The underlying instability in statutory child protection: understanding the system dynamics driving risk assurance levels.

AuthorMansell, James

Abstract

A core component of the level of statutory assurance against the risk of child abuse is hazard detection through notifier surveillance, and through risk screening by both notifiers and the statutory child protection agency. Surveillance and screening are undertaken with a great deal of decisionmaking uncertainty and, as in most public risk-screening decisions, errors are common. In the New Zealand system it was found that increased attention to failed alarms (in the form of child deaths) drove reactive change to increase the level of risk assurance demanded of notifiers and the child protection agency. The combination of high error rates, high-stakes consequences for some errors and the ability to shift interventions thresholds, and competing pressures to meet incommensurable demands (i.e. to save all children from continued abuse, manage within resource constraints and avoid harming innocent families) suggests that deep instability in the underlying system will always be a feature of statutory child protection. The best that can be done is to tackle the main issues that contribute to the instability; specifically, intolerance of errors, lack of ability to defend errors, and the inability to transparently target a defendable and specified optimum level of risk assurance.

INTRODUCTION

Since 2001 demand for a statutory child protection investigation, as measured by client notifications to Child Youth and Family (2) within New Zealand, has doubled. The research presented here was initially motivated by a desire to understand the drivers of this sudden surge in demand in New Zealand (see Figure 1).

[FIGURE 1 OMITTED]

The received view tends to be that demand is driven by exogenous variables such as changes in demographics (youth population and/or ethnic mix) and/or poorer social outcomes (e.g. increasing poverty, social isolation, etc) driving increased rates of abuse. While this may provide some of the explanation, the evidence presented here demonstrates that the main factors driving the demand surge are endogenous--factors relating to changes in the behaviour of the child protection system itself.

Understanding the system that can drive surges in demand has also provided a wider perspective on the relationship between the particular system pressures that are causing concern in New Zealand and how these are merely symptomatic of deeper issues for child protection in general.

The findings presented in this paper suggest that the underlying problem facing child protection is the instability of the level of risk assurance demanded, and that this instability is fundamental to the nature of the child protection system.

The evidence suggests that this central issue underlies the seemingly disparate range of difficulties that child protection agencies face: surging demand, inability to forecast or manage demand, the inability to respond to criticism for not being responsive enough (e.g. driven by high-profile child deaths), the inability to defend against criticism for being too intrusive (United Kingdom experience), pressure to apply reactive changes to intervention thresholds and continual pressure to risk-manage intake, and becoming more forensic to avoid errors, thereby shifting resources away from effective intervention (CYF 2000a, CYF 2003a, CYF 2003b, E. Munro 1999, Scott 2006).

The figures below show a comparison of increases in notifications in some states in Australia compared with New Zealand. Although it is difficult to make a direct comparison of the numbers, it should be noted that there have been similarly large increases in notifications in each of these regions (AIHW 2006).

The research here was undertaken within a system-thinking framework. This is an iterative process of investigating the nature of the dynamics of the wider system underlying child protection, modelling this, and then testing it against organisational knowledge and through data analysis.

To this end, the next section, "The Nature of the Child Protection System of Intake", looks into the properties of the risk-screening process in child protection. "System Pressure to Increase Risk Assurance" then reviews the evidence from the New Zealand situation, in particular, the pressures driving calls for increased risk assurance. "The Effects of Pressure to Increase Responsiveness" summarises the observations of changes in demand trends that accrued due to system pressures, and in so doing the proposed model is tested against the evidence and data analysis. The following section, "Child Protection Systems Under Demand Pressures", summarises the model illustrating the system driving demand pressures that the New Zealand child protection system is currently under. The final section, "The Underlying Instability of Statutory Child Protection", places the New Zealand child protection experience into a wider context, providing an understanding of the root causes of the difficulties faced by all attempts to provide assurance against the risk of abuse to children through the work of statutory protection agencies.

It is clear from the results--and should be noted at the outset--that the issues facing child protection in New Zealand should not to be taken as a criticism of New Zealand's child protection agency in particular. The results here suggest that the system of child protection, as practised in many Western countries, will always place unrealistic demands upon their child protection agencies. The underlying system dynamics will always drive instability and so expose the statutory agencies responsible for delivering statutory child protection to unfair and ill-informed criticism and censure. As will become clear, these agencies are only ever part of a much wider system of statutory child protection.

THE NATURE OF THE CHILD PROTECTION SYSTEM OF INTAKE

Providing a level of risk assurance from abuse to children requires that hazards (in this case the risk of continued abuse) be identified and screened before escalation towards a statutory child protection response (investigation/intervention/placement, etc). To understand how demand can surge (in New Zealand since 2001 (3)) one must take a closer look at the first of these tasks, the nature of child protection agencies' intake and screening process. "Risk assurance" used here refers to the initial risk-screening function. As will become clear, in fact risk screening occurs throughout the statutory engagement with children and their families.

The Risk-Screening Process in New Zealand

The risk-screening process in child protection is a complex system that includes multiple stakeholders. The community, media and government set demands for levels of risk assurance and so influence risk-screening thresholds. Notifiers (4) undertake environmental scanning for hazards to children, and escalate these concerns for action when the notifiers consider them to warrant a formal investigation. These concerns can be forwarded to the child protection agency and/or to non-government organisations (NGOs). The child protection agency's role is to receive and further screen concerns, and to escalate those that are believed to be of sufficient concern to warrant a statutory investigation.

There are, therefore, a number of screening points in the New Zealand child protection context. For example, in 2004 it is estimated that from one million phone calls (and faxes) per annum, 140,000 (14%) were forwarded to intake social workers on the basis of the belief by the receptionist that they might be a substantive intake concern. Of these 140,000, about 35,000 (25%) resulted in a formal notification being lodged. Each notification was typically for more than one child, giving a final tally of 63,000 client notifications in 2004 (i.e. at 1.8 children per notification).

Each individual participant in the intake system--the notifier, telephone service operator and intake social worker--must determine whether to escalate the concern or not. At each of these steps multiple factors may influence the probability of the concern being escalated further into the intake system. The level of risk assurance provided within New Zealand is a combination of the community's demands, the notifier's environmental scanning (surveillance) and escalation threshold, and the child protection agency's own risk-screening and escalation threshold (see Figure 2).

[FIGURE 2 OMITTED]

One of the pervasive features of this system is that all three decision makers (notifier, telephone service operator and intake social worker) screen concerns under conditions of a high degree of uncertainty and potentially serious consequences for making an error.

Decision Making Under Uncertainty

It is well recognised in the social work literature that social workers have very difficult decisions to make (Benbenishty and Chen 2003, Gambrill 2005, Gambrill and Shlonsky 2000).

On the basis of [notification] information elicited some cases are clear-cut. However there are "grey area" cases caused by complex, unclear, ambiguous or unreliable information. Decisions in these circumstances can be characterised as "decision making under uncertainty". (CYF 2000a) Caseworkers must distinguish between child neglect, bad parenting and the effect of poverty and they must do this without the aid of accurate assessment tools... Rarely is all relevant information available, hampering problem solving efforts. (Gambrill and Shlonsky 2000) Assessing risk and identifying child abuse and neglect are difficult tasks ... Some mistakes are inevitable because they are due to our limited knowledge. (E. Munro 1999) Causes of uncertainty include:

* ambiguity about what counts as a reasonable definition of and evidence for a concern (particularly difficult for emotional abuse and neglect, for example)

* resistance by people being interviewed

* conflicting information

* lack of information

* time pressure

* limitations on human judgment; that is, the difficulty of integrating a...

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