2016 International Congress on Child Abuse and Neglect
Held by the International Society for the Prevention of Child Abuse and Neglect in Calgary, Canada
Good afternoon. It’s a pleasure to be here in Calgary today to speak about the work I have done as Australia’s first National Children’s Commissioner, among so many eminent peers from across the globe.
Before I begin, I would like to acknowledge the Traditional Owners of the land we gather on today, and pay my respects to Elders past, present and future. I would also like to acknowledge the other speakers in this session, country women Susan and Stephanie, and session Chair, Sue Bennett.
My job is to monitor and promote the rights of all children in Australia but I can and do pay particular attention to needs of vulnerable children. In doing this, I report annually to the Australian Parliament about the human rights of children in Australia. To date, I have produced three reports and I am currently finalising my fourth.
Each report has contained the findings of a major investigation and each investigation has been inspired by findings from the previous work. Today, I would like to say a bit about my journey as Children’s Commissioner so far and give particular focus to the intersection of intentional self-harm among children and their experiences of family and domestic violence.
Using a child rights framework
My work is grounded in the Convention on the Rights of the Child (the Convention), and its four guiding principles of: non-discrimination, best interests, survival and development, and the right to be heard.
Issues of intentional self-harm and suicidal behaviour and exposure to family and domestic violence have direct relevance to the rights of children. Of particular relevance is the inherent right to life of every child (article 6(1) of the Convention).
As a State Party to the Convention, Australia has committed to ensuring, to the maximum extent possible, the survival and development of all Australian children (article 6(2)) and to protect children from all forms of violence, abuse, neglect, maltreatment or exploitation (article 19).
Using a rights-based lens also illustrates how these issues disproportionately affect certain groups of children and young people who are subject to discrimination, disadvantage and exclusion.
The UN Committee on the Rights of the Child for example has expressed particular concern about the high rate of suicidal deaths among young people in Australia, particularly Aboriginal and Torres Strait Islander young people. (1)
This graph (below) demonstrates the disturbing overrepresentation of Aboriginal and Torres Strait Islander children in the numbers of deaths due to intentional self-harm, particularly among younger age groups. It was taken from data provided to me by our National Coronial Information System (NCIS) concerning 333 children and young people aged 4 to 17 years who died due to intentional self-harm over a five-year period, around 22% of whom identified as Aboriginal or Torres Strait Islander. (2)
The Committee also expressed concern about the high levels of violence against women and children in Australia, again particularly against Aboriginal and Torres Strait Islander women and children. (3) In 2012-13, Aboriginal and Torres Strait Islander women in Australia were 34.2 times more likely to be hospitalised for non-fatal family violence-related assaults than non-Indigenous females and males. (4)
2013 Children’s Rights Report – The Big Banter
When I began in this role, my first priority was to talk to children about their rights. At the heart of the Convention on the Rights of the Child is the voice of children and hearing what they have to say. So, I went on a listening tour called ‘the Big Banter’ and spoke to over 2,300 children and young people, and many of their advocates, from across Australia.
When I asked children and young people about what would make life better for children in Australia, they spoke a lot about safety and freedom from violence, having strong family and community relationships, getting the help they and their families need when they need it, not being treated unfairly, and being seen, respected and heard. These observations formed the ongoing core thematics for my work.
2014 report – Intentional self-harm and suicidal behaviour
As a result of what people were telling me, my second report in 2014 focused on intentional self-harm and suicidal behaviour in children and young people under the age of 18 years.
Before I began, I knew that intentional self-harm among children and young people was a significant public health challenge for Australia. The issue of youth suicide has not been without investigation and there have been a number of inquiries conducted at a national, and state and territory level. Despite this focus, children, young people and their advocates continued to raise this issue with me, especially with respect to younger children, as an area in need of greater attention.
