Improving the measurement and surveillance of child abuse in Queensland emergency departments

There are no population studies of prevalence or incidence of child maltreatment in Australia. Child protection data gives some understanding but is restricted by system capacity and definitional issues across jurisdictions. Child protection data currently suggests that numbers of reports are increasing yearly, and the child protection system then becomes focussed on investigating all reports and diluting available resources for those children who are most in need of intervention. A public health response across multiple agencies enables responses to child safety across the entire population. All families are targeted at the primary level; examples include ensuring all parents know the dangers of shaking a baby or teaching children to say no if a situation makes them uncomfortable. The secondary level of prevention targets families with a number of risk factors, for example subsidised child care so children aren't left unsupervised after school when both parents have to be at work or home visiting for drug-addicted parents to ensure children are cared for. The tertiary response then becomes the responsibility of the child protection system and is reserved for those children where abuse and neglect are identified. This model requires that child safety is seen in a broader context than just the child protection system, and increasingly health professionals are being identified as an important component in the public health framework. If all injury is viewed as preventable and considered along a continuum of 'accidental' through to 'inflicted', it becomes possible to conceptualise child maltreatment in an injury context. Parental intent may not be to cause harm to the child, but by lack of insight or concern about risk, the potential for injury is high. The mechanisms for unintentional and intentional injury overlap and some suggest that by segregating child abuse (with the possible exception of sexual abuse) from unintentional injury, child abuse is excluded from the broader injury prevention initiative that is gaining momentum in the community. This research uses a public health perspective, specifically that of injury prevention, to consider the problem of child abuse. This study employed a mixed method design that incorporates secondary data analysis, data linkage and structured interviews of different professional groups. Datasets from the Queensland Injury Surveillance Unit (QISU) and The Department of Child Safety (DCS) were evaluated. Coded injury data was grouped according to intent of injury according to those with a code that indicated the ED presentation was due to child abuse, a code indicating that the injury was possibly due to abuse or, in the third group, the intent code indicated that the injury was unintentional and not due to abuse. Primary data collection from ED records was undertaken and information recoded to assess reliability and completeness. Emergency department data (QISU) was linked to Department of Child Safety Data to examine concordance and data quality. Factors influencing the collection and collation of these data were identified through structured interview methodology and analysed using qualitative methods. Secondary analysis of QISU data indicated that codes lacking specific information on the injury event were more likely to also have an intent code indicating abuse than those records where there was specific information on the injury event. Codes for abuse appeared in only 1.2% of the 84,765 records analysed. Unintentional injury was the most commonly coded intent (95.3%). In the group with a definite abuse code assigned at triage, 83% linked to a record with DCS and cases where documentation indicated police involvement were significantly more likely to be associated with a DCS record than those without such documentation. In those coded with an unintentional injury code, 22% linked to a DCS record with cases assigned an urgent triage category more likely to link than those with a triage category for resuscitation and children who presented to regional or remote hospitals more likely to link to a DCS record than those presenting to urban hospitals. Twenty-nine per cent of cases with a code indicating possible abuse linked to a DCS record. In documentation that indicated police involvement in the case, a code for unspecified activity when compared to cases with a code indicating involvement in a sporting activity and children less than 12 months of age compared to those in the 13-17 year old age group were all variables significantly associated with linkage to a DCS record. Only 13% of records contained documentation indicating that child abuse and neglect were considered in the diagnosis of the injury despite almost half of the sample having a code of abuse or possible abuse. Doctors and nurses were confident in their knowledge of the process of reporting child maltreatment but less confident about identifying child abuse and neglect and what should be reported. Many were concerned about implications of reporting, for the child and family and for themselves. A number were concerned about the implications of not reporting, mostly for the wellbeing of the child and a few in terms of their legal obligations as mandatory reporters. The outcomes of this research will help improve the knowledge of barriers to effective surveillance of child abuse in emergency departments. This will, in turn, ensure better identification and reporting practises; more reliable official statistical collections and the potential of flagging high-risk cases to ensure adequate departmental responses have been initiated.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the Queensland Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Queensland. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., teachers, doctors, nurses, and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Screening for drugs in oral fluid : illicit drug use and drug driving in a sample of urban and regional Queensland motorists

