The Hidden Cause of Child Abuse

Sadly, I see another police investigation has started following the suspicious death of a baby in the Bay of Plenty. This is in addition to the critically ill child currently in Starship hospital with serious head injuries. Physical child abuse is probably the most harrowing presentation that I see in the emergency department, worse than any other form of trauma, even partner abuse. Although I can intellectually understand many of the reasons why a parent would do such a thing to their own child, the reality always fills me with horror and makes me angry. Child abusers are not my favorite people.

All the books and studies on child abuse talk about it being “multifactorial” - caused by many different factors. This is certainly true from a statistical point of view. However, in my (fairly extensive) experience working in Emergency Departments, I have only ever seen two factors at play.

The first is quite rare: mothers with severe post-natal depression. They either smother their babies or shake them hard enough to cause brain damage. These mums draw my sympathy and my anger is directed at those professionals (doctors, district nurses, CYFs workers) who did not recognise the very obvious symptoms of depression (you don’t harm your baby unless your depression is very severe and easily recognisable.)

The second group have what I have called the hidden cause (it’s often not so easy to spot). That cause is substance abuse, predominantly either alcohol or methamphetamine. I see it in every single case of physical child abuse and neglect that is not due to the first cause. And it is by far the most common cause of physical child abuse.

Now you can rabbit on about addressing childhood poverty as a leading cause of abuse. But poor people don’t abuse their children – drunkards do. You can happily ban smacking, thinking you are doing something towards child abuse. But parents who use an occasional smack do not abuse their children – drug addicts do. It is no accident that, of the child in the Starship Hospital, the Herald reports: 

“Neighbours say they know little of the occupants who have lived in the Housing New Zealand home for at least four years.

“But they told of frequent parties being held on weeknights that frequently end in yelling and screaming.”

Violent, noisy parties = alcohol. And then:

“A resident in the street said police arrived at the house last year in what is believed to have been a drug raid.”

I guess I can rest my case…

I am dubious that throwing money at welfare, as Cindy Kiro suggests, is going to make much dent in our terrible child abuse statistics. I also doubt if making smacking illegal is going to make an iota of difference. I suspect that until we, as New Zealanders, cease to treat drunkenness as acceptable behavior, alcohol-fueled child abuse will continue its toll. Until we empower the police with the numbers and resources to come down on drug dealers, and provide drug addicts with the resources they need to properly rehabilitate, children will continue to be murdered by drug-crazed relatives. This is not a problem that a government alone can tackle effectively. This is a problem for all of us.

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