The policy debate that should come out of the death of Alex Radita

Canadian media is covering the current trail of Emil and Rodica Radita for the first degree murder of their 15 year old son Alex. The allegations involve medical neglect of their son's diabetes leading to his death. The family is reported to have been involved in child protection systems in British Columbia and Ontario prior to his death in Alberta.

Much has been made of the supposed failure of British Columbia social workers to notify their counter parts in Alberta when they learned the family had moved left B.C. They had found out about the move as they were looking for the family when it became apparent they were not following through with Alex's medical care.

There has also been significant criticism of a judge in B.C. for returning Alex to parental care even when the child protection workers and specialists were arguing against it. National Post columnist Christie Blatchford has been quite critical of that decision and the failure of B.C. social workers to follow up with Alberta.

Alex Radita at age 15 (Source: Calgary Herald from photos released by the Court)

Child protection systems are often criticized for their failure to effectively communicate with agencies. It is a theme that has cropped up in most of the 91 public reviews I have examined in Canada. It is also very common in reviews in other countries.

There is an issue that needs discussing in Canada though, but also in countries such as the United States. Canada's constitution places control of child protection within provincial and territorial jurisdiction (there are specific aspects that are different for Aboriginal on reserve families but that is for another post). Health care and child protection legal processes also fall under provincial jurisdiction. Thus, each province and territory operates their own system, except for Ontario which places delivery of child protection into a complex network of children's aid societies following provincial legislation.

What this means is there is no national child protection system. It is a series of unique systems. Each jurisdiction has its own legislation, policy, procedures and service delivery mechanism. There is  no national requirement for data sharing. Families can and do move between jurisdictions to avoid continuing scrutiny by child protection. They are quite able to do so once their case in one province is no longer active.

When a case opens in one area, families are asked about their history elsewhere but there is no national database to work from. Should there be? Protagonists of data sharing might well argue for one but those who argue for protection of information and privacy might well make an alternative argument. Child protection legislators and senior managers across Canada might well take the Radita case as an opening for a national discussion. I want to emphasize that many of the workers I know make efforts to learn about families past participation in other parts of the country.

The Radita case raises some important policy issues and we should not let the chance pass. Another one is about legal duty of care. Like the Jeffrey Baldwin case in Ontario, it appears there were other adult children in the Radita home. Yet the criminal code does not place a duty of care on those who are not parents or legal guardians. Thus, other adults in the home who were aware Alex and Jeffrey were at risk cannot be held accountable . That too should be reconsidered.

It is important to note that, at the time of writing, the criminal trial noted above is still ongoing. Thus, the accused have not been convicted of a criminal offence in this matter. 

Managing the undefineable - the human judgments of child protection

Child protection is the front end of a bargain between a child and society. Essentially, society says that they will leave a family to raise their children as long as they do so safely. The deal with the child is that, if that does not happen, society will protect the child and the child protection authority will act on behalf of society. It's a bargain that we often do not know how to uphold.

To begin with, we lay that bargain out through legislation. Inherent in most such laws is a belief that the family is the root of society and is an institution that requires preservation. In other words, society should intrude into the family only as much as needed to protect the child.

Next comes the decision by child protection to enter the family - but there are certain hurdles:

• Someone must alert the child protection authority that there is a concern. Many countries have mandatory reporting laws that require a variety of professionals to call them. Many do but there are many examples of professionals who do not because past efforts to report a concern have led to no apparent action. Some won't because they are so uncertain about whether the child really is in danger. Some professionals feel that there is little point in reporting a child because the child is already so disconnected and won't comply with efforts to help. This was seen very clearly in the Paige case that led to a blunt review by the B.C. Representative for Children and Youth. 
• Once the report is filed, a human judgment is made by an intake worker to investigate or simply note the report in case there are further reports. This very human  judgment is influenced by such factors as how the report was framed, the degree of danger seems to exist, the resources available as well as the presence or absence of past reports.
• If the report is investigated another human judgment is made which is whether or not there is a risk to the child; how serious is that risk; is it serious enough to open a case; could it be handled in a less intrusive way or is the risk sufficient to become quite intrusive.

