Allan, K., & Lefebvre, R. (2012). Mental or Emotional Harm by Primary Substantiated Maltreatment. Based on, Trocmé, N., Fallon, B., MacLaurin, B., Sinha, V., Black, T., Fast, E. et al. (2010). Chapter 4: Characteristics of Substantiated Maltreatment. In Public Health Agency of Canada (Ed.), Canadian Incidence Study of Reported Child Abuse and Neglect-2008: Major Findings. Ottawa: PHAC. Canadian Child Welfare Research Portal: Toronto, ON.
Introduction
The Canadian Incidence Study of Reported Child Abuse and Neglect-2008 (CIS-2008) is the third nation-wide study to examine the incidence of reported child maltreatment and the characteristics of children and families investigated by child welfare authorities in Canada. In addition to the tables presented in the Major Finding report [fn value=1]Public Health Agency of Canada (PHAC). (2010). Canadian incidence study of reported child abuse and neglect, 2008: Major findings. Ottawa: Authors.[/fn], the Supplementary Tables Information Sheet Series describes key child, household and investigation characteristics by primary category of substantiated maltreatment including confirmed risk[fn value=2]The mental or emotional harm variable was only collected for maltreatment investigations.[/fn]. This Information Sheet examines the presence of mental or emotional harm as a result of maltreatment.
Findings
There were an estimated 174, 411 maltreatment investigations conducted in Canada in 2008, of which, 49% were substantiated (85,440 investigations). Workers were asked to indicate whether the child was showing signs of mental or emotional harm (e.g., nightmares, bed wetting or social withdrawal) following the maltreatment incident(s).
Figure 1 displays mental or emotional harm by primary category of substantiated maltreatment. Mental or emotional harm was noted in 47% of substantiated sexual abuse investigations, 36% of substantiated emotional maltreatment investigations, 32% of substantiated neglect investigations and in 26% of substantiated physical abuse and substantiated intimate partner violence (IPV) investigations.
Figure 1: Mental or emotional harm by primary category of substantiated maltreatment in Canada in 2008
In investigations where mental or emotional harm was noted, workers were asked to indicate whether the child required treatment to manage the symptoms of this harm. In 94% of substantiated sexual abuse investigations where mental or emotional harm was noted, the harm was severe enough to require therapeutic treatment. This is in contrast to 63% of emotional maltreatment investigations, 61% of neglect investigations, 59% of exposure to intimate partner violence (IPV) and 51% of physical abuse investigations noting mental or emotional harm (as shown in Figure 2).
Figure 2: Therapeutic treatment required for noted mental or emotional harm by primary category of substantiated maltreatment in Canada in 2008
Background to the CIS-2008
Responsibility for protecting and supporting children at risk of abuse and neglect falls under the jurisdiction of the 13 Canadian provinces and territories and a system of Aboriginal child welfare agencies which have increasing responsibility for protecting and supporting Aboriginal children. Because of variations in the types of situations that each jurisdiction includes under its child welfare mandate as well as differences in the way service statistics are kept, it is difficult to obtain a nation-wide profile of the children and families receiving child welfare services. The Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) is designed to provide such a profile by collecting information on a periodic basis from every jurisdiction using a standardized set of definitions. With core funding from the Public Health Agency of Canada and in-kind and financial support from a consortium of federal, provincial, territorial, Aboriginal and academic stakeholders, the CIS-2008 is the third nation-wide study of the incidence and characteristics of investigated child abuse and neglect across Canada.
Methodology
The CIS-2008 used a multi-stage sampling design to select a representative sample of 112 child welfare service agencies in Canada and then to select a sample of cases within these agencies. Information was collected directly from child protection workers on a representative sample of 15,980 child protection investigations conducted during a three-month sampling period in the fall of 2008. This sample was weighted to reflect provincial annual estimates.
For maltreatment investigations, information was collected regarding the primary form of maltreatment investigated as well as the level of substantiation for that maltreatment. Thirty-two forms of maltreatment were listed on the data collection instrument, and these were collapsed into five broad categories: physical abuse (e.g., hit with hand), sexual abuse (e.g., exploitation), neglect (e.g., educational neglect), emotional maltreatment (e.g., verbal abuse or belittling), and exposure to intimate partner violence (e.g., direct witness to physical violence). Workers listed the primary concern for the investigation, and could also list secondary and tertiary concerns.
For each form of maltreatment listed, workers assigned a level of substantiation. Maltreatment could be substantiated (i.e., the balance of evidence indicated that an incident of maltreatment had occurred), suspected (i.e., maltreatment could not be confirmed nor ruled out) or unfounded (i.e., the balance of evidence indicated that an incident of maltreatment had not occurred).
A detailed presentation of the study methodology and of the definitions of each variable is available at www.cwrp.ca/sites/default/files/publications/en/CIS-2008_StudyMethods.pdf.
Limitations of the CIS-2008
The CIS collects information directly child welfare workers at the point when they completed their initial investigation of a report of possible child abuse or neglect, or risk of future maltreatment. Therefore, the scope of the study is limited to the type of information available to them at that point. The CIS does not include information about unreported maltreatment nor about cases that were investigated only by the police. Also, reports that were made to child welfare authorities but were screened out (not opened for investigation) were not included. Similarly, reports on cases currently open at the time of case selection were not included. The study did not track longer-term service events that occurred beyond the initial investigation.
Three limitations to estimation method used to derive annual estimated should also be noted. The agency size correction uses child population as a proxy for agency size; this does not account for variations in per capita investigation rates across agencies in the same strata. The annualization weight corrects for seasonal fluctuation in the volume of investigations, but it does not correct for seasonal variations in types of investigations conducted. Finally, the annualization weight includes cases that were investigated more than once in the year as a result of the case being re-opened following a first investigation completed earlier in the same year. Accordingly, the weighted annual estimates represent the child maltreatment-related investigations, rather than investigated children.
Comparisons across CIS reports must be made with caution. The forms of maltreatment tracked by each cycle were modified to take into account changes in investigation mandates and practices. Comparisons across cycles must in particular take into consideration the fact that the CIS-2008 was the first to explicitly track risk-only investigations. In addition, readers are cautioned to avoid making direct comparisons with provincial and First Nations oversampling report because of differences in the way national and oversampling estimates are derived.