Publications
The Tragedy of Child Abuse
We all share blame for the death of Bradley McGee
By Douglas J. Besharov
This article originally appeared in The St. Petersburg Times, Setpember 3, 1989.
Little Bradley McGee's tragic death reminds us of how dangerous
being a young child can be in today's shifting social environment
and how - despite the creation of elaborate child abuse programs -
children can be killed even after their plight is brought to the
attention of the authorities.
Depending on the community, between 25 and 50
percent of all child abuse fatalities involve children previously
reported to child protective agencies.
Our deep horror at these deaths - and our natural
desire to prevent more of them - leads us to look for individual
culprits. Last week, four of the caseworkers responsible for
Bradley's safety were indicted.
Perhaps they were so grossly negligent that criminal punishment
is appropriate. It's too early to tell, but too often workers
are the scapegoats for society's failure to make key decisions
about protecting children from dangerous parents.
Innocent social workers
In recent years, a number of child protective and
child welfare workers have been indicted for "allowing" the
children in their care to suffer further maltreatment. Almost
all have ended up with the cases against them dismissed, usually
because they were doing the best they could under difficult
conditions.
Even when workers win in court, however, they
lose. Legal vindication comes at a high price. Newspapers
carry many stories about the indictment, usually focusing on the
untested allegations. News of the dismissal is usually buried
on the back pages, if it is reported at all. And, for long
after, friends, colleagues and clients remember that the worker's
conduct, judgment and ability were challenged in court.
Legal fees from $ 5,000 to $ 50,000 and more also
have to be paid, whether one wins or loses. In one El Paso
criminal prosecution, for example, even though the charges were
dropped before trial, the indicted workers incurred legal fees of $
15,000 - for which they were solely responsible.
The harmful effects of unfairly blaming child
protective workers go far beyond the individuals
involved. News of last week's indictments has already spread
throughout the state;many workers now fear that they will be
blamed whenever one of the children on their caseloads is killed,
whether or not there was any reason for thinking that the child was
in danger.
Recruiting qualified people for children's services
is hard enough.
Salaries are low (starting at about $ 19,000 a year), working
conditions poor, and positive feedback from clients
minimal. There are many more rewarding areas of human services
work. As one high-ranking official with the Department of
Health and Rehabilitative Services (HRS) said in the wake of these
four indictments: "How do you expect to fill these jobs, if workers
can be indicted for making a wrong decision. "
There is an even more insidious
effect. Criminal prosecutions put great pressure on workers to
take no chances and to remove children from their parents whenever
they might be criticized for not doing so.
The dynamic is simple enough: Negative media publicity and a
prosecution are always possible if the child is subsequently killed
or injured;but there will be no critical publicity if it
turns out that intervention was unneeded, and absolutely no chance
of an indictment.
Susan Besharov, my wife, a psychiatric social worker
at D. C. Children's Hospital, interviewed workers and agency heads
in a number of states where there had been prosecutions. She
found that: "Workers are often preoccupied with knowledge of suits
in other agencies, and even other cities. When a suit is
filed, it is perceived as a threat to all workers, not just those
named in the complaint, especially when the workers are apparently
acting in good faith and to the best of their ability under trying
circumstances. The director of an agency in which three
workers were indicted described 'tremendous, agency-wide panic.
As rumors about the case spread, morale plummeted, and children
were removed from their families at the slightest hint of
danger. "' No one should attempt to defend
reckless and insensitive conduct, and if it turns out that
Bradley's social workers were guilty of an egregious violation of
their duty to him, criminal prosecution may be technically
justified. But if the objective is to improve the level of
protection provided to abused and neglected children, we need to
address more deep-seated problems.
Manageable caseloads
To do their jobs, child protective workers need
manageable caseloads. Child abuse tragedies are often the
inevitable result of inadequate staffing. In most communities,
the number of investigators has not kept pace with the rapid, and
continuing, increase in reported cases. Bradley's caseworker,
for example, apparently averaged 47 cases per month, about 50
percent higher than other members of her unit.
