A Child Psychiatrist’s View on the Cases of Child Abuse Reported in the Media in South Korea
Seung Min Bae*
Department of Psychiatry, Gachon university Gil Medical Center, South Korea
Submission: February 17, 2017; Published: April 03, 2017
*Corresponding author: Seung Min Bae, Department of Psychiatry, Gachon university Gil Medical Center, South Korea.
How to cite this article: Seung M B. A Child Psychiatrist’s View on the Cases of Child Abuse Reported in the Media in South Korea. Acad J Ped Neonatol. 2017; 4(2): 555692. DOI: 10.19080/AJPN.2017.04.555692
Abstract
Child abuse is a serious event that can affect not only the victimized child but also the family, the community, and even the whole society. Relatively lack of practices in this field, compared to other medical expertise, contributes to the situation in South Korea. Recent series of child abuse events has become a nationwide issue, and I would like to share the experiences I had as a clinician and adviser in these cases with colleagues around the world.
Keywords: Child abuse; Child maltreatment; Child battering; Abuse
Introduction
In other OECD countries, the roles of pediatric experts in preventing and responding to child abuse have been well defined, and a wide range of educations and seminars are being actively organized [1-5]. Nevertheless, since the tragic event, clinicians’ awareness, and the participation of social role in child abuse are coming to fore now in South Korea. The purpose of this paper is to organize the activities of child psychiatrists in child abuse crimes to help establish academic and practical applications in the future.
Child abuse is a serious social crime not only restricted to an individual and family, but also to a community and furthermore historical problem having intergenerational transfer of violence and unhappiness [1-5]. Therefore, treating and stopping the tragedy of such violence and participation of related experts who can acts accurately as a professional and preventive role is significant at this point [1,3,4]. Additionally, child abuse is a personal and social pathological phenomenon; a problem involved with physical and psychological abnormalities, and is generally associated with family dysfunction [4]. Due to a complex dynamic involvement of personal, psychosocial and environmental factors, detect and diagnose of child abuse is highly difficult [3,4]. However, paradoxically, the early detection and diagnosis is essential due to the failure of early detection ultimately leads to increase of prevalence and mortality rate in chronic abuses and other diseases [3,4]. If these abuses remain unexposed or expose but no proper response is followed, one third of victims will continue to re victimized and eventually 5-10% of them will lead to death [6]. Moreover child abuse is generally not a single form as already known as well, and clinically classified in to four types. Neglect is the most frequent type of child abuse which consist 80 % of child abuse, followed by physical abuse, sexual abuse and emotional abuse [3,4,6].
According to the study, the first reason for medical staff miss detecting child abuse, is due to lack of education during medical training on child abuse and assessment, secondly, hesitation of declaration, and finally, fear of losing the patient (guardian fleeing by not bringing patient to the medical facility or taking them to another physician who would not notice). For this reason, only 10 percent of physicians report adequate abuse even if they have identified child abuse [7]. Thus, it is the academic circle’s recommendation that, at least up to school age, children should be assessed under a health-related system in a regular and structured form [3]. At this point, the author suggests that the utilization of the infant health screening system(provided by the National Health Insurance Corporation to the children under 6 years old, a total of 7 times (4-6 months, 9-12 months, 18-24 months, 30-36 months, 42-48 months, 54-60 months, 66- 71 months), the stage-specific health screening program since 2007) [8] in South Korea should be strengthened in this regard, and that it should be accompanied by comprehensive and accurate education and guidance of physician practicing child abuse.
As many experts in the field have emphasized, majority of child abuse is caused by a biological parent or primary caregiver, who is not a stranger [1,3,7]. In such a case, even if the child completes the report through a difficult process, large number of family members force child to perjury to defend and protect the perpetrator, and scorn and frighten child in a situation where physician and jurisdictional authority have no control [4]. Ultimately, professionals who are dealing with child abuse should be seriously aware of the possibility that not only the perpetrator but also the surrounding families could be potentially threat to the child [1,2,4]. In addition, it is extremely urgent to build a system that can protect the victim from these potential threats. In many cases, issues between family members are assumed not as a crime but as a blatant blow, and it is often difficult for professional intervention to take a place. This is more prominent culture in Asia, including Korea [9]. It also should be considered that the separation of perpetrator leads to another state where proper guardian is absent and child is neglected. Many children may not be able to report violence because of the perpetrators ‘ threat, but also to a fear of being neglected from possibility of families tearing apart followed by the report [4,9].
