters called “compartmentalization.” The pieces of the puzzle are sitting in different departments that are not communicating.
“We have to break down the silos of information,” said Bexar County Judge Peter Sakai.
The challenge is greater because of privacy laws, though in Texas suspected child abuse does supersede HIPPA. Law enforcement, medical, and social service professionals must step carefully within the law to communicate the vital information needed to act on behalf a child at risk. It requires dedicated and meticulous individuals working across systems. According to Judge Sakai and others, this is what is necessary to create a “child-centric strategy.”
All agreed that to take on the issue in earnest, more funding is needed. Funding is hard to get in Texas where a conservative legislature deems most increases as “throwing money at the problem.”
Rep. Doggett contends that the situation is quite the opposite for the underfunded social welfare programs in the state. Caseworkers and court personnel are overloaded and underpaid, thus turnover is high.
“We can’t just throw words at this problem,” said Rep. Doggett.
Judge John Specia, commissioner of Texas Department of Family Protective Services, made the case for expanding preventative efforts before the first case report is filed. He cited a statistic that fewer than 50 percent of the child abuse and neglect fatalities were children already known to the system. The first case report was too late.
To change that statistic requires sweeping programs and resources.
True prevention will be costly, if we follow the recommendations of Doggett, Specia and others who spoke before the commission. It would mean expanding Medicaid and other forms of assistance to give families access to mental health services. It would mean subsidizing childcare for more children in “high risk” homes.
“Families must be put back together. Families must be rehabilitated,” said Sakai.
In a conversation with Specia after the event, we spoke personally of the strain of parenting, and how desperate it can feel even in the best of situations. How much more so for those who don’t know where to look when they feel overwhelmed?
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“Families need help to reach out to,” Specia said.
The theme came up in the presentations again and again. Families need help. They need help coping with the stress of parenting. They need help protecting their children. That help can come from churches, non-profits, or government agencies, as long as they are well-funded and staffed with people who understand the issues.
*Featured/top image: LeQuinne Ferebee of Child Advocates San Antonio (CASA) with CASA children Kassandra, George and Alyssa. Photo courtesy of Will Langmore Photography/CASA.