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rights

Institutional abuse and the rights of children and youth

Jacqui Michael

“The effects on children of being abused within a context in which they had every right to expect safety can be devastating. “ – Giles

There is no ethical defence of practice which removes children from a familiar but violent context and places them in an unfamiliar and violent one. Children and youth are removed from unsafe and troubled environments and supposedly placed in institutions so that they can be adequately cared for. Very often their environments have been impoverished, deprived, disrupted, abusive and violent before they came into care.

As Child and Youth Care practitioners, our task is to create a therapeutic milieu which does not repeat any of the factors for which children and youth were removed. Young people in care tend to feel insecure and commonly experience relationship difficulties. They deal with many issues around separation, loss and bonding, and are vulnerable because of the experiences they have had and the fact they are living in institutions away from their families.

It is imperative that the “care” they receive is consistent, competent and responsive to “their” needs. The environment created by the staff must be such that all the developmental needs of these children and youth can be met. It is not enough to place the child in an environment which may not be violent, but is “still inconsistent”, “incompetent “and “not able to respond” to his needs in a way that promotes his development.

Definition
There have been numerous attempts made to define institutional abuse. Giles, in his chapter on “Violence in group care” quotes the categories suggested by Rabb and Rindfleisch. These are:

non-accidental injury
sexual abuse
failure to provide care
failure to supervise
emotional maltreatment
questionable moral behaviours (by staff)
harmful restraint and
Setting young people up to fail or be humiliated.

Institutional abuse can refer to abuse by individual staff members, abusive practices within the institution and or in society in regard to institutional care.

For the purpose of this paper, we will present in tabular form the needs and rights of children and youth and how the violation of these constitutes abusive practice.

PHYSIOLOGICAL

Provision of:
Food/drink

Abusive

Insufficient provision;

Deprivation of,

Cooked, served and presented without care and consideration;

Lack of regular meal routine.

Non-abusive

Ensure meal times are pleasant and avoid conflict;

Know children's needs;

Monitor basic care;

Ensure equal and appropriate distribution

Warmth
Shelter
Fresh Air
Personal Hygiene
Sleep and Rest
Recreation/ exercise

Insufficient provision and deprivation of these needs.

Ensure equal and appropriate distribution of resources. Assess needs.

Apply standard of care.

Personal Space

Not giving any personal space or belongings;

Removing personal belongings as a punishment;

Intrusion in child's privacy.

Appropriate allocation depending on available space and resources e.g. own bed own locker private time etc.

PHYSIOLOGICAL

Provision of:
Clothes

Abusive

Inappropriate clothing;

Unfashionable clothing;

Clothes that humiliate e.g. fit,
style etc.

Clothes that draw attention to them dirty, unpresentable clothes.

Non-abusive

Own clothes, if possible;

Fitting clothes;

Appropriate to occasion;

Clean/ tidy;

Presentable;

Fashionable.

Sexual Needs

To deny child's sexuality;

To ignore child's sexual development;

To label child's sexual behaviour.

To understand child's feelings and confusions re: sexual development;

To provide safe, non-judgemental environment for child to
question and discuss sexual issues e.g. development, contraception, sexually transmitted diseases, sexual behaviour, etc.

SAFETY NEEDS

Protection from:
Physical Abuse

Abusive

Any form of physical harm, i.e. pinching, hitting, pushing, punching, etc.

Corporal punishment;

Harmful restraint;

Deprivation of medical/dental care;

Allowing children to hurt each other;

Allowing children to carry out discipline procedures which should be done by staff.

Non-abusive

Definite philosophy about acceptable discipline;

Procedures for children and staff to
report abuse;

Procedures for preventing recurrence;

Accountability;

Teaching children to resolve conflicts and problem solve constructively.

SAFETY NEEDS

Protection from:
Emotional Abuse

Abusive

Lack of respect;

Humiliating children;

Lack of value for children and youth in talking to and about;

Ridiculing/ making fun of;

Labelling;

Putting down ;

Breaching confidentiality.

Non-abusive

Respect for each individual’s dignity and equality;

Praise;

Encouragement;

Laughing “with them” not “at them”;

Non-judgemental;

Respecting confidentiality.

