The Cost of Child Abuse

I recently enrolled in an MA for Human rights – beginning in March 2013.

I have expressed to the Glenn Inquiry (New Zealand) that I would appreciate the opportunity of undertaking my internship with their organisation. I see the ‘Glenn Inquiry into All Forms of Child Abuse and Domestic Violence in New Zealand’ as a ground breaking, privately funded inquiry that stands to bring about serious and meaningful change, free from the constraints of government and very much a case of a good man stepping forward and putting his money where his mouth is. The Glenn Inquiry has assembled a wealth of talent from around the globe – world leaders in the field and is headed by veteran child abuse campaigner Ruth Herbert. Hopefully I can learn a lot from the best and give something back as just one of those who was abused as a child in New Zealand.

What was suggested as a thesis would be to “examine” and write about what constitutes adequate care for adult survivors of child sexual abuse – Ruth Herbert suggesting, “If you can make part of the Glenn Inquiry the basis for your thesis we would certainly be open to you taking a strand of the work and writing it up as your thesis – have a think about what specific focus you would want to take – my experience from Masters’ thesis is to keep your topic as defined/specific as you can – maybe examine / document what the ideal system response should be for adult survivors of child sexual abuse.”

Sounds good. Once the dust settles on commissions and inquiries what then? One certainly hopes for positive outcomes for children. Safe and secure environments, early intervention, family support, qualitative standards and best practice policies that prevent abuse in the first instance, the erosion of child poverty, the reinstatement of state subsidised housing in NZ etc. Real outcomes that can be measured and quantified, but what of survivors? The healing process – the support/ counselling, access to the right medication, the recovery/rebuilding stage of child abuse and domestic violence can go on for many years and if the right services/system are not there throughout, failures occur and often the consequence is other social problems. I.e. mental health, alcohol and drug dependency, suicide, crime etc. This is supported  by Judge Carolyn Henwood who heads the ‘Confidential Listening Service’ in New Zealand. She says, “she’s listened to the stories of 600 New Zealanders who were in state care before 1992 and says it’s clear that poor care leads to crime and prison.”1

Australian, NSW premier Barry O’Farrell recently stated that sexual abuse has “robbed young children of their futures”. He strongly suggests that the lives of child abuse survivors have been irrevocably compromised and the only substantive action we can take needs to be proactive and prevent abuse from occurring in the first place. Once it has happened, it’s too late. This represents the state’s failure to provide adequate health services to child abuse survivors.

The moral rationale for addressing child abuse and neglect is undisputed. Child abuse is abhorrent to all sections of society. This was reflected in a recent Nielson Poll for the Australian ‘Royal Commission into Historic Child Abuse’ when 95% of Australians voted in favour of the Commission – the most universally supported poll ever. The overwhelming support for the Commission should send a loud and clear message to politicians that the welfare of children goes beyond political rhetoric and could well become an important election issue.

There is, however, another dimension to child abuse which needs to concern policy makers — the economic costs to a nation. One direct way to measure the magnitude of child abuse is to quantify its economic costs. Estimating the collective costs of child abuse is central to understanding the impact and burden of such abuse on both the individual and society.

Numerous studies demonstrate that around two thirds of both inpatients and outpatients in the mental health system have a history of childhood sexual and/or physical abuse.2 Adults who were sexually abused as children have poorer mental health than other adults. The suffering continues throughout their lives. Many adults who were sexually abused as children experience depression, anxiety and in some instances an overwhelming sense of panic. They are more likely to have a history of eating disorders, depression, substance abuse, difficulties in personal relationships, and suicide attempts. Sexual abuse is also associated with financial problems in adulthood (Silverman, Reinherz et al. 1996). Research shows that male survivors of sexual abuse exhibit significantly more interpersonal sensitivity, depression, anxiety, and phobic anxiety than female adults that were sexually abused as children.3 Research also shows that abused and neglected children perform less well on standardised tests and achieve poorer school marks, even when socio-economic status and other background factors are taken into account (Mills, 2004). Adults who were abused as children are greatly overrepresented in the criminal justice system. They are also greatly overrepresented in mental health wards, alcohol and drug rehabs and cemeteries as a result of increased risk of suicide and accidental  fatal drug overdose (Mahin Bayatpour et al, 1991; Margaret Dexheimer Pharris et al, 1997; Margaret C Cutajar et al, 2010). Trauma caused by experiences of child abuse and neglect has been shown to have serious physiological effects on the developing brain, increasing the risk of psychological problems (Streeck-Fischer & van der Kolk, 2000). Extensive research has identified a strong relationship between abuse/neglect and post-traumatic stress disorder (Gilbert et al., 2009; Schore, 2002; Streeck-Fischer & van der Kolk, 2000). Recent research suggests that diagnosing children with post-traumatic stress disorder does not capture the full developmental effects of chronic child abuse and neglect and many researchers now prefer the term “complex trauma” or “complex post traumatic stress disorder” (Cook et al., 2005).  Exposure to complex and chronic trauma can result in persistent psychological problems. Research has shown that those who endure complex trauma during early childhood are more prone to long-term and severe consequences. Additionally, those who endure trauma for an extended period under the age of twelve are proven to present more devastating results in adulthood than complex trauma afflicted upon someone who is already an adult. This is because morality, social skills, and life skills are all taught in childhood.4

