Workers have "hands tied"...

by Elaine Riley
(Lancashire, UK)

Darlene, I've just had to send you this letter after watching on TV the coverage of the harrowing Jessica Randall UK child abuse case.

Baby Jessica died at the hands of her father, who physically and sexually abused her. Jessica's case is being investigated in the Northamptonshire area where her family lived. Her father has now been imprisoned. A report has been commissioned, to detail the findings of the investigation. This notes... "At no stage was Jessica Randall recognised as a child at risk and in need of protection... In recognising that opportunities had been missed to identify signs of abuse we must conclude that the outcome for Jessica Randall may have been different had these signs been acted on" (Local Safeguarding Children Board report, 2008).

As both a survivor of childhood abuse, and a professional Social Worker, I can sadly see both sides of the coin. I spent many years as a child and teenager, enduring abuse at the hands of my parents, abuse which went completely unnoticed by the adults I came into contact with; adults who included Healthcare professionals, Teachers and Youth Group Leaders, as well as the extended family, and parents of my peers. To this day, I firmly believe that had my abuse been spotted then, I would not now be suffering its legacy.

But since beginning employment as a Social Worker, I have begun to ask questions. Many are based upon my own experiences of abuse, and how these experiences have been reflected in those of the people with whom I have worked.

You see, things are never "cut and dried"! Abuse is a shameful and uncomfortable subject to broach, a "Taboo", and maybe for this reason alone, it is "passed over" by many members of society. After all, why would anyone want to believe that abuse occurs, when they can live happy in the blissful ignorance that it does not?

To return to my own case; my parents were respectable professionals, both well educated, both working, both on good salaries. My father had his own Engineering company, and my mother worked as a part-time Civil Servant. She was also my father's accountant, having qualifications in this field. My parents were "social climbers" of a very determined nature, having risen from impoverished (and abusive) childhoods of their own, to having a spacious detached house, two cars, and yearly holidays abroad. They presented to society the image of being articulate, well dressed and ambitious. They met easily with the societal ideal of the "nuclear" family; mummy, daddy and two kids.

Where, amongst any of the above, would anyone spot my parents' potential to become abusers? Would someone spot my mother's hidden history of mental illness; her dependence upon Antipsychotic medication, Barbiturates, and regular consumption of excessive quantities of alcohol? Would anyone spot my father's evil and explosive temper, his constant irritability and volatile moods? Would anyone suspect that my parents' constant emphasis of the need for respect, rules and regulations might lead to their use of constant threats, physical punishments, curfews...? Would anyone notice my parents' inconsistency, their frequent explosive rows, their separations and getting back together, their constant picking of faults, and criticism, their lack of praise and physical displays of affection, their neglect, emotional and physical abuse?

In brief... NO! You see, abusers can be crafty. When someone is presenting to the outside world an image that is all "sweetness and light" then why should anyone imagine it to be otherwise? My parents were clever. Bruises were never obvious; and besides, it was made clear to me that the more severe the "punishment", the more "bad" I had been. I believed this. As I got older, friends were discouraged more and more from coming to my house, and the rigid rules got stricter - I had fewer opportunities to disclose my abuse. But even had I wanted to, the threats were always present. I was told when I cried that I was "putting it on" or "being melodramatic". When I questioned my parent's rules they threatened that without such measures I'd "go off the rails and end up in prison" or that "I'd never get a good job". When I was sick and needed time out, I was forced into school or work with threats that I'd be seen as "a time waster" or regarded as "lazy". My self expression was limited by my parents' constant taunts that my clothes gave off a "bad image" or made me look "slutty". Any contact with boys was deemed a risk, and it was automatically assumed that I was having intimate relations - after all, my mother explained to me "men only want you for one thing".

I ran away from home several times, resulting in Police involvement. But my parents always made it out to be my rebelliousness that had caused the problem. I was branded a problem child. When I finally succumbed to eating disorders as a way to cope, my mother threatened "to have me put in a Mental Hospital that I'd never get out of". I got bullied at school, but nobody seemed to care. It was clear that the problem was me!