Statistical overview of intentional self-harm and suicidal behaviour by Australian children and young people
Tragically, the latest data shows that in 2014 intentional self-harm was the leading cause of death among Australian children and young people aged 5 to 17 years (5) with on average one child every week taking their own lives. An additional 50-60 children are admitted to hospital each week in as a result of self-harming behaviours, with hospital data I sourced showing that in the five year period to 2013 there were 18,277 hospitalisations for intentional self-harm in children aged between 3 and 18 years. (6)
Some experts estimate the actual level of self-harm in children and young people to be between 40-100 times greater than the number of incidents resulting in death. (7)
I also requested data from the Kids Helpline, a national call centre for kids in distress. That data revealed that around 40% of calls from children aged 5 to 17 years during 2012 to 2013 related to suicide or self-injury or self-harm. (8)
Data sourced from the NCIS that showed that in the 2007-2012 period, there was a 657% increase in the number of deaths between the 12-13-year age range and the 14-15-year age range.
This tells me that intervention and prevention measures must be targeted at children much earlier, which means working with children aged 12 and under - to build resilience, identify risk and protective factors and encourage help-seeking. (9)
Aboriginal and Torres Strait Islander children: culture, context, risk and protective factors
To emphasise again the stark statistics regarding Aboriginal and Torres Strait Islander children’s suicide rates, Aboriginal and Torres Strait Islander children and young people comprise around 6% of Australia’s youth population, yet the data provided to me by the Australian Bureau of Statistics shows they account for 28.1% of all recorded deaths in children under 18, and around 80% of deaths of children under 11. (10)
It is the case that individual Aboriginal and Torres Strait Islander children disproportionately experience particular risk factors at greater rates and some protective factors at lower levels.
For example, in 2013–14, Aboriginal and Torres Strait Islander children were seven times as likely as non-Indigenous children and young people to be receiving child protection services. (11)
In fact, Aboriginal and Torres Strait Islander children are more likely to be overrepresented in just about every measure of disadvantage. Aboriginal and Torres Strait Islander children are more likely to be exposed to, or victims of, domestic violence; are overrepresented in out-of-home care; have higher levels of disability than non-Indigenous children; poorer health and educational outcomes, much higher contact with justice systems, and are more likely to live in rural and remote areas.
However, the story behind the statistics represent complex, cultural contexts in which Aboriginal children live, relate and grow.
Data I sourced about hospitalisations for intentional self-harm showed that of the 18,277 hospitalisations from 2007 to 2012 of 3-17 year olds, 7 per cent involved Indigenous children, a rate much lower than their rate of suicides. (12)
We don’t know the reasons for this, but this might suggest that many Aboriginal and Torres Strait Islander children and young people do not seek help from health services or hospitals, or that these services are just not accessible to them.
Vulnerability to suicidal ideation and behaviour is increased for children who are exposed to multiple risk factors and who experience a lack of key protective factors.
In the 2014 Report I discussed distal risk factors that predispose a child or young person to the risk of suicidal behaviours; and proximal risk factors which can be the ‘tipping point’ for those already exposed to distal risk factors; and protective factors associated with reduced suicidal and self-harm behaviours. Examples of distal risk factors include:
- mental health problems
- alcohol and drug abuse
- child abuse
- domestic violence
Which, when mixed with proximal factors like, a relationship breakdown, a death in the family or being expelled from school, increases risk exponentially.
There are particular cultural and contextual issues that need to be understood in terms of Aboriginal children.
Professor Pat Dugeon a respected elder from WA has summarised the inter-related contextual factors, both distal and proximal, that contribute to the disproportionate rates of suicidal behaviour and self-harm among Indigenous children as: ‘the brutal history of colonisation, the inter-generational trauma left by Stolen Generations policy, and ongoing racism, combined with the everyday realities in many Aboriginal communities, such as unemployment, poverty, overcrowding, social marginalisation, and higher access to alcohol and drugs.’ (13)
Canadian Indigenous communities appear to have many of the same social and economic problems found in Aboriginal communities in Australia. Remote communities in both countries appear to share some of the most serious disadvantages. And they share disproportionately high rates of suicides, in particular youth suicides in some communities.
In March this year, in Looma, in West Kimberley, a 10-year-old Aboriginal girl took her own life. Newspaper reports say she was one of 19 Aboriginal and Torres Strait Islander people who took their own lives in remote Western Australia in the previous three months.
In the same month, the Indigenous Canadian community of Pimicikamak Cree Nation in northern Manitoba declared their own state of emergency after six suicides in a period of just a few months.
One month later, in April this year, newspapers reported that over 100 people from the Ontario First Nation of Attawapiskat had attempted suicide in the preceding 8 months.