Therefore, concern of making an environment that can protect the child temporarily or in a long term depending on the situation should be held by the whole society. Despite these problems, tragically, under low and limited circumstances child could be isolated from the perpetrator followed by the abuse report [4]. In many cases of child abuse, even after reporting, the fast involvement of the judiciary is often missed due to the limitations of various resources, and even when intervening, perpetrator is often let off with simple warning and proper post-processing is not applied[4,6]. In this case, the perpetrators can become more threatful to a child with dangerous idea of, “Even if I am reported, it is just for the moment and can be overcome easily.” or “I should not give a child a chance to report me “[4,9]. Therefore, not only law-enforcement authorities but also experts in child abuse should evaluate the likelihood of reoffenders [4]. Considering the complexity and various difficulties of child abuse cases, the recent national interested incidents such as the barefoot mass exodus of abused children [10], child abusing at a day care facilities [11] has been dealt relatively systematically and professionally. The biggest reason for such comparatively positive progress is due to the spotlight of mass media along with the visual stimulus of the two events, such as CCTVs, and attraction of massive public’s interest [10,11].
However, looking at the child abuse cases at other daycare center at the same period, the victim’s family were blamed by other guardians and caregivers due to the specificity of a daycare center, (because of an idea that other guardians thinking the cause abuse came from victimized child not a childcare teacher’s since other children were not abused, the victim’s family exaggerated a case, or due to the inconveniences that other children became unable to use the daycare center) and were not only unable to take appropriate legislative process but also child’s safety and their psychological protection were put at stake [12].
These recent incidents showed a tragic reality that perception of child abuse differentiates greatly even between parents of same positioning, and these perceptions differentiate even greater between experts and non-experts. Experiencing these cases as clinicians and legal advisors, the importance of sharing these experiences with other specialists, and to communicate with experts from other areas within the relevant agencies involving child issues, were perceived. Child sexual abuse and pedophilia have become known to the public relatively recently and the sexual education in the regular education program has started to be achieved [12]. As well as to the expert group associated with the child, the intensive publicity and education of child abuse toward public is necessarily needed is the conclusion of the author who has recently addressed domestic child abuse cases.
Conclusion
As mentioned earlier, child abuse is a tragic case confined not just to some children, but it is a widespread social crime that also affects family, surrounding community, and even the immediate and the future generation. Therefore, even if it is difficult and limited to develop a healthy, society the severity and desperation of child abuse should not be overlooked, and to prevent, early detect and realize proper social justice, expert and the whole society should put interest. Under this direction, the author would like to conclude some suggestions outlined in the text.
a. Enhancement in public publicity, lecture and education for the public.
b. Practical use of infant health screening system.
c. Multidisciplinary cooperation through medical-judicialrelated academic seminars.
d. Development of practical capacity and improvement of necessary legal system so that existing legislation on child abuse law becomes realized.
e. Increase in number of specialists and police force and continuous development of capability in the child abuse area.
References
- Flaherty EG, Stirling J (2010) Clinical report-the pediatrician’s role in child maltreatment prevention. Pediatrics 126(4): 833-841.
- https://www.nice.org.uk/guidance/cg89
- Marchand J, Deneyer M, Vandenplas Y (2012) Detection, diagnosis, and prevention of child abuse: the role of the pediatrician. Eur J Pediatr 171(1): 17-23.
- American Academy of Child and Adolescent Psychiatry (1997) Practical parameters for the forensic evaluation of children and adolescents who may have been physically or sexually abused. J Am Acad Child Adolesc Psychiatry 36: 423-442.
- Violence campaign, calls for changes in medical school curricula. J Am Med Assoc 267:3131.
- Koc F, Oral R, Butteries R (2014) Missed cases of multiple forms of child abuse and neglect. Int J Psychiatry Med 47(2):131-139.
- Gunn VL, Hickson GB, Cooper WO (2005) Factors affecting pediatricians’ reporting of suspected child maltreatment. Ambul Pediatr 5(2): 96- 101.
- Ahn DH (2005) Child abuse. In: Hong GE, Korean (Eds.), Textbook of Child Psychiatry. Jungang, Seoul, Korea, pp. 474-488.
- National Child Protection Agency. http://korea1391.go.kr/new/bbs/ board (1727) Accessed: 2015.
- National Child Protection Agency. http://korea1391.go.kr/new/bbs/ board (1506) Accessed:, 2015.
- National Child Protection Agency. http://korea1391.go.kr/new/bbs/ board (1500) Accessed: 2015
- Ministry of Education. http://www.moe.go.kr/board (49870) Accessed: 2017.