Inherent in this series of human judgments is defining safety and risk. There are a  multitude of factors that are taken into consideration and the investigator must try to weigh the various options and meaning of the data. Some have suggested that this means structured decisions should be used by entering data into various investigative formats. Yet, in those cases, someone must still find a way to operationalize a way to define and measure safety. Even in cases of structured tools, the front line worker must make meaning out of the data; must find the data; must contextualize the data; must know what to look for and be able to see it. To enter the data they must be able to discern what is in front of them. It is a human judgment process to make meaning out of information even when you enter it into a decision making tool.

Safety is an incredibly complex concept in which many factors interact in an unpredictable way - parenting, mental health, addiction, community, culture, poverty, housing, schooling, resources, temperament and personality of the child to name a few. The worker has to figure out the interactions. The worker is asked to predict probability for the safety of the child.

The worker is but one of the decision makers. The data gathered by the worker will be presented to a variety of other human judgment makers as the open case moves along - supervisors, colleagues, contracted community resources, lawyers and the courts, for example. Each will weigh the data (which is typically constantly changing) and judge what is and should happen.

The family are also making a series of human judgments - what to tell; what to cooperate or not cooperate around; what to try and self manage; how to interpret the direction of child protection and other parties. 

It is a series of human judgments made by many parties with ever changing data that is typically imperfect seeking to predict the behaviour of human beings in an environment where no prediction tool shows reasonable accuracy. No wonder child protection gets things wrong at times - indeed how could they not. So why are we not telling that story?

Looking at the Sixties Sxoop

The Sixties Scoop has come to represent the transition from Residential Schools as a means of controlling and disrupting Aboriginal families, communities and cultures across Canada. Indeed, Cindy Blackstock of the First People's Child and Family Caring Society has termed child welfare as the new Residential school.

An MRU journalism student sought to have a look at the Sixties Scoop and offer some insights into what that period was and profiles two people who were impacted by it. The blog can be found here.

In another relevant report, I have been part of a group that has been looking at how First Nations parents are assessed in the child welfare system. The report, Nistawatsimin: Exploring First Nations Parenting: A Literature Review and Expert Consultation with Blackfoot Elders:

This report provides a comprehensive overview and analysis of the scholarship that encompasses relevant topics surrounding the theme of Aboriginal parenting. It seeks to contribute to a larger conversation about the relationship between child protection services (CPS) and Aboriginal peoples. The focus is on how parents are considered and assessed by CPS. In this report, the authors raise the notion that the foundations of assessment have not been rooted in Aboriginal cultural and their world view of family and parenting.

It is one step in challenging how child protection looks at First Nations parents. It is rooted in a Blackfoot view and thus the work requires extension and adaptation to other Aboriginal cultures. But it is a place to start.

The tragedy of the Jian Ghomeshi case but it's not about the judge

The acquittal of Jian Ghomeshi on four counts of sexual assault has rightly caused an uproar in Canada. But the focus of the debate is not about what the judge did unless you want to congratulate him for doing precisely what we ask judges to of. He assessed the evidence and the credibility of it against the appropriate standard of whether or not there was a reasonable doubt. He concluded there was.

The real lessons come from what evidence was put in front of the judge which led to the decision. One might also criticize the theatrics of the defence counsel. One might go further and ask whether or not the case was presented in the light of what we really know about the victims of sexual assault.

In Canada, only about 6 per 100 cases of sexual assault are reported to the police. It's a pathetic statistic but there are many reasons why it exists:

• There is fear of how the victim will be judged - certainly we saw good reason for that fear based on how the victims were dealt with by Ghoneshi's lawyer. That lawyer will no doubt state that she was doing what she was supposed to do - vigorously defend her client. Yet, should a victim leave a cross examination more damaged when she came into the court? The Macleans magazine interview with one victim, Lucy DeCoutere illustrates the high price she paid.
• Witnesses are often not believed. My own experience with victims is that telling the story is a huge risk as the victim is not often seen that way. They are probed for evidence that they led the perpetrator on, failed to make clear they were not offering consent or had allowed themselves to become too impaired to properly protect themselves. It's called victim blaming and it's real.
• There is much shame arising from being a victim. This arises from some of the same victim blaming forces. There are also some communities and cultures who will also see the victim as forever "damaged goods". 

There are many other reasons but these are some of the most powerful. But there is one even greater reason - women are vulnerable to the societal structures that allow men to dominate, control and demand. We are still socializing boys to believe that somehow they "deserve" what they want which includes sex. 