In the U.S. it is estimated that the annual cost of child abuse is 124 billion5; Australia, between 10.8 – 30.1 billion6; New Zealand, two billion7; and Canada, over 15 billion annually8. These figures are likely conservative and present only a partial picture of the true range of costs resulting from child maltreatment.9

This dimension may not offend one’s sense of decency or morality, but it may be an argument to focus the minds of politicians, economists and planners. The high costs of child abuse to society can be used as a means of persuading politicians and policy makers that it is time to act. Economic costing of child abuse also establishes a baseline for improvement of services to victims. From an economic perspective it is vital that adequate aftercare for victims exists.

Safety and justice are fundamental human rights – so too are health and well-being. Abuse survivors need to be helped, not just heard. Justice for victims of childhood abuse needs to extend beyond the rhetoric of inquiries and commissions.

Too often the system fails us.  We grew up in environments where we were not safe or protected. We were abused because those entrusted with our protection failed us or, indeed, became our abusers. Now, as adults, we find ourselves unable to access adequate care that addresses the impact of trauma and abuse on our lives. Too many of us become societies outcasts – lacking education, unemployed, homeless, in and out of prisons, mental health wards and alcohol and drug rehabs. A vicious cycle where the abuse is perpetuated. Too many of us live below the poverty line, unable to access/afford private services.

As a result, we receive inappropriate, ineffective or even dangerous forms of treatment that compounds the harms of abuse and revictimises us. But effective treatment does exist . The fact is that governments have not invested in them, made them available or provided enough abuse-specific training to health and welfare workers.

Commissions and inquiries have the power to address policy issues. The prevention of child abuse is one issue. Providing and ensuring access to effective care/support in the aftermath of abuse is the other, and it has long been neglected. Child abuse is at the very centre of the burden of mental illness and other social implications in the community. Until steps are taken to address the health needs of survivors/victims, this burden will remain a significant financial cost to the community. If not on moral/humane grounds it makes economic sense to provide  survivors with the appropriate support, care and services.

I guess this is the beginning of my thesis…

Read about my experiences of care here…. 

Refs:

  1. http://www.radionz.co.nz/news/te-manu-korihi/111159/judge-hopes-tainui-can-prevent-its-children-going-into-care
  2. Hussain & Chapel, 1983; Emslie & Rosenfeld, 1983; Mills et al. 1984; Bryer et al., 1987; Jacobson & Richardson, 1987; Craine et al. 1988; Swett et
    al., 1990. Read et al. (2004) compared 40 studies published between 1984 and 2003 that examined the prevalence of child abuse among female
    psychiatric inpatients and among outpatients where at least half the patients were diagnosed with a psychosis. Also see V. Sar, `Epidemiology of
    Dissociative Disorders: An Overview’ (Review Article) Epidemiology Research International, Vol 2011 (2011) Art ID 404 538.
  3. Steven N. Gold, Barbara A. Lucenko, Jon D. Elhai, Janine M. Swingle and Alfred H. Sellers (1997) A comparison of psychological/psychiatric symptomatology of women and men sexually abused as children
  4. McLean, Gallop, 2003, Implications of Childhood Sexual Abuse for Adult Borderline Personality Disorder and Complex Posttraumatic Stress Disorder
  5. Fang, X., et al. The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse & Neglect (2012), doi:10.1016/j.chiabu.2011.10.006 Retrieved from:  http://www.sciencedirect.com/science/article/pii/S0145213411003140
  6. Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C. and De Bortoli, L. (2008). The Cost of Child Abuse in Australia, Australian Childhood Foundation and Child Abuse Prevention Research Australia: Melbourne.
  7. Every Child Counts (2010) The Nature of Economic Costs From Child Abuse and Neglect in New Zealand
  8. Audra Bowlus, Katherine McKenna, Tanis Day and David Wright (2003) The Economic Costs and Consequences of Child Abuse in Canada: Report to the Law Commission of Canada
  9. Audra Bowlus, Katherine McKenna, Tanis Day and David Wright (2003) The Economic Costs and Consequences of Child Abuse in Canada: Report to the Law Commission of Canada

2 comments on “The Cost of Child Abuse

  1. Jayne Routhan on said:

    You know women who have no historical sexual abuse history and are raped, sodomized and the person found not-guilty at 37 yrs old, then left to parent children alone without enough support also develop life-threatening stress disorders.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

HTML tags are not allowed.