How to assess the needs of children and families across the community to prevent child maltreatment: A needs-responsiveness matrix

The prevention of child maltreatment requires a wide range of interdisciplinary and cross-sector prevention measures. Unfortunately, there is an overreliance on mandatory reporting by many child-facing services. This is not acceptable as it does not address vulnerabilities and risks inherent within the actual workplace. It has also burdened the statutory child protection system.

A more nuanced approach is needed that is responsive to the needs of children and families across the community. When needs are high, the right services provided in the right way can avoid statutory intervention.

Statutory child welfare systems are broadly based on a three-pronged model of reporting, investigation, and ultimately child removal and placement into out-of-home care (with some limited options for 'differential' streaming of lower-risk cases to voluntary engagement with a child/family welfare agency).

Limitations of mandatory reporting

While there are valid reasons for mandatory reporting, the main objective is to ensure that children who are at risk of serious harm don't fall through the cracks. And so the community, and in particular those professions who, within their jurisdictions are 'mandated reporters', are required to let statutory child protection services know their concerns.

In Australia, mandatory reporting responsibility varies widely:

• In Queensland and Victoria it is limited to one or two professions (like doctors or teachers).
• In the Australian Capital Territory, Queensland, Victoria and Western Australia, it is limited to concerns about some but not all types of harm, and in different contexts (schools, etc.).
• In the Northern Territory, all adults within the community must report any type of harm.

Burden created by mandatory reporting

This has led to a massive rise in 'notifications' (phone calls or other forms of advice) received by statutory child protection agencies about a child at risk of harm. The volume of notifications is at unsustainable levels, of which only a small proportion can be investigated. According to the AIHW, only 43% of children about whom a notification was made received an investigation.

But we know even less about whether raising the concerns led to a response that helps the child or family and meets their needs.

And what about the children and their families in those other 57% of children where someone observed a 'need' but there was no investigation, let alone a response provided?

The most accurate data on the size of the problem of child maltreatment is even bigger than what comes to the notice of child welfare services. The Australian Child Maltreatment Study showed that 62% of Australians aged 16 years and over have experienced one or more types of child maltreatment. No statutory child maltreatment service can ever be big enough, agile enough, or responsible enough to address that level of need on their own.

The current culture of mandatory reporting as the first-and only-action from the community is creating a considerable gap in the provision of supports that could prevent child maltreatment from occurring, address vulnerabilities and risks, and move towards creating safety in a sustainable way for the child. A review of the adequacy of mandatory reporting laws and service system capability might help overcome the shortcomings.

Recognising the needs of the child and their family

There is a pressing need across the community for greater recognition of the needs of the child and their family. In addition, there is an urgent need to enhance the capacity of the family and the community supports that can be put around them to meet those needs.

Only a small proportion of those cases, where substantial risk remains, should require a statutory welfare response.

So how do we turn things around so that we don't have to rely so much on statutory child welfare systems? How can we have a way of understanding needs so that families and children get the supports they deserve?

To do this, we must look at the level of need (risk) in the context of the capacity of the family itself, and its support systems (extended family, and those already engaged with the child and family) to respond to those needs to keep children safe, well, and connected to their family.

The Needs-Responsiveness Matrix looks like this:

It is important to stress that a statutory child protection response is required for the highest risk cases, where there is imminent risk of death or serious harm that can only be mitigated by an action with the full force of the welfare system (as shown in the shaded quadrant). But all other areas of need should be responded to by the community. These responses should include the 'universal' (primary care) and more specialised 'targeted' (secondary) services such as education and health.

Build support that responds to needs

Understanding 'need' is important. Children and their families with higher levels of need are at greater risk of children being exposed to maltreatment. However, thinking about 'need' (or risk) on its own is not enough. The other dimension in the matrix is often ignored: responsiveness. How responsive is the family to the offer of help? And how responsive is the community and the existing services to provide that help? It's only when the family and/or the services that exist around them are unresponsive that we should expect the statutory system to intervene.

According to a 'blended prevention' perspective, responsibility for meeting the needs of a child and their family should be the extended family, the local community, and all the service systems that the child's family routinely encounter. These services include early childhood education, schools, maternal/child health services, GPs and other health/mental health services. They are responsible for things like:

A 'blended' prevention model focuses on good communication and collaboration across systems (education, health, child welfare) that addresses the needs of families more directly, efficiently, comprehensively, and compassionately. Needs should be addressed with the least possible intervention by statutory agencies that potentially contravene the rights of children and their families.