Contagion and clusters
An important contextual risk factor which appears to differ for Aboriginal and Torres Strait Islander children and young people is in relation to contagion and clusters. Broadly speaking, we still know very little about these phenomena.
While in some communities there is a perception rather than evidence of suicide contagion or clusters, in the case of Aboriginal and Torres Strait Islander children and young people, death due to intentional self-harm is indeed more likely to occur in clusters.
It is probable that these children and young people were exposed to multiple sources of risk, and that exposure to other suicides and self-harming in their communities contributes to and heightens this pre-existing risk profile.
It is also likely that in communities where most people speak English as a second, third or fourth language, expressing feelings, and what would encourage help-seeking about those feelings, may not be most effectively done in English.
This ‘Words for Feelings Map’ was produced by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women’s Council from central Australia, to help people find the right words to express emotional states. I used this in my 2014 report and in case anyone is wondering it can be purchased on their website!
Given all this, it is likely that traditional methods and types of data collection, evaluation and research needs rethinking to accommodate culture and context, to gain a deeper understanding of what children are experiencing, and to build effective responses and facilitate help seeking.
During the course of my investigation I was consistently alerted to the relationship between domestic and family violence and suicidal behaviour in Indigenous communities. In particular, I heard about the disproportionate exposure to lateral violence which Aboriginal and Torres Strait Islander children experience and witness in community.
The NPY Lands Women's Council told me that data collected over the past three years in the NPY region of Central Australia showed that, ‘domestic and family violence is the most significant factor that is contributing to these incidents [that is, suicides], along with prior exposure to suicide in close family members’. (14)
A 2014 report by the Australian Crime Commission supported this view, when it concluded its eight year investigation of abuse in Aboriginal and Torres Strait Islander communities and reported that ‘there are clear links between suicide and self-harm and domestic violence’. (15)
Findings and recommendations
To summarise, in this examination, I looked at:
- common barriers to children seeking help,
- the issue of ‘help negation’ – where children and adolescents with higher levels of distress demonstrate lower levels of help seeking,
- risk, resilience and ‘protective factors’, and
- what we know about intentional self-harm and suicidal behaviour in vulnerable groups of children.
As a result of this work I primarily found that too much continues to be unknown about children and young people who engage in intentional self-harm and suicidal behaviour, from prevalence to prevention.
To address this, I made a range of recommendations to lift the quality, consistency and breadth of data collection and research in relation to child self-harm and suicide. And while progress seems glacially slow, progress is happening.
For example the Australian Government has:
- commissioned a National Research Priorities and Implementation Framework for youth mental health research,
- sponsored the development of a National Minimum Data Set for suicide, and
- added data tables to the published Australian Bureau of Statics’ data on causes of death, for the first time including data on suicide deaths of children aged 5 to 17 years. (16) ABS has also promised to release regular data on hospitalisations for self-harm.
2015 report – the impact of family and domestic violence on children
The issues raised during my 2014 examination led me in 2015 to explore the impact of family and domestic violence on children and young people, and its potential intersection on self-harm rates among children.
The UN Committee on the Rights of the Child had already explicitly recognised intentional self-harm in children and young people as a health consequence from exposure to violence and maltreatment. (17)
Family and domestic violence is seen as a distal risk factor, that predisposes a child or young person to risk. It can also negatively impact upon protective factors, like parent and family connectedness and support, or help seeking, that help reduce the risk of intentional self-harm and suicidal behaviour in children and young people.
Previously unpublished data provided by the Kids Helpline for my 2014 Report showed that, of the children and young people who called Kids Helpline whose main concern was suicide or self-harm, over 17% also had additional concerns about their relationship with their parents or other family members. (18)
A number of stakeholders also highlighted the presence of family and domestic violence in the lives of children and young people they had come into contact with who had committed or had attempted to commit suicide. (19)
A police officer at one of the roundtables convened for this project told me that ‘every child who suicided in the last 12 months came from a domestic violence family’. (20)
So, it became increasingly clear that exposure to, and being a victim of, family and domestic violence is a particular risk factor for suicide and self-harm in children – it is another intersection if you like; another key contextual factor which we need to understand and address.
