Jay Kuten: Paper not strong on child abuse prevention

In the 1960s, fresh out of training in child psychiatry, I fell into some luck. I had volunteered to serve in the US Air Force which had decided to establish a programme in child psychiatry.

As the first psychiatrist to head the programme, I was encouraged to design it, as there was no prior Air Force experience to create guidelines for such a service.

I elected to develop a family-centred service for families of servicemen and women. While that approach would be very mainstream today, at the time, with the psychoanalytic model in ascendancy, the view of the family as the source of problems and their solution was far from usual.

I tell this to offer not just my bona fides but the fact that I've invested in issues around families, such as child abuse, for nearly 50 years. That's where I'm coming from as I look at Paula Bennett's white paper on child abuse.

What is praiseworthy about her plan is that there is renewed awareness of the fact that we have a problem with intra-familial violence. What's not so great is that the basic approach taken by a conservative government is one that deviates generally from conservative principles.

The approach will ensure a bloat in bureaucracy, involve expenditure of much taxpayer money, ultimately to little effect - if by successful problem solving we mean to cut down on the annual rate of child abuse, currently 10 deaths, 15 serious injuries and 21,215 other types of abuse.

This is a strong rebuke, but what else is warranted for a plan that essentially operates at the tertiary level - that is, after, not before, the abuse occurs? This white paper locks the barn door after the horse is gone. Its emphasis is on interdiction, not prevention. While better co-ordination between agencies such as CYF and Winz, Health Care and police is desirable, the basic thrust is toward creating a bigger pool of dobbers-in and an ultimate disposition such as termination of parental rights that further disrupts the family.

It's a big-stick approach and there are few if any carrots.

The idea of prevention gets a passing mention in the white paper, despite pleas of responders in the green paper submission, several of whom lobbied for a kinder, gentler approach. The fact is, prevention programmes do exist and have already been trialled successfully in Canada and in New Zealand.

Childhood bullying and adult child abuse exist on a continuum in which the common thread is relative deficiency of empathy. One programme for enhancing empathy is called Roots of Empathy and consists of introduction to early grade children of an infant (with mother in attendance) to the classroom on a regular basis, allowing children to watch a more vulnerable being develop over a period of time. The programme, which has been used in more than 60 schools in Auckland, Wellington, Christchurch and Rotorua, works to diminish bullying and ultimately to generate a greater sense of identification with the needs of a smaller being, the core of empathy. That's putting future parents on the right road.

Another approach consists of early incorporation into curricula of parenting programmes to teach potential young mothers and fathers skills necessary to care for a child as well as coping with frustration without resort to violent words or deeds.

Thorough sex education and the availability of contraceptive education helps prevent teen pregnancy, another source of the problem.

At-risk families can be identified. Most serious are single mothers with resident non-paternal boyfriends. Here, mentoring - such as Whanau Toko I Te Ora, a big-sister approach staffed by older mothers from the community of those at risk - can make a difference.

The absence of prevention in Ms Bennett's approach means we'll all share the grief of 21,240 future tragedies - tragedies we can avert at much less cost in money and life and limb.