Consider the underlying trauma

The following is a paper I presented at the 11th International Mental Health Conference in Gold Coast August 2010. The conference focussed on depression and anxiety and my point was to highlight the need to consider, acknolwedge and address any underlying trauma.

To read the paper go to Underlying trauma

Child abuse a pervasive problem

Posted on online opinion 15th July 2009
Read this article on Online Opinion
Author – Dr. Cathy Kezelman, chairperson ASCA (Adults Surviving Child Abuse)

The Productivity Commission’s report Overcoming Indigenous Disadvantage released on July 2 and commented on by Minister Macklin reveals the parlous rates of child abuse and neglect of Indigenous children. The figures indicate a significant increase on prior figures, and while they may in some part reflect an increase in reporting, they, without a doubt, highlight the devastating scale of a problem which remains largely unaddressed despite the concerted but often paternalistic interventions of successive governments.

The report also demonstrates that the rate of child abuse and neglect for non-Indigenous children has risen as well. It remains challenging to accurately analyse these trends because Australia does not have reliable child abuse and neglect statistics; definitions as to what constitutes the various forms of abuse vary between our states and territories.

A report released last year by Access Economics suggests that the true rate of abuse and neglect in Australian communities may be up to five times that of official figures. There are other difficulties in assessing the true prevalence of the problem – child abuse and child sexual assault remain secret crimes, with multiple bars to disclosure and the pervasive attitudes of denial within our society contribute to the silencing of both child and adult victims.

Either way the relentless parade of new and intractable cases shows that the combined force of current initiatives is not stemming the tide of abuse, child sexual assault or neglect in any communities across Australia. The Forgotten Australians and Lost Innocents Report as well as the report by the Anglican Church into sexual abuse within the Church both released last month have taken positive and proactive steps to address institutional abuse both historically and going forward.

These are crucial initiatives but we also need to shift our focus to the domestic domain, where far too many Australian children are being criticised, humiliated, beaten, molested and raped on a daily basis by those responsible for their care.

Statistics consistently show that the vast majority of cases of child abuse and neglect are perpetrated by a child’s natural parents. One report documented that 96 per cent of abusers have a relationship with the child with 72 per cent being the natural parents. Last month ASCA, the key national organisation for advancing the needs of adult survivors of child abuse, lodged a submission to the Human Rights Commission Consultation in support of the first human rights charter.

ASCA’s submission, co-authored by Dr Jennifer Wilson from the Centre for Peace and Social Justice and myself as ASCA chairperson, urges child abuse and child sexual assault in the private domestic domain, perpetrated by primary caregivers, for example parents, step parents and legal guardians, to be acknowledged as human rights violations and to be introduced into Australia’s first charter of rights as such. Previously the human rights discourse has only concerned itself with the public domain and transgressions between the state and its agents, and the individual.

ASCA’s submission is based on Article 19 on the Convention of the Rights of the Child, which clearly establishes a relationship between children and their primary caregivers. When parents fail to keep their young safe the state must intervene. Sadly the incidence of new child abuse and child sexual assault cases shows that despite the best efforts of police and child protection agencies, the human rights violations of child abuse and child sexual assault in domestic settings by primary caregivers continue unabated.

This Federal government has commissioned and is implementing some important initiatives including the Framework for the Protection of Australia’s Children and the Time for Action report developed by the National Council to Reduce Violence against Women and Children. The Framework for Protecting Australia’s Children states that “All children have the right to be safe and receive loving care and support … However parents have the primary responsibility for raising their children and ensuring that their rights are upheld.”

ASCA contends that a human rights approach must be taken if we are to see a real reduction in the incidence of child abuse, child sexual assault and neglect across the board. To achieve this the domestic domain can no longer remain private and untouchable. We would all prefer to believe that all Australian children are receiving the loving care and attention they deserve and need from those charged with their care. Sadly for the 55,000 children substantiated to have been abused in 2008 and the up to five times children who were abused but failed to come to the attention of child protection authorities this is no more than a fantasy and we must act. As quoted in the background paper to Time for Action:

The growing international consensus on human rights stresses the right of women and their children to live free from violence.

