O'Donnell Melissa, Scott Dorothy, Stanley Fiona
Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Western Australia.
Aust N Z J Public Health. 2008 Aug;32(4):325-30. doi: 10.1111/j.1753-6405.2008.00249.x.
Australia is seeing an unprecedented increase in the rate of child protection notifications and children being taken into care. The burden of such high levels of notifications and removals impact not only the children and families but also the system which is trying to resource them. The concern is that these increases are unsustainable and overloaded child protection systems can be dangerous for the vulnerable families and children they are trying to protect and support. This paper hopes to raise some alternative thinking as to the overall approaches to child abuse and neglect with a greater focus on prevention. Is it time to consider a public health approach, using population-based measures of child abuse and neglect to accurately describe the epidemiology of population risk and protective factors? Should we investigate the potential of universal health, welfare and education services as platforms for prevention? And should we investigate whether the provision of secondary prevention for vulnerable families which address major contributing factors, such as parental substance dependence and mental health issues are effective in reducing abuse of children in these families?
澳大利亚儿童保护通报率以及被送入托管机构的儿童数量正经历前所未有的增长。如此高的通报率和移送率所带来的负担不仅影响儿童和家庭,也对试图为他们提供资源的系统造成冲击。令人担忧的是,这些增长是不可持续的,不堪重负的儿童保护系统可能会对其试图保护和支持的弱势家庭及儿童构成危险。本文希望引发一些关于虐待和忽视儿童整体应对方法的不同思考,更加注重预防。是否到了考虑采用公共卫生方法的时候,即利用基于人群的虐待和忽视儿童衡量标准来准确描述人群风险及保护因素的流行病学情况?我们是否应该研究普及健康、福利和教育服务作为预防平台的潜力?我们是否应该调查为弱势家庭提供二级预防措施(这些措施针对诸如父母物质依赖和心理健康问题等主要促成因素)在减少这些家庭中儿童受虐待情况方面是否有效?