With more cases than they can handle, workers do not
have enough time to give individual cases the attention
required. In the press to clear cases, many key facts go
undiscovered as they are forced to perform abbreviated
investigations. It becomes impossible to monitor dangerous
home situations with sufficient intensity to assure a child's
safety.
In part, reducing caseloads means spending more
money, and Gov. Martinez's proposal to add the hiring of 162 new
workers to the issues to be considered in the Legislature's
upcoming special session is welcomed. But there will never be
enough money for all the investigators that are needed if the
reporting process is not reformed.
Like those in many other states, Florida's
Department of Health and Rehabilitative Services is being inundated
by "unfounded" reports.
Last year, 58 percent of all the reports it received were
determined, after an investigation, to be
"unfounded. "Twenty-four percent were "indicated" and only 17
were actually "substantiated. "
The determination that a report is unfounded can be
made only after an unavoidably traumatic investigation that is,
inherently, a breach of parental and family privacy. To
determine whether a particular child is in danger, caseworkers must
inquire into the most intimate personal and family
matters. Often, it is necessary to question friends, relatives,
and neighbors, as well as school teachers, day-care personnel,
doctors, clergy, and others who know the family.
Few unfounded reports are made
maliciously. Studies of sexual abuse reports, for example,
indicate that, at most, from 4 to 10 percent are knowingly
false. Many involve situations in which the person reporting,
in a well-intentioned effort to protect a child, overreacts to a vague
and often misleading possibility that the child may be
maltreated.
Others involve situations of poor child care that, though of
legitimate concern, simply do not amount to child abuse or
neglect. In fact, a substantial proportion of unfounded cases
are referred to other agencies for them to provide needed services
for the family.
Of course, an unfounded report does not necessarily
mean that the child was not
actually abused or neglected. Evidence of child maltreatment
is hard to obtain, and may not be uncovered when agencies lack the
time and resources to complete a thorough investigation or when
inaccurate information is given to the investigator. Some cases
must be closed because the child or family cannot be located.
A certain proportion of unfounded reports,
therefore, is an inherent - and legitimate - aspect of reporting
suspected child maltreatment and is necessary to identify
endangered children. Hundreds of thousands of strangers report
their suspicions;they cannot all be right. But unfounded
rates of the current magnitude go beyond anything reasonably
needed. Worse, they endanger children who are really abused.
The flood of unfounded reports is overwhelming the
limited resources of child protective agencies. For fear of
missing even one abused child, workers perform extensive
investigations of vague and apparently unsupported
reports. Even when a home visit of an anonymous report turns
up no evidence of maltreatment, workers usually interview
neighbors, school teachers and day-care personnel to make sure that the
child is not abused. And even repeated anonymous and unfounded
reports do not prevent a further investigation. All this takes
time.
As a result, children in real danger are getting
lost in the press of inappropriate cases. Forced to allocate a
substantial portion of their limited resources to unfounded
reports, child protective agencies are less able to respond
promptly and effectively when children are in serious
danger.
To call for more careful reporting of child abuse is
not to be coldly indifferent to the plight of endangered
children. Rather, it is to be realistic about the limits to
our ability to operate child protective systems. If child
protective agencies are to function effectively, they must be
relieved of the heavy burden of unfounded reports.
Getting control of unfounded reports is not as easy
as it might seem. In our eagerness to protect as many abused
children as possible, hot-line staff have been harshly criticized
for screening out cases that later result in a child's serious
injury - even though, at the time, there was no real reason for
thinking that the child was in any danger. Hot lines need
support from the highest levels of government in order to reject
inappropriate reports. One hopes that the special session will
also consider legislation to explicitly encourage such
screening.
Realistic guidelines
Child protective workers also need much more
realistic decision-making guidelines. Because child
maltreatment usually occurs p p in the privacy of the home, it is
often impossible to know what really happened. Moreover, some
home situations deteriorate sharply and without warning, so that
assessing the degree of danger to a child requires workers to
predict the parents' future conduct. Yet, the unvarnished
truth is that such sophisticated psychological predictions are
often beyond the reach of the most skilled clinicians.
