Keeping children safe from predators

As more US states respond to the Larry Nassar case, one must realise that reporting can’t be a substitute for social-services interventions

Since details of disgraced United States sports doctor Larry Nassar’s abuse of young athletes came to light, legislators have been searching for ways to prevent such horrific, ongoing abuse. In particular, the revelations that multiple responsible adults may have been aware of the abuse and yet failed to report it. Recently, Olympic champion McKayla Maroney said that she had informed a coach after Nassar abused her in 2011. This has fuelled calls for statutes expanding mandatory reporting of suspected child abuse.

While an expansion of mandatory reporting may seem logical, there is simply no evidence that it works. There is, however, plenty of reason to believe that increased reporting often further intensifies racial and socioeconomic disparities in child welfare involvement, including which children are removed from their homes.

Over the past 50 years, policymakers have promoted increased reporting as a solution to what is fundamentally a problem of services and resources. Without the ability to provide comprehensive support and services to struggling families, the government has instead focused its efforts on enhancing reporting, creating a culture that emphasises investigation over assisting families in need.

Children at risk of physical and sexual abuse require swift intervention. Yet more reporting may actually contribute to making children less safe. A flood of reports from laypeople, which are less likely to be accurate (and are often focused on social issues tied to poverty, rather than actual abuse), thins out already underfunded resources, while turning the attention of caseworkers away from children who need immediate intervention.

Mandatory reporting began in the late 1960s as a response to what was touted as a new medical syndrome: Child abuse. Florida was viewed as a successful example of increased reporting. Yet, many of the reports conflated abuse with poverty. For example, reports received in the first two years of the hot line’s existence overwhelmingly dealt with “malnutrition; physical neglect; disorganised family life; alcoholism; abandonment; and lack of food, clothing, or shelter”. While all of these situations may be dangerous to children, there is a distinct difference between families lacking food and shelter and children being abused.

Yet all these cases were lumped together. A 1974 radio announcement somewhat disingenuously proclaimed that “over 19,000 children were beaten, battered, burnt, raped, starved, tortured, neglected and murdered”. Rather than highlighting how society was failing families that were often poor, hungry and homeless, these announcements exaggerated the prevalence of severe physical abuse while urging listeners to “save a life” by reporting struggling families.

‘Mental injury’

The passage of the Child Abuse Prevention and Treatment Act (Capta) in 1974 further pressured states to adopt federal standards as a requirement for federal funding for treatment and prevention programmes. For instance, in 1975, South Dakota reluctantly added “mental injury” to their reporting requirement, to be eligible to receive funding for a child abuse programme state officials were developing. Yet, broadening the definition of child abuse caused much confusion and, as many experts had predicted, enabled discretion and bias in determining what in fact qualified as child abuse.

Even proponents of mandatory reporting wondered whether it had gone too far. Senator Walter Mondale (Democrat, from Minnesota), a long-time advocate for abused children, sponsored and developed Capta. Yet, in 1975, when the Department of Health, Education and Welfare attempted to require further expansion of mandatory reporting, Mondale came out strongly against the change.

The problem: While serious physical and sexual abuse of children is a medical diagnosis, the definition of neglect remains cultural and context-dependent. A 1973 statute in Idaho, for instance, took a broad view of “emotional neglect”, allowing the court to take charge of a child whose behaviour indicated “social or emotional maladjustment”. Four decades later, little has changed.

As American states respond to the Nassar case, it’s important to understand what reporting does and doesn’t do. Reporting in and of itself does not keep children safer, and it cannot be a substitute for public health and social-services interventions. More reporting is not the same as more-accurate reporting. Ensuring access to social services, health care, addiction treatment, food and shelter would go much further than expanding a system that simply creates more reports. ■ Mical Raz, a practising physician and historian of health policy, will be an associate professor of history at the University of Rochester in 2019. She is the author of What’s Wrong with the Poor? Psychiatry, Race and the War on Poverty.

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