How many times had there been a chance for someone to notice? How many times had my outward behaviour been a sign of the torment within? But instead, my parents were able to get away with passing it all off as no more than "teenage behaviour". I smoked, drank, had piercings, became a Goth, truanted, shoplifted... I ran away from home, my "friends" were often experimenting with drugs, and often much older than me... I had inappropriate relationships with older men... I was raped at 15. NONE of this was spotted. Nor was the vomiting, taking laxatives, cutting my arms with razors... How can this be missed?

On several occasions my teachers wrote to my parents to arrange meetings to discuss my behaviour. They wrote suspecting I was taking drugs, as I often fell asleep in class. They noted my weight loss, but tried to force me to eat, making the situation worse. They noted my changed appearance and behaviour. But never did they sit down and ask ME what was going on. Instead, they made assumptions, and believed my parents.

This leads me to the present day... After working for Social Services and the NHS, I can see the other half of this picture. Due to funding and resource restrictions, staff training is often infrequent and inadequate. Staff are overworked and under-supported. I have personally held complex caseloads of over 30 individuals, all with high levels of need and risk. I have had to do my job in offices which are short-staffed, with poor morale. I have had to "hotdesk" and share computers because of lack of office space and facilities.

The major problem is that there is too high a demand for services than can be adequately met. As a result, mistakes occur; corners get cut. There are too many conflicting demands on workers. Workers have to meet the demands of turnover (i.e. waiting lists), of budgetary constraints, of ensuring client confidentiality, of ensuring risk is managed, of giving good levels of care, of meeting the patient's needs, of balancing the patients' needs with family/carer needs and with budgetary constraints... The list goes on. Legislation changes. Rules, policies and procedures change. Somewhere, the poor old worker gets left behind! They feel unsure and out of their depth. They aren't aware which procedure to follow, as it might have changed so many times as to have become confusing. Methods of reporting may be inconsistent from service to service, area to area, sometimes even ward to ward. Faced with all of this, some workers may opt to do nothing, rather than risk "doing it wrong". And besides, there often isn't enough time in a working day to be asking enough of the right questions. The pressure to meet demands in terms of paperwork and hands on work with patients is overwhelming. Managers are often busy, distant figures who are unavailable when assistance is needed. Too many difficult decisions fall upon the shoulders of under-qualified staff (think Victoria Climbie).

There is somewhat of an issue of "worthiness" about this whole healthcare debate. You know, there are hundreds of services and charities out there for Cancer, or the Blind... but not for the Schizophrenic, or the HIV sufferer. Special needs babies will always receive more funding and support than elderly dementia cases. Why? Perhaps because people are by nature nothing like as altruistic as they would like to seem, and Governments are much the same. A baby is "cute", it's "media friendly" - an old, toothless "wrinkly" is not! Cancer can't be seen easily as the victim's fault - but what about substance misuse?

Abuse of children is an uncomfortable issue that many do not want to be confronted with. Whilst it remains such a social taboo, ignorance pervades. Who'd feel comfortable talking in the Pub about child abuse? Who'd talk openly about it at school? When something is hard to talk about, it remains shrouded in mystery. It also remains a topic lower down the list of priorities for professional services to deal with. At the end of the day, the Health and Social Services are driven directly by public demand, and therefore will prioritise the need to meet those demands that the general public are most openly concerned about. These syphon away funding from less publicised issues.

Perhaps we all need a "wake up call". Burying one's head in the sand may seem a way of distancing oneself from issues, but it won't make them go away. Yes, we can blame Social Services, or Hospitals. Yes, we can blame Schools, the Police, Youthworkers... It's true, they all do have opportunities to notice and act upon cases of child abuse. But we all have a wider responsibility. To accept that it happens, and to call for more to be done to help fund initiatives to stop it.

This article titled 'Workers have "hands tied"...' was originally posted to Child Abuse Articles page on this site February 15, 2008