Domestic and family violence can no longer be hidden as a private matter within families, nor sexual assault hidden as a personal shame beyond the reach of governments or the sanction of our communities. Violence against women and children violates the universal human rights instruments to which the international community has agreed through the United Nations.

ASCA asserts that it is impossible to separate the abuse of the child from the whole of life consequences of the adult survivor and that human rights abuses, begun in childhood, almost invariably continue into the survivor’s adult experiences. Our current laws let survivors down and are not relevant or sufficiently comprehensive. The long-term repercussions suffered by the more than two million adult Australians surviving child abuse are well documented, and the mental health impacts, human rights abuses particular to women and the homeless, contribute further to the marginalisation of this already victimised group.

Article 19 on the Convention on the Rights of the Child also makes provision for appropriate referral, follow-up and treatment following abuse, child sexual assault and neglect. Historically systemic failure to provide appropriate care and support for children following child maltreatment, and for adult survivors, to help them find a better sense of health and well being, has had disastrous long-term consequences not just on individuals but on the social and economic health of this nation.

Abuse within institutional settings, religious and otherwise, and that within the Indigenous community requires urgent attention. However it is high time child abuse and child sexual assault in Australia are acknowledged as pervasive social practices, reinforced by long-standing cultural beliefs and norms at the core of which is a basic lack of respect for a child’s human rights. By broadening the terminology around human rights to include ‘private abuses’, the majority of cases of child abuse and child sexual assault, we will improve the climate for disclosure, acceptance and understanding for both child and adult victims and empathic support and follow up.

Appropriate care and support for child and adult victims would be enormously helpful to victims who currently experience inadequate support for coping with the after-effects of abuse and a silencing taboo. Greater community open-mindedness in the community will help reduce the legacy for adult survivors and reduce the ongoing marginalisation.

ASCA is calling on the Federal government to show leadership in helping to shift community attitudes, and the attitudes of commentators, policy makers and organisations concerned with human rights to encapsulate child abuse, child sexual abuse and the human rights of surviving adults within the mainstream human rights discourse. The health of our children and of our nation depends upon it.

Human Rights Advocacy

In 2009 Cathy, in her ASCA role co-authored a submission to the Human Rights Consultation together with Dr. Jennifer Wilson, Centre for Peace and Social Justice, Southern Cross University.

ASCA’s submission sought to have child abuse and child sexual abuse perpetrated by non state actors, acknowledged and named as abuses of the fundamental human rights of children. It argues that human rights discourse in Australia does not currently sufficiently acknowledge and publicise violence and sexual violence against children by non-state actors as human rights abuse. It also argues that the impact of abuse in childhood frequently leads the victim/survivor to suffer further human rights abuses, including mental health issues, homelessness, and various other difficulties that frequently transgress several articles of the Universal Declaration of Human Rights. The submission is supported by a comprehensive statistical analysis of child abuse and its impacts in Australia as well as by a number of survivor stories. We would like to acknowledge each and every survivor who has come forward to tell their story and commend them for their courage and fortitude.

This submission is groundbreaking in terms of the human rights discourse in Australia because for the first time it seeks to reframe the suffering of children being abused within the private domestic sphere, in human rights terms. As human rights concerns, these abuses can become far more transparent, and far less likely to be silenced by denial. It is particularly timely as the Human Rights Commission works towards drawing up Australia’s first federal charter of human rights.
To read ASCA’s submission please click here.

The submission is accompanied by 2 appendices. Appendix A is a background document highlighting relevant statistics around child abuse and its impacts.
To read appendix A click here.

Appendix B holds a number of personal stories, courageously provided by adult survivors in support of ASCA’s submission.
To read appendix B click here.

Presentation to parliamentary briefing session Feb 2009

This paper was presented to a parliamentary briefing session Feb 2009:

“Just imagine a plague that’s not immediately fatal. It attacks in childhood and lurks in the bodies and minds of its victims into adulthood and old age. It makes its victims up to sixteen times more likely to experience debilitating mental illnesses such as anorexia and bulimia, self harm and suicide, persistent nightmares and flashbacks, drug and alcohol abuse. It prevents its victims from getting an education, finding a job, forming relationships and feeling okay about themselves and leaves them struggling day-to-day to get to first base, to do those things that most people take for granted.