The judge was missing some clear evidence that helped the court fully understand the behaviours of victims. What the women described on the stand (at least as reported by the media) is quite typical of victims of sexual assault. This includes believing that they were somehow at fault. This leads to further contact with the perpetrator. Victims are also often caught up in the enmeshed dysfunctional relationship were they feel they are responsible for making it better. Courts need expert evidence on these types of behaviours. The effects of sexual trauma also distort memory, impact decision making and influence the cohesiveness of the story. Traumatic memory can compartmentalize the story such that when it is told, it is told incompletely. The court also needs expert evidence to explain the neurobiology of traumatic memory and behaviours that arise from that. 

Children who have been sexually abused are just as likely as an adult not disclose, particularly given that the perpetrator is most often someone they know and trust. As Esposito (2015) notes:

Sadly, disclosure of childhood sexual abuse is often met with disbelief, anger, or rejection. This leaves a child feeling isolated, unnoticed and unsure. Children say they don’t disclose because they are afraid of the consequences to themselves and others, they feel ashamed or in some way responsible for the abuse, they are unsure whether an abuse has occurred, or they do not know where to turn to for help. Children therefore make calculated decisions about disclosing; they consider who they will tell, whether they will be believed and how much detail they should provide. (p.1)

We have an urgent conversation in Canada which is how to encourage disclosure and make it safe to do so. We must also speak about how these cases are managed in the courts. The Ghomeshi trial will have a chilling effect on the willingness and ability of victims to disclose. The real lesson from the trial: "You will not be believed; You will be attacked and vilified; Your perpetrator will get away with with it, so why try".

As a nation, we need to change these messages but we also need to change the message that sexual assault is ever permissible. The cultural position of boys and men needs to change (and yes, males are  by far the most common perpetrators). They need to truly understand that consent is a necessity.

Our non-judicial institutions also need to protect victims far better than they have been. There has been an avalanche of media coverage about sexual assault on post secondary campuses. These stories have, unfortunately, also highlighted how victims in post secondary are not protected. This is an example of how institutions can play a role in prevention but also in supporting victims.

The story of sexual assault needs changing. Ghomeshi's case took us further away from protection and prevention. The message is loud and clear - even if you are found out and charged, your chances of being convicted are poor. The odds are stacked in favour of perpetrators in this country. How truly sad!

Reference: Esposito, c. (2015). Child sexual abuse and disclosure: What does the research tell us? New South Wales: Office of the Senior Practitioner, Family and Community Services. Available at this link

Child Death Reviews - An American imperative?

Youth Today is reporting on a recommendation from a US Federal Commission that:

wants the states to examine all child abuse and neglect fatalities from the past five years as part of a national strategy to end such deaths.

The notion is interesting. Trying to understand what has gone wrong in the past is often seen as a way to help prevent further deaths. Looking into deaths has become common in many countries. For example:

• Serious Case Reviews in the UK are used as a way to find leanings from deaths that might help the child protection system do a better job protecting children
• Large scale formal public reviews are used by politicians to look into high profile cases. In Canada, there has been the Phoenix Sinclair review which published its report in 2015 after months of public hearings. Another example is the Victoria Climbe case in the UK.
• The Jeffrey Baldwin case saw a high profile Coroner's Inquiry which received national media attention.
• There are inquiries by agencies that represent children and youth such as the Child and Youth Advocate in Alberta which this week issued a report on the death of Lily. These reviews offer an independent lens on what might have gone wrong.

There are other methods as well such as aggregate reviews by third parties along with internal reviews. The latter are not typically made public. The advantage of many review processes is that they are public allowing citizens to feel that there is a sense of accountability.

There are downsides however. There is somehow a feeling that all deaths can be prevented. That is not the case as it is not possible to predict with any certainity who will or will not kill a child. There is also the negative impact that these stories have in child protection practice. In particular is the impact on worker's decision making - they tend towards bringing more children into care in order to not be the worker with the next case on the front page. That may not serve children well.

The recommendation in the United States may not be the best use of resources. There are literally hundreds of inquiries in the western world that show oft repeating patterns of practice errors that contribute to poor outcomes for children. A better use of resources might have been to analyze and learn from those inquires. A next step might be to set up a way to use that knowledge while also setting up methodologies to learn from new cases. Going back over a 5 year period will use a lot of resources and be unlikely to yield information that is different from the existing knowledge base.

By using existing data, there has been an opportunity to reframe how child protection is delivered. This is an opportunity missed. Doing it differently has more promise than spending time looking backward especially when a large database of such learning already exists.

