Children at Risk
Breaking the Cycle of Abuse

The state has seen a 30 percent increase in child abuse cases in the last seven years.
Services for children at risk and their families have simply not been able to keep up.

by Jack Kelly

Kailua-Kona: Michele was first sexually abused when she was in second grade - by a distant family friend. She told the police, but nothing ever happened. Life at home was a brooding hell as her gambling-addicted mother constantly subjected her to severe criticism, insults, and frequent beatings. When she was in tenth grade her best friend anonymously tipped the police about the treatment Michele was enduring at home, she told the Hawai'i Island Journal.

April is Child Abuse Awareness Month. Why should we want to be aware of child abuse? It's the kind of subject we would rather sweep under the rug.

How could anyone abuse, hit or mistreat a helpless child? Hard to understand, but it happens every day and every night. There are children in our community who go to bed in fear, unsure of what might come their way.

Parents out of control. Drugs, poverty, depression, regression. The violence of it all is like an open sore on a society that allows its youngest members to become the victims of all its ills.

Child Protective Services removed Michele from her mother's home and placed her in foster care. But for some reason, six months later she was put back in her mother's home. Michele can't remember if the CPS worker ever came back to check on her. The beatings continued. According to Michele, she and her father had a great relationship. He adored her and her three siblings. When he was home he showered his children with love but due to his work he wasn't home much.

"The intensity of abuse cases has skyrocketed," says Hawai'i Island attorney Elizabeth Croom, who works extensively with women and children who have been victims of abuse. "Used to be you'd have a case of physical abuse and another one of sexual abuse but now you run the whole gamut of abuse within one family. You have children coming out of these hellholes with all kinds of psychological problems. Parents juiced up on "ice," doing strange things around the house. The kids become all sexualized at very young ages. The ice is ripping our society apart."
"Bottom line is it's all about poverty," says Jude Lyon, Development Director of Family Support Services of West Hawai'i (FSSWH). "Poverty and drugs."

Statewide, nearly 4,000 confirmed reports of child abuse were investigated in 2002, growing from 2,500 in 1996, according to the Department of Human Services Child Welfare Services, a division of the State Health Department. The department has had a 30 percent increase in caseloads over the past seven years.

The incidence of child abuse in South Kona is the highest in the state.

The incidence of Hawaiians addicted to ice and involved in the system due to abusive relationships is the highest of any racial subgroup. Forty-three percent of all reported incidents involve Hawaiian or part-Hawaiian families.

The loss of their relationship to their culture, the loss of their land and the ways of their grandparents, the loss of their ability to feed themselves and practice their culture is devastating to the Hawaiian population. This scourge is taking out a whole generation, a gap that will never be filled.

The children of immigrants who worked the cane for a hundred years also bear the perception that their lives are a dead-end street. The towns that they grew up in are dying as the old folks pass on and the children flee. The big sugar companies, the large landowners, take no responsibility. After 200 years as the caretaker of the plantation people, they just packed up and left town. The family unit is in shambles.

In the gated communities, behind the walls, the evidence of abuse is harder to unveil. It is often more a psychological abuse, more subtle, but there still. Economic power keeps the results behind the closed door of the private practitioners - out of the system and out of the public eye.

Under the Law
Chapter 350 Hawai'i Revised Statutes requires that "any licensed or registered professional of the healing arts and any health-related occupation who examines, attends, treats, or provides other professional or specialized services who has reason to believe that child abuse or neglect has occurred or that there exists a substantial risk that child abuse or neglect may occur in the reasonably foreseeable future, shall immediately report the matter orally to the department of Human Services or to the Police Department."

Under the rules, the verbal report must be documented by a written report by the department or the police and all records including medical records and reports must be provided.

The specific forms of child abuse or neglect enumerated under the law are physical abuse, neglect, medical neglect, sexual abuse, psychological abuse and threatened harm.

Child Protective Services is an arm of the Department of Human Services mandated to investigate and follow up on any report of possible harm to any child under the age of 18. Their jurisdiction stems from the Family Court, which has the primary jurisdiction in these cases under the provisions of HRS 571(Family Courts). The rules under which CPS operates are outlined under HRS 587 (Jurisdiction). Their job is immense, given normal caseloads.

A national Study of Child Protective Services and Reform Efforts conducted by the U.S. Department of Health and Human Services in 2001 found that "many of the tensions within the CPS system have been evident for the last 100 years, e.g., the tension between social support, social rehabilitation, and punishment; the opposing themes of child needs versus family needs; and the concerns for privacy versus accountability. As state and local CPS systems have evolved, they have tended to tilt in one direction or another. They have not all, however, tilted in the same direction at the same time."

Locally, CPS has come under fire. In 1998 the Legislature asked the state auditor to conduct an audit of the Child Protective Services system.

Auditor Marion Higa reported in 1999 "we found that Department of Human Services has not ensured that all child abuse and neglect reports are investigated when appropriate. Supervisory review at key decision-making points has been insufficient and staff have failed to follow established procedures to assess the risk of harm when receiving and investigating reports of suspected abuse and neglect. We also found that the DHS' communication within its Child Welfare Services Branch and with the County Police and the Family Court is ineffective. In a one-month period that we reviewed, DHS failed to refer to the County Police about 40 percent of the reports of child sexual assault that it received. Also the police do not consistently inform DHS of all child abuse and neglect cases reported to the police. DHS has also been remiss in its obligation to seek Family Court jurisdiction when required," Higa said.

In 2003 the audit was updated and Higa found that little progress had occurred.