What we know about children’s experiences of family and domestic violence
Family and domestic violence is a big problem in Australia, as it is for many other countries, despite our relative wealth.
While there is no reliable prevalence data, a 2012 Personal Safety Survey (PSS) estimated that 17% of women and 5% of men in Australia over 15 years of age have experienced violence by a partner. (21) The survey also revealed that much of the partner violence reported by women and men is seen or heard by children in their care. (22)
It is important to remember that children are not just bystanders, but are also direct victims of family violence.
Through my investigation I was able to dig deeper into the survey results to find out more about what adults recall of their experiences of violence when they were children.
This revealed that approximately 1.4 million men and women experienced physical violence before the age of 15, and over 600,000 experienced sexual abuse, where the perpetrator was a family member. (23)
I was also able to source ABS Victims of crime data for 2010-2013 (available for some states only) which indicated that there were 14,048 child victims of physical assaults, and 12,073 child victims of sexual assault, where the perpetrator was a family member. (24)
The data showed that children aged 0 to 9 years accounted for a significant proportion of child victims who reported that the perpetrator was their parent. (25) This data also revealed a spike in assaults by siblings and intimate teen male partners. (26)
And of course children are not just injured through assaults by family members. In the most tragic cases children are killed in the context of family and domestic violence. In Australia for example, statistics show that one child every fortnight is killed as a result of filicide, (27) 51% of these children were between one and nine years of age. (28)
Information from child protection data sets help to further build the picture of children’s exposure to violence and show that family violence is a major driver of children into out of home care systems.
In 2014-15, 42,457 children were the subjects of substantiated child protection notifications in Australia. 43% concerned emotional abuse (which frequently involves exposure to domestic violence), 26% concerned neglect, 18% concerned physical abuse and 13% concerned sexual abuse. (29)
Research also tells us that family violence and child abuse are interrelated, with one study estimating that domestic violence is present in 55% percent of physical abuse cases and 40% per cent of sexual abuse cases against children. (30)
Homelessness data reinforce the deep impact of family violence on children, with according to available information more than one quarter of those assisted by specialist homelessness services were children, with family violence reported as the reason for seeking help in around 24% of cases. (31)
The Kids Helpline provide me with data about contacts concerning family and domestic violence during 2014/15. Of these 40% related to exposure to violence between parents, or between a parent and a partner or ex-partner. (32)
42% were made by children aged 13 years and under. Key co-concerns raised by children related to self-harm and suicide and physical and emotional child abuse. (33) 17% of children were assessed as having mental health issues.
14% were from children from culturally and linguistically diverse backgrounds, and only 2% from Aboriginal or Torres Strait Islander children. (34)
14% concerned sibling violence. (35) In approximately half of the contacts that included detailed case notes, children reported that their parent was aware of the violence, but was either unwilling or unable to prevent it. In some contacts, it was clear that parents had attempted to intervene, but were either scared themselves or ineffectual and took no further action. Some parents actively ignored or downplayed the severity of the issue.
Findings and recommendations
Children are witnesses, bystanders and direct victims of violence in the home. The physical and emotional injuries children sustain are both immediate and far-reaching, and the experience of children witnessing or being exposed to family and domestic violence has been increasingly recognised as a form of child abuse.
Importantly, children’s involvement in domestic violence is not ‘peripheral’ – it is an experience of being a victim of violence, in itself, and needs to be recognised as such, and better and more widely recorded and flagged across services and systems.
In addition to providing further information regarding the prevalence and impact of family and domestic violence experienced by children, my examination enabled me to identify some of the gaps in our understanding and areas that warrant further attention.
In the Australian context in particular, there is, as with suicide and self-harm, significant work to do to develop reliable national data about the prevalence of family and domestic violence perpetrated around and against children.
Such data gaps undermine our ability to understand the full impact of family and domestic violence on children. At present it is very difficult to build a national picture about children impacted by family and domestic violence, nor identify the most effective ways to address it.
A key barrier concerns definitional challenges. Across Australia, there are no consistent definitions, legal frameworks or common methods are used to identify family and domestic violence.
