Child protection: rough justice

The vilification of social workers after the death of Baby P shows the public ignorance of the challenges they face…

When we learned the terrible truth about Harold Shipman murdering his patients, I suspect most of us didn’t think our own doctor was a potential mass murderer. But when a social worker is thought to have missed something when investigating a child protection allegation, the impression given by some of the media is that all social workers are incompetent.

The reasons for this are complex, but they include two key features. Firstly, we all know doctors, teachers, nurses, even lawyers, personally; but most of us have never met a social worker. Secondly, and as a direct consequence, most of us have little idea of what social workers really do, especially in the field of child protection. Many believe—erroneously—that they can enter houses against occupants’ wishes, demand to see children and, if denied access, remove them to be examined by medical experts.

It would be inappropriate to comment on the situation of Sharon Shoesmith, former director of social services in Haringey – except to reflect upon the anger and hate directed towards her after the death of Baby P in her borough. She told Radio 4’s Woman’s Hour that she had considered suicide, and that the police had warned her not to stand too near the platform at a tube station. In some respects Shoesmith seemed more despised than Shipman.

The real problem about doing child protection social work is that the signs and symptoms used to assess abuse are notoriously unreliable as future predictors. After studying 350 Serious Case Reviews of children who died or had been seriously abused at the hands of those meant to care for them, the researchers concluded that most cases were too complex for serious injury and death to be predicted. To witness domestic violence, serious drug or alcohol abuse is never optimal for children. But if we were to remove every child where this happened it would result in a huge increase in residential care. And most children would be deeply unhappy to have been taken away.

Fortunately, there are ways of knowing that a child is being abused which do not rely on visible signs, such as bruising. Where there are irrefutable signs, it is vital to act quickly; but in many cases of abuse and neglect there are no signs, because some abusers are good at covering their tracks. For example, sexual abuse is rarely accompanied by tell-tale physical indicators that a social worker would see during a visit. Similarly, emotional abuse involving persistent derogation or humiliation seldom produces unambiguous accompanying outward signs.

Experienced social workers know that asking a child if they have been abused is unlikely to produce an accurate response, because the child may have been threatened with violence if they talk to anyone. And even the most inexperienced practitioner will be only too aware that many children are not able to speak about their unimaginable terror and sorrow. So what can social workers do to be more confident in spotting abuse and neglect? The key lies in understanding that it is the way the child’s mind operates which holds the clues. When children are abused by those who are meant to love them, their brain “protects” them by creating a series of internal messages that effectively say: “This must be happening because I am unworthy and unlovable.” It is rare that a child being abused—especially in cases of sexual and emotional abuse—would actually blame the adult. And here is the true horror of child maltreatment: not only do these children suffer the abuse, they are very likely to believe it was their fault.

But it is precisely such pernicious and powerful internal messages that, if the social worker is trained to understand and recognise them, can provide some of the evidence needed to protect a child. A recent report on child protection by Lord Laming contains many sound recommendations. But for me, the real test of its success will be when child protection workers are supported in the difficult work they do, both by manageable systems and sound supervision, and by a media that truly understands what they do – or at least does not seek to undermine it.

David Shemmings is chair of social work at the University of Kent