Jeffrey Baldwin: A thematic analysis of media coverage and implications for social work practice

ABSTRACT

Jeffery Baldwin died in 2002 in the care of his maternal grandparents. The case received intense media attention at various times over an almost eight-year period. Along with other public documents, the media coverage permits an analysis of the practice errors by Child Protection Services that are related to the failure to protect Jeffrey. Nine key themes emerged around core child protection practices: opening a file; the role of prior knowledge; issues related to assessment; knowing the child and their needs; the role of culture; case supervision; the child as the client; the enmeshment of child abuse; and the role of stability and healing. This analysis offers key lessons to be learned from such cases.

This article has been published in Child Care in Practice

Sexual assault - two worrisome public events

The Canadian media has been buzzing with the trial of Jian Ghomeshi. He is a former broadcaster with the Canadian Broadcasting Corporation (CBC). There were women who came forward to tell of their allegations that sexual activity with Ghomeshi was not consensual. He was fired from the CBC and charged with several offences.

The trial has been high profile. It is perhaps the way that the women have been treated in the court that is the most sensational story. Their behaviour has been dissected in salacious detail. The women have been on trial as opposed to Ghomeshi who did not testify in his defence. The challenge is that victims of sexual assault suffer from memory distortions, enmeshed relationships, shame and guilt and a tremendous amount of fear about how they will be treated by friends, family and the community. The intense cross examination they received in court will have only added to these fragile emotional states. Stories from victims are typically disjointed and often have inconsistencies in them.

Jian Ghomeshi

We await the decision of the court in March.

However, the real lesson here is for other victims. There is little value in coming forward with your story. You will be treated badly. Your story will be challenged in a way that will go to the heart and will be discredited.

A good look at the memory issue can be found in this CBC story. What is important as a take away, is that traumatic memories are not formed and recalled in cohesive, through ways but more as the essential essence of what took place. By comparison, cross examination in courts will focus on minute details, inconsistencies, contradictions and things forgotten. In other words, cross examination will use the very weaknesses of traumatic memory as the basis to discredit the witness.

The second story comes out of the Vatican. As Time magazine reports (as do many other news outlets)

The Catholic Church is allegedly telling newly ordained bishops that they have no obligation to report child-sexual-abuse allegations to law-enforcement officials, saying instead that the decision to take such claims to the authorities should be left to victims and their families.

Given that the Roman Catholic church has been plagued with sexual abuse scandals for decades now, this announcement is somewhat incredulous. The Church is shifting responsibility off to the victims. Many victims will find that obligation onerous. It takes tremendous courage to come forth with sexual abuse allegations but now the victims are being told they must carry the burden further and make a separate decision to bring in the police. That is a lot to ask of victims. Again the Church is failing its victims.

However, there is a story here that is getting missed which is the obligation in many parts of the world to involve the authorities via child protection. A common theme through much child protection legislation in the developed world is that of mandatory obligation to report when a child may be at risk of harm. Most often that is thought of as a caregiver but priests, nuns and brothers often act in roles of parents in schools, orphanages, athletics and so on.

We see in Canada how the Church engaged in sexual and physical abuse of First Nations children in the Residential Schools for decades. Those children and their families lacked the capacity to get action. This should be remembered. The obligation to act should rest with the institution on whose behalf the cleric acts.

Both of these cases highlight how society continues to fail in their obligation to protect people from sexual abuse and assault. The clear messages are that victims will have to struggle to be heard, believed and protected from further abuse.

The graphic above shows very clearly that we have not created an environment where sexual assault can be spoken about. These two stories add to the power of silence. Even if Ghomeshi is found guilty, the trial has sent a clear message to victims, telling the truth is very hard to do and the way in which the case will be managed may do you a lot of harm.

UPDATE

The Associated Press reports that, since the course noted above for Catholic clerics:

Pope Francis' top adviser on clerical sex abuse says bishops have a "moral and ethical responsibility" to report all cases of suspected rape, molestation and other abuse to police — even where local laws don't require it.

A statement released by Boston Cardinal Sean O'Malley goes beyond the Vatican's current guidelines for bishops. Those 2010 guidelines say bishops and superiors must report suspected cases where civil reporting laws require it.

O'Malley, who heads the pope's abuse advisory commission, issued the statement after a recent course for new Catholic bishops on handling abuse cases featured a French monsignor who reportedly said bishops don't have to report cases. He said it is up to families and victims to do so.