Sexual Abuse

Any form of sexual touching by staff of child;

Allowing or condoning any form of sexual touching from other residents;

Not keeping child safe from any sexually abusive situation;

Not taking action.

Teaching children to care for and
respect their bodies;

Staff must be knowledgeable about
sexual abuse in order to prevent it;

Staff must ensure protection of children and youth at all times;

Encourage openness to discuss these issues.

Discrimination

Any form of discrimination based on age, sex, sexual orientation, race, colour, culture, social circumstances, sickness or handicaps.

Ensure admission and treatment criteria are based on available resources, NOT
discrimination;

Constant evaluation of philosophy.

BELONGINGNESS AND LOVE

Family Involvement

Abusive

To discipline by – preventing family
contacts/ access unnecessarily;

Ignoring existence of child's family;

Being judgemental of child's family;

Not doing permanency planning;

Child care workers trying to replace family;

Not involving families in decision making.

Non-abusive

To involve families from the beginning
whenever possible;

To understand the importance of families;

To empower and involve families;

To accept the family as part of the child.

Staff

Incompetent care and lack of commitment;

Uncaring behaviour and environment;

Constant complaints and resentment re job;

Resistance to training;

Inadequate supervision;

Haphazard, unplanned intervention.

Receive training and supervision;

Self-development;

Self-awareness;

Providing youth with;

better opportunities to develop than
previous settings;

Being informed about developmental needs and appropriate intervention;

Must be trustworthy.

ESTEEM/SELF

Building Self-Esteem

Abusive

Humiliation;

Lack of encouragement;

Lack of individual knowledge of the child – his strengths as well as weaknesses;

Lack of acknowledgement.

Non-abusive

Understand where the child is at;

Encourage and praise;

Find out child's strengths and weaknesses;

Be person-focussed not problem focussed.

Developing Self-Esteem

Abusive

Disempowering children;

Not creating growth opportunities;

Not allowing children to master tasks and situations;

Not allowing independence;

Making decisions “for” not “with”;

Not “gloating” if they make mistakes.

Non-abusive

Being aware of one’s own needs;

Not keeping children dependent;

Allowing them to resolve their own situations with support;

Creating situations where they can
develop and master life tasks;

Involve them in decision making;

TRUST them.

Summary

In summarising this paper there are some important points to mention.

Any system which does not exist to develop children and youth and make them more competent, can be termed abusive.
It is essential to have clear procedures to guide Child and Youth Care workers when abuse is detected so that they know what to do.
It is vital that children and youth have procedures through which they can report any type of abuse. It is also important that there are channels for children and youth to discuss their rights, needs and preferences.
Every institution should have clearly defined rights for staff and residents.
If abuse is suspected or reported, corrective and decisive action must be taken immediately. To ignore the incident exacerbates the abuse. The CYC-Online (s) must always be addressed.
Training must be aimed at educating staff about the incidence and causes of institutional abuse.
Management must be responsible for staff matters and must have clear procedures for dealing with staff who abuse children. If management allows abusive practices to continue, they are just as guilty of the abuse and violation of the children in their care.
Every child should have a permanency plan and clear admission and discharge criteria and procedures must be followed. This will ensure that children do not get “lost” in the system.
Specified standards should be legislated in terms of institutions and they should be inspected regularly to ensure that these standards are being maintained.

Finally, I would like to stress the fact that we are all accountable for everything we do with, and to the children and youth in our care. In caring for children and youth we are challenged to examine our own behaviour as scrupulously and rigorously as we examine that of these children's parents. Are we prepared to do this?

The message we give children and youth is ... “This is a caring place. We will protect you and help you grow. Try us.” If we violate that promise and trust, we have failed.

I would like to end with a quote from George Thomas:

Children coming into care need to grow and develop. Institutions must meet this need for each individual. Failure to do so, represents in the most fundamental sense, an abuse of children's developmental progress and constitutes Institutional Child Abuse.

Let us not be guilty of this!

Reference

Giles C. Violence in group care. In McKendrick, B. and Hoffman, W. (1990). People and Violence in South Africa, pp. 373-404.

This feature: Michael, J. Institutional Abuse and the Rights of Children and Youth. in Gannon, B. (1994). (ed.) Children and Youth at Risk: HIV/AIDS issues Residential Care and Community Perspectives, Cape Town: NACCW. pp.41-47