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The World Health Organization defines child maltreatment as physical and emotional mistreatment, sexual abuse, neglect and negligent treatment of children, and child exploitation. This definition may be expanded to include a child’s exposure to intimate-partner violence. Child maltreatment, a major public health concern, is linked to developmental impairment and significant suffering in childhood, adolescence and adulthood.
Child Maltreatment and Mental Health
Children who are maltreated are at greater risk of lifelong anxiety, eating, behavioural and substance abuse disorders, depression, and both suicidal thoughts and attempts. In general, the earlier the maltreatment begins, the poorer the mental health outcomes. Important sex differences have been identified, with some disorders more likely among males (antisocial behaviour, etc.) and others more likely among females (depression, etc.). Lastly, many children experience more than one type of maltreatment — and a corresponding increase in poor mental health outcomes.
Research, Prevention and Intervention in Canada
While national data are collected through Statistics Canada and the Canadian Incidence Study on Reported Child Abuse and Neglect, this is limited to cases that are reported to police and child welfare agencies, respectively. There are therefore no current nationally-representative data on child maltreatment — which means many questions about child maltreatment in Canada remain unanswered. To further our understanding of child maltreatment in the Canadian context, it is vital that our research be based on Canadian data. The key goals of intervention strategies should be to prevent the occurrence and recurrence of child maltreatment, and to provide treatment and help for these children to ensure their lifelong health and well-being. Intervention activities must be rigorously tested for effectiveness, and implemented early to minimize children's exposure to violence and chances of developing mental disorders.
Afifi, T.O. (Forthcoming). Child Maltreatment in Canada: An understudied public health problem. Canadian Journal of Public Health.
Afifi, T.O., Mather, A., Boman, J., Fleisher, W., Enns, M.W., Macmillan, H., & Sareen, J. (2011). Childhood Adversity and Personality Disorders: Results from a nationally representative population-based study. Journal of Psychiatric Research, 45, 814-822. doi: 10.1016/j.psychires.2010.11.008
Public Health Agency of Canada. (2010). Canadian Incidence Study of Reported Child Abuse and Neglect 2008: Major findings [Report]. Ottawa. Available at: http://www.phac-aspc.gc.ca/ncfv-cnivf/pdfs/nfnts-cis-2008-rprt-eng.pdf
World Health Organization. (2006). Preventing child maltreatment: A guide to taking action and generating evidence [Report]. Available at: http://www.who.int/topics/child_abuse/en/
By Dr. Abby Goldstein, University of Toronto
Youth on the Street and Youth Involved in Child Welfare: Maltreatment, Mental Health and Substance Use was a collaborative study by the University of Toronto, Health Canada and the Public Health Agency of Canada, in partnership with the Mental Health Commission of Canada and Human Resources and Skills Development Canada.
The study explored risk factors associated with concurrent mental health and substance abuse problems in three population groups: 1) street youth with a history of maltreatment; 2) street youth with no history of child welfare involvement; and 3) young people currently involved in the child welfare system. Two data sets were used to conduct analyses: The Youth Pathways Project (2002-2006), and the Maltreatment and Adolescent Pathways Longitudinal Study (2008-2009).
The study found that concurrent mental health and substance abuse problems existed in all three population groups. The highest rates were among street youth with no history of child welfare involvement. Engaging in intimate partner violence was also linked to concurrent mental health and substance abuse problems, as was homelessness, while current child welfare involvement appeared to be protective. The study covered a wide range of strategies and interventions for addressing the issue. The study will be released in December 2011. To view or order a copy of the report, visit: http://www.phac-aspc.gc.ca/ncfv-cnivf/index-eng.php or contact firstname.lastname@example.org.
By Hoori Hamboyan based on an interview with Mohammed Baobaid, Executive Director of London, Ontario’s Muslim Resource Centre for Support Services and Integration (MRC) and Eugene Tremblay, Clinical Manager of the MRC’s Safe Integration Project , an early intervention program for immigrants and refugees coming from conflict zones
Many immigrant families arriving in Canada are survivors of political violence in their countries of origin, and may consequently suffer from post traumatic stress disorder (PTSD). The acculturation process may add to the stress of PTSD, and the Centre's service providers have noted resulting episodes of family violence. This is not typical cyclical family violence, but a situational crisis we must address in conjunction with PTSD to ensure these dysfunctional patterns are not passed down from generation to generation.
The Safe Integration Project offers specialized, intensive and ongoing services to help these families recover. It also offers, soon after a family's arrival in Canada, individual screening and group information sessions to address the complex realities and impact of violent trauma and emigration. Families are more willing to discuss and address the issues once they are explored and demystified in these sessions, especially when they see that service providers understand and respect their culture. The program offers integrated services to effectively address the layers of complexity surrounding these issues, and the response team coordinates and liaises with other organizations and services that assist the se families.
The MRC is preparing a manual to help mainstream service providers develop their knowledge and expertise in assisting families from conflict zones who experience domestic violence.
By the Research and Statistics Division , Department of Justice Canada
The Open Doors to Safety project is an innovative program from the New Hampshire Coalition Against Domestic and Sexual Violence (NHCDSV) . Presented at the International Conference on Violence against Women , the goal of the project is to address the complex needs of intimate-partner violence survivors experiencing mental health and/or substance abuse problems arising from their victimization.
The project offers intensive training and technical assistance to help intimate-partner violence programs better meet the needs of victims experiencing mental health and/or substance abuse problems. The findings of a project assessment by the University of New Hampshire were positive, showing that staff members were better trained and more confident of their ability to help survivors with substance abuse and mental health issues. The research thus found that survivors’ needs were being met more effectively.
The NHCDSV also recently published a report on The Mental Health Needs of Children Exposed to Violence in Their Homes . The report presents a summary of literature, and findings from interviews with national and state child experts and crisis centre directors, on how to better meet the needs of children exposed to violence in the home. Its key recommendations include ways to: increase the availability of trauma-informed services; more widely disseminate knowledge of the needs of children exposed to violence in the home; and develop a common language among providers to develop services that best meet the needs of these children.