Early intervention can prevent multiple types of maltreatment

The Australian Child Maltreatment Study confirms what other research has shown about the circumstances of parents and families that create vulnerabilities for children. Children are at greater risk of experiencing multiple types of child maltreatment when their parents are experiencing difficulties such as:

• separation/divorce
• mental illness
• suicidality
• alcohol or drug problems
• economic hardship.

A public health system of prevention puts the responsibility for addressing needs, where families (and the services they encounter) can jointly respond to those needs. Even when the needs are high, the right services provided in the right way can avoid the need for statutory intervention. For example, home visiting programs are the 'gold-standard' in child abuse and neglect prevention outside of the child welfare system.

Universal access to support removes stigma

Parents need support and should be able to benefit from evidence-based programs. But to do that, they need to access these programs in a non-stigmatised environment - like a school, child-care centre, GP clinic or community centre. Embedding evidence-based support in these places where families already engage is a good way to ensure they receive support with raising their children.

Using a Needs-Responsiveness Matrix can help primary and secondary care services to work together-to draw on advice and support from statutory services where needed to respond to need, and to collectively create safety for children.

To do this, we need skilled workers that do not judged or risk the family feeling stigmatised. They need to provide advice, mentoring and support for families to address the needs that they observe, in collaboration with the family. Focusing on 'responsiveness' as much as risk/need can help create not only shared language, but also shared responsibility for supporting all families.

These 'public health' prevention strategies should support families with access to evidence-based parenting supports, tailored to their life circumstances and challenges.

Let's not leave it up to an overworked child welfare system. Let's take responsibility collectively as a community to support all families and keep all children safe.

Author

Professor Daryl Higgins

Acknowledgement

I would like to acknowledge Amber Fabry, Chief Practitioner, Specialist Child Protection Unit in the WA Department of Communities. Her discussions with me about her Churchill Fellowship (to explore systems and approaches to complex families, to prevent children being removed from their families due to harm from abuse or neglect) inspired me to articulate this needs-responsiveness framework. Thanks to Amber for her input and feedback.

References

This matrix also draws on data and ideas presented in a range of documents by my valued colleagues, whose contributions I acknowledge. These include:

Australian Institute of Family Studies. (2020). Mandatory reporting of child abuse and neglect. www.tinyurl.com/y6pcu6rv

Australian Institute of Health and Welfare (2023). Child Protection Australia 2021-22. https://www.aihw.gov.au/reports/child-protection/child-protection-australia-2021-22/contents/insights

Doyle, F. L., Morawska, A., Higgins, D. J., et al. (2022). Policies are needed to increase the reach and impact of evidence-based parenting supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families. Child Psychiatry & Human Development.https://rdcu.be/cEvhu

Herrenkohl, T., Scott, D., Higgins, D., Klika, B., & Lonne, B. (2021). How COVID-19 is placing vulnerable children at risk and why we need a different approach to child welfare. Child Maltreatment, 26(1):9-16. https://journals.sagepub.com/doi/10.1177/1077559520963916

Herenkohl, T. I., Lonne, B., Higgins, D., & Scott, D. (2020). The personal security of children demands bold system reform. International Journal on Child Maltreatment: Research, Policy and Practice 3, 9-17. https://doi.org/10.1007/s42448-019-00027-4

Herrenkohl, T. I., Leeb, R. T., & Higgins, D. J. (2016). The Public Health Model of Child Maltreatment Prevention [Introduction to the Special Issue of Trauma, Violence, & Abuse]. Trauma, Violence, & Abuse, 17(4), 363-365. https://doi.org/10.1177/1524838016661034

Higgins, D. & Mathews, B. (2023). Australian Child Maltreatment Study - the shocking findings. [Online] MJA InsightPlus.https://insightplus.mja.com.au/2023/11/australian-child-maltreatment-study-the-shocking-findings/

Lonne, B., Scott, D., Higgins, D., & Herrenkohl, T. (Eds.) (2019). Re-visioning public health approaches for protecting children. Child Maltreatment 9: Contemporary Issues in Research and Policy Series. Springer. https://doi.org/10.1007/978-3-030-05858-6