Police services in a number of Australian states and overseas jurisdictions have begun to implement or consider random road-side drug testing of drivers. This paper outlines research conducted to provide an estimate of the extent of drug driving in a sample of Queensland drivers in regional, rural and metropolitan areas. Oral fluid samples were collected from 2657 Queensland motorists and screened for illicit substances including cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamines, ecstasy, and cocaine. Overall, 3.8% of the sample (n = 101) screened positive for at least one illicit substance, although multiple drugs were identified in a sample of 23 respondents. The most common drugs detected in oral fluid were ecstasy (n = 53), and cannabis (n = 46) followed by amphetamines (n = 23). A key finding was that cannabis was confirmed as the most common self-reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs. drink driving detection rates for one region of the study, revealed a higher detection rate for drug driving (3.8%) vs. drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland roads, and may in fact be more common than drink driving. This paper will further outline the study findings’ and present possible directions for future drug driving research.

Teenagers' perceptions of advertising in the online social networking environment : an exploratory study

This study explores teenager perceptions towards advertising in the online social networking environment. The future of online social networking sites is dependant upon the continued support of advertisers in this new medium, which is linked to the acceptance of advertising on these sites by their targeted audience. This exploratory study used the qualitative research methods of focus groups and in-depth personal interviews to gain insights from the teenager participants. The literature review in Chapter Two examined the previous research into advertising theories, consumer attitudes and issues such as advertising avoidance, advertising as a service and trust and privacy in the online social networking environment. The teenage consumer was also examined as were the influences of social identity theory. From this literature review eleven propositions were formed which provided a structure to the analysis of the research. Chapter Three outlined the multi-method research approach of using focus groups and in-depth interviews. The key findings were outlined in Chapter Four and Chapter Five provides discussion regarding these findings and the implications for theory and advertising practice. The main findings from this study suggest that teenagers have very high levels of advertising avoidance and are sceptical towards advertising on their online social networking sites. They have an inherent distrust of commercial messages in the online social networking environment; however they are extremely trusting with the information that they disclose online. They believe that if their site is classified as private, then the information disclosed on this site is not accessible to anyone. The study explores the reasons behind these views. This research has resulted in the identification of seven motivations behind online social networking use. A new model of advertising avoidance in the online social networking environment is also presented and discussed. This model makes a contribution towards filling the gap in available research on online social networking sites and advertising perception. The findings of this study have also resulted in the identification of the characteristics of online social networking sites as an advertising medium. The newness of online social networking sites coupled with the enthusiastic adoption of online social networking by the teenage demographic means that this exploratory study will be of interest to both academics and practitioners alike.

Differences between journalistic and academic accounts of child sexual abuse in Australia

The paper uses qualitative textual analysis to compare journalistic and academic accounts of child sexual abuse. There are seven main differences. Academic accounts suggest higher levels of neglect, emotional abuse, and physical abuse than sexual abuse in Australia, by contrast, journalistic accounts highlight sexual abuse. Academic accounts suggest that child sexual abuse in Australia is decreasing; journalistic accounts suggest that it is increasing. Academic accounts suggest that the majority of cases of child sexual abuse are perpetrated by family members; journalistic accounts focus on abuse by institutional figures (teachers, priests) or by strangers. Academic accounts have shown that innocent sexual play is a normal part of childhood development; journalistic accounts suggest that any sexual play is either a sign of abuse, or in itself constitutes sexual abuse. Academic accounts suggest that one of the best ways to prevent sexual abuse is for children to receive sex education; journalistic accounts suggest that children finding out about sex leads to sexual abuse. Academic accounts can gather data from the victims; journalistic accounts are excluded from doing so. Academic researchers talk to abusers in order to understand how child sexual abuse can be prevented; journalistic accounts exclude the voices of child sexual abusers.

Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders

Objectives: To determine opinions and experiences of health professionals concerning the management of people with comorbid substance misuse and mental health disorders. Method: We conducted a survey of staff from mental health services and alcohol and drug services across Queensland. Survey items on problems and potential solutions had been generated by focus groups. Results: We analysed responses from 112 staff of alcohol and drug services and 380 mental health staff, representing a return of 79% and 42% respectively of the distributed surveys. One or more issues presented a substantial clinical management problem for 98% of respondents. Needs for increased facilities or services for dual disorder clients figured prominently. These included accommodation or respite care, work and rehabilitation programs, and support groups and resource materials for families. Needs for adolescent dual diagnosis services and after-hours alcohol and drug consultations were also reported. Each of these issues raised substantial problems for over 70% of staff. Another set of problems involved coordination of client care across mental health and alcohol and drug services, including disputes over duty of care. Difficulties with intersectoral liaison were more pronounced for alcohol and drug staff than for mental health. A majority of survey respondents identified 13 solutions as practical. These included routine screening for dual diagnosis at intake, and a range of proposals for closer intersectoral communication such as exchanging client information, developing shared treatment plans, conducting joint case conferences and offering consultation facilities. Conclusions: A wide range of problems for the management of comorbid disorders were identified. While solution of some problems will require resource allocation, many may be addressed by closer liaison between existing services.

Teachers reporting suspected child sexual abuse : results of a three-state study

Over 3000 cases of child sexual abuse are identified every year in Australia, but the real incidence is higher still. As a strategy to identify child sexual abuse, Australian States and Territories have enacted legislation requiring members of selected professions, including teachers, to report suspected cases. In addition, policy-based reporting obligations have been developed by professions, including the teaching profession. These legislative and industry-based developments have occurred in a context of growing awareness of the incidence and consequences of child sexual abuse. Teachers have frequent contact and close relationships with children, and possess expertise in monitoring changes in children’s behaviour. Accordingly, teachers are seen as being well-placed to detect and report suspected child sexual abuse. To date, however, there has been little empirical research into the operation of these reporting duties. The extent of teachers’ awareness of their duties to report child sexual abuse is unknown. Further, there is little evidence about teachers’ past reporting practice. Teachers’ duties to report sexual abuse, especially those in legislation, differ between States, and it is not known whether or how these differences affect reporting practice. This article presents results from the first large-scale Australian survey of teachers in three States with different reporting laws: New South Wales, Queensland, and Western Australia. The results indicate levels of teacher knowledge of reporting duties, reveal evidence about past reporting practice, and provide insights into anticipated future reporting practice and legal compliance. The findings have implications for reform of legislation and policy, training of teachers about the reporting of child sexual abuse, and enhancement of child protection.

Girl in the Shadows and resilience and coping strategies in contemporary young adult fiction

The novel manuscript Girl in the Shadows tells the story of two teenage girls whose friendship, safety and sanity are pushed to the limits when an unexplained phenomenon invades their lives. Sixteen-year-old Tash has everything a teenage girl could want: good looks, brains and freedom from her busy parents. But when she looks into her mirror, a stranger’s face stares back at her. Her best friend Mal believes it’s an evil spirit and enters the world of the supernatural to find answers. But spell books and ouija boards cannot fix a problem that comes from deep within the soul. It will take a journey to the edge of madness for Tash to face the truth inside her heart and see the evil that lurks in her home. And Mal’s love and courage to pull her back into life. The exegesis examines resilience and coping strategies in adolescence, in particular, the relationship of trauma to brain development in children and teenagers. It draws on recent discoveries in neuroscience and psychology to provide a framework to examine the role of coping strategies in building resilience. Within this broader context, it analyses two works of contemporary young adult fiction, Freaky Green Eyes by Joyce Carol Oates and Sonya Hartnett’s Surrender, their use of the split persona as a coping mechanism within young adult fiction and the potential of young adult literature as a tool to help build resilience in teen readers.

