Dear friends,

You may be a parent, an employee or an employer. It is very much important that we are aware how to tackle situations like Child Abuse, if it happens around us.

Here are some guidelines by NIMHANS Bangalore.

National Institute of Mental Health And Neuro-Sciences has sent an advisory to schools, parents, police and media to enable them to deal with a case of child sex abuse, in the right way.

Many a times, schools and parents do not know how to deal with Child Sexual Abuse (CSA). The result is delayed complaints / no complaints, destruction of concrete evidence unknowingly, not caring for the identity and dignity of the child enough, insensitive media coverage etc., which come in the way of delivering justice and to the traumatised child and family and getting their life back on track.

National Institute of Mental Health And Neuro-Sciences (NIMHANS) has prepared an advisory which has many important points to be taken care of by everyone.

Need for a child-centric response to CSA

The continual reporting of child sexual abuse (CSA) by media, in the context of many recent events raises the challenge of how to tackle the national menace of this ‘silent violent epidemic’. A critical aspect of child protection, also a child public health issue, CSA warrants systemic approaches that are uncompromisingly child-centric.

Part of this has to do with preventive programs in schools and other childcare agencies. Focus on prevention has the potential to reduce sexual victimization and even sexual offences in the general population. However, when an event occurs, it is addressed by systems of criminal justice, police, schools, families, and healthcare, which generate a flurry of incoherent activity, albeit in good faith, thereby compromising the child’s best interests.

The major emphasis of these activities are directed towards the child ‘victim’ through enquiry, interrogation and intrusive detailing of the event to verify it and then bring the perpetrator to book. The balance between the need for justice and empowered rehabilitation of the child becomes precarious. There is thus an urgent need to develop a protocol-based systemic response ensuring that the child’s agenda i.e. healing and recovery, is at the core of it.

Over the past year, the Department of Child & Adolescent Psychiatry at NIMHANS has received several children with CSA issues. When they come for help, they are extremely overwhelmed after visits to the Child Welfare Committee, police station, the hospital; by then, the child has been subjected to questioning on multiple occasions and therefore to re-traumatization.

There are many areas which have to be systematically addressed namely, the child’s reaction to the abuse, ensuring the child’s immediate safety, medical and mental health needs of the child, the concerns of the family, including social stigma. On the other hand, there is a sense of urgency to in legal procedures. Towards this, there is an understandable emphasis by the police on evidence and enquiry processes and related pressure from media and civil society, raising questions on the timely nature and effectiveness of these processes.

What a child-centric response entails:

Based on our experience, NIMHANS believes that planned, protocol-based, comprehensive and sensitive care should be provided at all stages of intervention to victimized children. The primary goal is to create a system of investigation which is child friendly and in accordance with principles of child rights and protection.

Where can families go for help?

• Protection of Children from Sexual Offences Act 2013 (POCSO) mandates that the child be provided with emergency medical services (EMS) within 24 hours of filing the FIR. EMS are provided by state Registered Medical Practitioners (RMP) in government hospitals (Vani Vilas and Indira Gandhi Institute of Child health) and only in absence of such an agency should the child be referred to other sectors. Where the Special Juvenile Police Units (SJPU) work in collaboration with government hospitals, the detailed enquiry can be completed in one sitting rather than the child being interviewed multiple times.

• Once the medical examination is done and there is medical evidence, what the Dept. of Child & Adolescent Psychiatry, NIMHANS can offer is combined therapeutic and forensic interviewing to assist both the healing of the child and the necessary justice processes. This interviewing is done based on existing international protocols which are child-sensitive and can stand the scrutiny of court procedures.

In children with symptoms, we work through trauma by encouraging expression of feelings regarding the abuse, validating experiences, and teaching personal safety. In very young children, this is done through art and play work. We offer social interventions in order to help the family cope with the consequences of abuse, also facilitating liaison with the Child Welfare Committee (CWC), Centre for Child and Law (CCL) and legal aid services as necessary.  

• It is important for parents to not ignore or undermine a child’s statements and innocuous remarks. When in doubt it would be prudent to corroborate the information from various sources. An open, supportive stance, assuming a position that child is right would be helpful to facilitate further disclosure on abuse. It would be judicious to err on the side of caution especially in face of long term consequences of CSA. It is also important not to blame the child. The support given by the parent helps in facilitating better healing of the victimized child.

School’s response

Preventive workshops, personal safety workshop, life skills education can help as preventive strategies. However, when an incident takes place the system should have a clear protocol for response. This protocol should entail the following:

• Whether the CSA incident occurs within or outside the school premises, by school staff or others, especially if a child reports to anyone in the school, the school’s position must be one of acknowledgement and involvement.

• Every school must have a pre-set response plan which should include:

  • An identified person (known to the children) who can respond in a sensitive and gentle manner to alleged instances of abuse reported by the child.

  • A next-level reporting authority (such as the principal) who will inform the parents.

  • The school should guide and make available to parents the first level medical and other facilities to seek assistance (described above).

• Unless the school has a trained counselor or CSA expert, it should not attempt to interrogate the child. This needs to be done by trained experts, preferably in child mental health agencies such as NIMHANS or accredited comprehensive child response units.

• The school needs to take a proactive stance with the concerned parents and other parents. They may also need to be alert to the impact on other children and get appropriate experts to do de-briefing as necessary.

• Furthermore, preparation needs to be made to receive the child back to the school in natural and non-stigmatizing ways so that the child re-integrates comfortably.

Police involvement

• In the immediate aftermath of trauma, when there is non-availability of a trained person within the police forces for sensitive interviewing of the child, they need to refer to an expert in agencies such as NIMHANS, where forensic interview protocols are followed in the context of  healing interventions.

• Police need to be cognizant that interview processes involving children cannot be hastened as it can exacerbate the trauma and be detrimental to the child’s well-being. For instance, taking a child back to the scene of crime and asking him/her to explain/demonstrate what happened, causes the child to relive the trauma and could interfere with recovery; also, such pressure on the child is less likely to elicit accurate information.

• They need to understand that there are robust acceptable methods of gathering forensic evidence to meet the immediate legal ends.

Media – good practice

Media should be proactive in responding to crisis in ways that instill hope and confidence in the public versus fueling cynicism as the latter may only serve to increase the child’s trauma, and the family’s fears of social stigma.

• The media must protect the identity and privacy of the child. This includes allowing and enabling the family to pursue due medical and legal processes without heightening their trauma by repeated and sometimes intrusive queries.

• It would be helpful for the media, at the time of query/ reporting, to assist the family with information about where medical, mental health and legal, paralegal services is available.

• Reporting on CSA could emphasize systems and treatments available for assistance, and strongly present the child’s entitlement to healing. This can be done by providing an on-going feedback about recovery and rehabilitation of the child.

Contact:

Dept. of Child & Adolescent Psychiatry, NIMHANS

E-mail: cpcnimhans@gmail.com; capnimhans@gmail.com

Telephone: 080-26995576; 26995351