Thus, the chances for human error are always
present. Child protective workers and their agencies cannot
guarantee the safety of all children known to them. Even if
workers placed into protective custody all children who appeared to
be in possible danger - a degree of over-intervention that few
would support - some children would continue to suffer further
injury and even death, because the danger they face would go
undetected, or unpredicted.
None of this explains why workers sometimes ignore
obvious signals of danger. In Bradley's case, for example, the
workers seem to have known many troubling things about his
parents. They reportedly knew but did not act on information
that his mother forced feces into his mouth in a bizarre version of
toilet training.
What's happening?Putting aside simple
incompetence or gross negligence, the problem is that as a society
we have failed to be clear-eyed about what can, and cannot, be done
to prevent child abuse.
A major tenet of current child welfare policy is
that children are almost always better off with their
parents. Workers have been trained, and trained, and trained
again in the importance of family preservation. The goal of
family preservation is an essential underpinning of any progressive
child welfare program, but some parents are beyond the reach of
even the most richly funded programs.
Child abuse caseloads are, in essence, made up of
two very different kinds of parents. The vast majority,
probably as much as 90 percent, can be helped to adequately care
for their children, who can be safely left at home. The
remaining 10 percent, however, represent a serious danger to
children who, barring an extraordinary turn of events, must be
removed from the home and, often, placed for adoption.
Unfortunately, the emphasis on family preservation
has not been accompanied by the promulgation of reasonable
guidelines about when efforts to keep the family together would
needlessly endanger children.
Florida law, for example, merely intones that: "No child shall
be removed from home . . . if, with the provision of appropriate
and available services, . . . the child could safely remain at
home. "
As a result, one repeatedly sees admirable but
misplaced efforts to give drug-addicted parents chance after chance
to turn their lives around. Four months after one New York
City infant was discharged from a six-month foster care placement
and returned to her mother and grandmother, she was found to have
serious burns on her back, possibly made by an iron. The child
was immediately returned to foster care.
Subsequently, the mother admitted using crack to her caseworker,
and six months later, despite being enrolled in a drug treatment
program, she gave birth to a baby with cocaine symptoms. Yet
the agency's goal was still to return the girl, by then almost 3
years old, as well as the newborn, to their mother.
To provide better guidance to workers, just last
March, HRS requested that the Governor's Expert Team for the
Protection of Children recommend that state law specifically
authorize the termination of parental rights in cases where (1) the
child has suffered severe or life-threatening physical or sexual
abuse, (2) parents suffer from severe schizophrenia, mental
retardation or addiction that makes them unable to protect the
child from harm, (3) parents have been committed to long-term
imprisonment, or (4) parents have abandoned the child. (This
proposal has also been included in the governor's call for the
special session. ) Such common-sense guidelines meet
with opposition because of an understandable but shortsighted
unwillingness to acknowledge that some parents are beyond the reach
of current treatment programs. For, this would be labeling
such parents, in effect, as "hopeless," something most of us feel
uncomfortable doing. And yet, it seems indisputable that firm
protective action must be taken against such obviously dangerous
parents.
When legislators are unwilling to face such
realities, is it any wonder that individual caseworkers seem
confused. In hindsight, it is easy to blame them for their
mistakes, but with foresight, we should realize that going too far
in keeping children at home is the inevitable result of our failure
to label unfit parents for what they are.
We will never know whether Bradley's death could
have been prevented by smaller caseloads and better
guidelines. But there is no doubt that their absence exposes
many thousands of other children to further abuse. So, before
we blame the individual caseworkers for what happened, we should
examine our own conduct. Did we, as a society, give them the
sources and the guidance needed to fulfill their life-saving
responsibilities? I don't think so.
Douglas J. Besharov is a Resident Scholar at the American
Enterprise Institute in Washington, D.C. , and was the first
director of the U. S. National
Center on Child Abuse and Neglect (1975-1979). He is the
author of The Vulnerable Social Worker: Liability For Serving
Children and Families. In July, he spoke before a Tallahassee
conference on technology transfer in protective services sponsored
by the American Public Welfare Association and the Florida
Department of Health and Rehabilitative Services.
(For a PDF version, please click here.)
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