Safeguarding rural Australia : addressing masculinity and violence in rural settings. Data report No. 4 - Risky behaviour - misuse of alcohol, illicit drugs, firearms use and abuse, other risky behaviour

This report focuses on our examination of extant data which have been sourced with respect to personally and socially risky behaviour associated with males living in regional and remote Australia . The AIHW (2008: PHE 97:89) defines personally risky behaviour, on the one hand, as working, swimming, boating, driving or operating hazardous machinery while intoxicated with alcohol or an illicit drug. Socially risky behaviour, on the other hand, is defined as creating a public disturbance, damaging property, stealing or verbally or physically abusing someone while intoxicated with alcohol or an illicit drug. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Men's intimate partner abuse and control : reconciling paradoxical masculinities and social contradictions

Intimate partner abuse and control is one of the most common forms of violence against women, and is considered an international problem of social, political, legal and human rights significance. Yet few studies have attempted to understand this problem from the perspective of male perpetrators. This gap is addressed by conducting in-depth interviews with 16 able-bodied men of white European ancestry born and educated in New Zealand or Australia, who have been physically violent and/or emotionally, intellectually, sexually or financially controlling of a live-in female partner. This thesis extends and deepens the dominant ways of thinking about men’s intimate partner abuse by utilising a new theoretical framework compatible with contemporary feminist scholarship. A synthesis of Connell’s theory of masculinities and Bourdieu’s field theory is utilised for the purpose of exploring more nuanced, complex understandings of manliness and men’s relationships with men, women and social structures. Through such an analysis, this thesis finds that men’s perpetration of power and control over women is driven by a need to avoid the stigma of appearing weak. As a consequence, their desire and ability to show love, care and empathy is suppressed in favour of a presumed honourable manliness, and their female partners are used as weapons in the pursuit of symbolic capital in the form of recognition, prestige and acceptance from real and/or imagined men. This research also uncovers the complex interplay between masculine practices and particular social contexts. For example, the norms of practice encountered from those in authority, such as teachers, sports coaches, police, court judges and workplace management, influences the decision making of the men in this study, to use, or not to use, physical violence, psychological abuse and structural control. The principal conclusion is that there is a repertoire of paradoxical masculinities and contradictory social messages available to the men in this study. But gender policing by other men, complicit women and those in authority provides little room for legitimate complexity in masculine practices. Perpetrators in this study reconcile these conflicts of interest by generally avoiding subordinated masculinity and possible ostracism, and instead practicing more heroic hegemonic masculinities by abusing and controlling women and particular other men. This thesis concludes that for intimate partner abuse and control to cease, changes in power structures have to occur at all levels of society.

Teachers reporting child sexual abuse : towards evidence-based reform of law, policy and practice

This report presents the results of the largest study ever conducted into the law, policy and practice of primary school teachers’ reporting of child sexual abuse in New South Wales, Queensland and Western Australia. The study included the largest Australian survey of teachers about reporting sexual abuse, in both government and non-government schools (n=470). Our research has produced evidence-based findings to enhance law, policy and practice about teachers’ reporting of child sexual abuse. The major benefits of our findings and recommendations are to: • Show how the legislation in each State can be improved; • Show how the policies in government and non-government school sectors can be improved; and • Show how teacher training can be improved. These improvements can enhance the already valuable contribution that teachers are making to identify cases of child sexual abuse. Based on the findings of our research, this report proposes solutions to issues in seven key areas of law, policy and practice. These solutions are relevant for State Parliaments, government and non-government educational authorities, and child protection departments. The solutions in each State are practicable, low-cost, and align with current government policy approaches. Implementing these solutions will: • protect more children from sexual abuse; • save cost to governments and society; • develop a professional teacher workforce better equipped for their child protection role; and • protect government and school authorities from legal liability.

The return of manhood suffrage to Queensland, 1863-1872

In 1859, Queensland was separated from New South Wales as an independent colony. At this time the new Governor conspired to ensure the citizens did not inherit the old colonies system of full male suffrage. This was not returned until the Elections Act of 1872. However, the extended franchise was not a result of either democratic values or other ideological intentions. This article will analyse parliamentary debates to show that the revision to full suffrage was a result of administrative expediency driven by an inability to prevent abuse of the limited franchise.