The plague of child abuse has caused more misery and suffering than any of the great plagues of history and yet the Australia community and successive governments continue to deny its consequences.

By conservative estimates, there are more than 2 million adults surviving child abuse in Australia and 8 million members of the Australian community directly affected by this tragedy. A 2008 study by 5 Australian universities of over 21 thousand older Australians found that over 13% of those surveyed reported having been sexually or physically abused in childhood. These figures are consistent with prior studies and do not include those who have been emotionally abused or neglected or forced to live in domestic violence situations. With Australia’s population sitting around 21.5 million people, the number of Australian adults surviving child abuse is probably more like 4 or 5 million – or every 4th or 5th person in this room.

This 2008 study showed that child abuse survivors are two and a half times more like to have poor mental health outcomes, four times more likely to be unhappy even in much later life, more likely to have poor physical health, to smoke and be physically inactive. The research also shows a higher prevalence of broken relationships, lower rates of marriage in late life, lower levels of social support, and an increased likelihood of living alone. A 2008 report by Access Economics, the Australian Childhood Foundation and Monash University found that the cost of child abuse to the Australian community in 2007 was $10.7 billion, and could be as high as $30.1 billion; and that the projected cost of the consequences of abuse over the lifetime for children abused for the first time in 2007 at $13.7 billion and could be as high as $38.7 billion. The cost of not addressing adult survivors’ needs is crippling.

These statistics may seem hard to believe but have been established by Australia’s most reputable institutions but the legacy of child abuse has long been challenged by the politics of disbelief. This very shame and stigma and a conspiracy of silence has long kept survivors isolated, stopped them speaking or accessing the help they need. Despite a recent surge of media stories about child abuse, the rates of abuse and neglect continue unabated at an estimated 5 times officially reported levels and no change in community attitudes to the issue. A 2006 study by the Australian Childhood Foundation showed that community concerns about child abuse had not altered between 2003 and 2006 and were ranked lower than concerns about the cost of petrol and the vagaries of public transport.

This issue of child abuse touches on some very raw social nerves. Children who are abused live in fear of disclosing while adults are expected to shut up and get over it. The majority of people would prefer to imagine that child abuse doesn’t go on and that if it does, not in our community and certainly not in our homes and families. However 85% of abuse occurs in the family and 96% is perpetrated by someone the child knows; no sector of Australian society is
immune. Until we tackle this issue head on survivors’ needs will continue to swamp our psychiatric hospitals and homeless shelters, and flood our criminal justice and welfare systems.

The impact of child abuse does not stop when the abuse stops. The advertising campaign, the TV component of which you are about to see is confronting and we make no apologies for that. It has to be to expose the entrenched taboo around the impact of child abuse, to highlight the plight of adult survivors and to confront a pervasive myth – the myth that it is easy to get over child abuse. Both the community and successive governments have turned a blind eye to the needs of adult survivors for too long and this inaction has caused devastating repercussions for all Australians.

I have no doubt that some of you will find this TV ad uncomfortable or perhaps even shocking. However speaking as a survivor of child abuse myself I would like to stress that being abused as a young and innocent child is far more uncomfortable than any 30 sec advertisement, and living long-term with the impact of that abuse is devastatingly shocking.

The needs of adult survivors are a significant social, health and economic challenge which have been crying out for government action for a long time. Since 1995 ASCA has helped thousands of survivors reclaim their lives. Our creating new possibilities workshops for survivors, education and training programs for health care workers, network of skilled service providers and other services are of proven benefit. We have the skills and expertise to help but our resources and funds are severely limited; we cannot solve this community scourge alone but we are ready to work together with government and other service providers on a solution.

It is high time we saw the needs of adult survivors high on the national agenda alongside other significant social and health issues such as depression, suicide, substance abuse and homelessness. As a prioritized focus for government with a minister with portfolio responsibility for policy around capacity building and service delivery and ongoing funding commensurate with the scale of the problem, and its impact. ASCA is committed to ensuring that all Australian adult survivors of child abuse will be able to find the help they need to find health well being and meaningful engagement in the Australian community. We look forward to working with you all on the way forward.”

Dr Cathy Kezelman

Read more about this presentation at:
http://www.asca.org.au/displaycommon.cfm?an=1&subarticlenbr=184