It is encouraging that efforts are underway to remedy this. For example, the Australian Bureau of Statistics, our premier statistical agency, has been tasked with developing a national data collection and reporting framework in relation to family violence. This will hopefully lead to a common language and definitional framework which can be used across Australian jurisdictions to record and measure family, domestic and sexual violence. But any definitional and monitoring system established must have the capacity to record the experiences of children as separate unique entries, and not just as part as an adult entry.
Further research is also needed in other areas, to adequately understand children’s experiences of family and domestic violence, including:
- breakdown on the age and circumstances of child victims
- the prevalence of family and domestic violence during pregnancy
- the prevalence and nature of sibling violence, and
- family and domestic violence experienced by female young people aged 15-17, perpetrated by their partners
It was evident from these two examinations was that, while there are clear links between intentional self-harm and suicidal behaviour in children and young people and their experiences of family and domestic violence, much remains unknown about this very vulnerable group.
One of the most significant common issues that emerged across these two projects was inadequate data collection and focused research involving children and young people themselves.
If we don’t measure these areas, or measure them well, we will never have the understanding we need to develop comprehensive and targeted policy responses. Nor will we gain the momentum needed to help the children who sit at the intersection of family and domestic violence and self-harm.
As highlighted by the UN Committee on the Rights of the Child throughout its recommendations to Australia, effective monitoring of what is happening to children is critical to the full realisation of their rights. It becomes a mouthpiece for them and their experiences, one of the many ways to tell their stories and to honour their right to be heard, visible, valued and respected.
As we have understood here today, silencing children never serves to protect them, it only serves to protect the systems, practices and people that ignore, neglect or deliberatively breach children's rights.
In the words of Nelson Mandela, 'Safety and security don’t just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free from violence and fear'.
(1) Committee on the Rights of the Child, Concluding Observations of the Committee on the Rights of the Child: Australia, 60th sess, UN Doc CRC/C/AUS/CO/4 (28 August 2012) .
(2) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 124, 151.
(3) Committee on the Rights of the Child, Concluding Observations of the Committee on the Rights of the Child: Australia, 60th sess, UN Doc CRC/C/AUS/CO/4 (28 August 2012) .
(4) Productivity Commission, Overcoming Indigenous Disadvantage – Key Indicators 2014 (2014) 95, cited in Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 103.
(5) Australian Bureau of Statistics, ‘Intentional self-harm by age’, Causes of Death, Australia, 2014, ABS cat. no. 3303.0 (8 March 2016).
(6) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 133.
(7) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 60.
(8) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 159.
(9) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 124, 150.
(10) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 124, 151.
(11) Australian Institute of Health and Welfare, Child Protection Australia 2013-14 (2015) Cat. no. CWS 52, 15.
(12) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 133.
(13) Mick Gooda and Pat Dudgeon, People Culture Environment, The Elders’ Report into Preventing Indigenous Self-harm & Youth Suicide (2014) 6.
(14) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 77.
(15) Australian Crime Commission, The Final Report of the National Indigenous Intelligence Task Force 2006–2014 (2014) 11.
(16) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 28.
(17) Committee on the Rights of the Child, Concluding Observations of the Committee on the Rights of the Child: Australia, 60th sess, UN Doc CRC/C/AUS/CO/4 (28 August 2012) .
(18) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 169, Table 5; 144, Table 7.
(19) Australian Human Rights Commission, Children’s Rights Report 2014 (2014) 103.
(20) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 99.
(21) Australian Bureau of Statistics, ‘Experience of Partner Violence’, Personal Safety, Australia, 2012, cat. no. 4906.0 (11 December 2013).
(22) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 102.
(23) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 244-50.
(24) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 110.
(25) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 154.
(26) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 160.
(27) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 104.
(28) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 104.
(29) Australian Institute for Health and Welfare, Child protection Australia 2014-2015 (2016) 22.
(30) Kelly Richards, ‘Children’s exposure to domestic violence in Australia’ (Research Paper No 419, Trends and Issues in Crime and Criminal Justice, Australian Institute of Criminology, 2011) 2.
(31) Australian Institute of Health and Welfare, Specialist Homelessness Services 2013–14, (2014) Cat No. HOU 276, 15.
(32) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 112.
(33) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 255.
(34) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 255.
(35) Australian Human Rights Commission, Children’s Rights Report 2015 (2015) 161.