"As in 1999, the problems centered on management controls," she said. "Management controls are an integral component of an organization that provides reasonable assurance that objectives, such as operational effectiveness and compliance with applicable laws and regulations are being achieved. When the stakes are high, as they are in child protection, additional assurances must be provided to the community that every reasonable action is being taken to guard the safety of vulnerable children. Complying with and enforcing management controls which are lacking at both the branch and division levels provides this assurance."

HIJ spoke with several CPS employees who were frank about the problem but unwilling to have their names printed. Here's some of what was said.

"Higa's right on with her audit. We're supposed to use a standard risk assessment matrix and people are just not using it. People are out in the field making decisions based on their own judgment so there is no control over what's going on... The caseload is overwhelming so I try to concentrate on the babies. Babies are the most vulnerable of all our clients and the ones most likely to be abused. Its much harder to abuse a teenager."

Even when the risk matrices were used, Higa found that half of them were completed incorrectly and 30 percent of them were not reviewed by a supervisor.

The lack of controls at CPS has a ripple effect on the rest of the provider entities and the overall effect is that the system chugs along while the problem is on the fast track. The treatment of child abuse and the incidence of it keeps growing by leaps and bounds and we are not keeping up.

Michele's first love was Jim. Freeing herself from the clutches of her mother and moving into a life of her own was a big step for Michele and one with disastrous results. Jim was abusive and controlling. He would make her stay home, beat her into compliance and then go out with his friends or other girls. He kept Michele in a psychological prison, not allowing her to work or have friends. When she was four months pregnant he beat her so badly one night that she began to miscarry. Jim refused to take her to the hospital because he knew he'd get busted for abusing her if they went.

Luckily, Michele's father stepped in and took her to the hospital. The doctors told them Michele would have died if she hadn't gotten there in time. The nurse on duty reported the abuse to the police and the system began to churn.

Treatment Opportunities

There is a wide array of private, non-profit programs and private practitioners specifically founded to serve abused children.

Mary Joe Westmoreland is Director of the Chaplain Child Protection Center, one of the pioneer organizations on Hawai'i Island.

"Our focus is the safety of children in our community," she says, "working with parents in counseling to help them become better parents. Presently we are spending much of our time working with grandparents, as an amazing number of grandparents have become the primary caregivers for their grandchildren."

Ice, crystal methamphetamine, is taking out a whole generation, leaving a gap in an age-old continuum. In Hawai'i County there are, at last count, 132 grandparent families that are involved with the system raising their grandchildren as the primary caregivers. This phenomenon of "kinship care" giving is, of course, a cultural safety net in Hawai'i where the concept of family means so much to so many.

"We have a multi-disciplinary team," continued Westmoreland. "We do initial assessments and consultations with abuse victims referred to us by Child Protective Services and give recommendations to CPS as to risk and possible treatments that might be available."

"Through our Title 4B Program, which we call our Community and Supported Living project, we work directly with the families involved and coordinate treatments with other agencies such as Family Support Services, ACCESS Capabilities who do substance abuse assessments, Turning Points for Families who conduct their Alternatives to Violence Program, BISAC which has a live-in program for folks recovering from substance abuse."

Title 4B is a federal program tied to the Adoption and Safe Family Act that provides money to communities that are allowed to individualize their programs with the money. For instance, in Hilo the money is used to maintain a recovery house for moms and keiki. On Kauai, the money is used to support substance abuse treatment programs.

"Eight-five percent of the referrals we get from Child Protective Services are involved with ice. The users become fixated on the drug, on the euphoria and everything else falls by the wayside," says Dr. Mark Schuster, a psychologist with the Chaplain Child Protection Center. "The children, the house or car, the rent. If there is a choice between buying an eight-ball of ice and diapers for the baby, the ice will win every time."

"There's many great service providers out there, but still not near enough for our needs," says Schuster. "We really need a mother/child center here in West Hawai'i where they can stay together."

When CPS goes into a home and takes the children, they have to have somewhere to place them. Often both parents have the drug problem but even if only one household member is using, CPS will still have to take the children because of the use in the house. The need for quality foster homes is great and sometimes problems of abuse arise in the foster home itself.
Across the board, the professionals interviewed by HIJ agreed that early intervention and parent education is the key to success in reducing the incidence of child abuse.

"Hope, all we can give is hope," says Dr. Schuster

Family Support Services offers a wide array of services to parents and their children including Healthy Start, Early Childhood and Youth Development Programs.

The original Family Support Services Council was formed in 1979 in response to a call from the Institute for Family Enrichment to attend an educational program on the cycle of anger.

That group included Debbie Abreu, Janice Baxter, Marilyn Yangston, Rafael Ramirez, Connie Santana, Meg Greenwell and David Garcia.

These folks, concerned by the lack of social services in Kona, began to meet and eventually decided to incorporate as a non-profit. Then the group was approached by the State Department of Health and asked to oversee a program for children from birth to three that later became the Healthy Start Program, a core program of the Family Support Services today. Administratively, the work was done under the watchful eye of the Chaplain Hospital system that still provides an array of assistance to abuse victims through its Child Protection Center.

FSSWH philosophy involves a strong dose of prevention and education.

"Representatives from the Healthy Start Program screen 100 percent of the births at both North Hawai'i and Kona Community Hospital," according to Jude Lyon. On-site workers, looking at the background and experience of the prospective parents, assess the risk factors for neglect of children that can be identified and intervention begun by educating the prospective or new parents and supporting them in their new roles as parents.

There is a strong connection between parents' inability to cope with life stresses, their own childhood history, and potential child abuse and neglect. If mothers have had little prenatal care, and if the baby was not planned, potential problems are possible. Single mothers with a non-biological father in the home can be an unsettling factor. "All this is done with an eye towards prevention and early intervention," says Lyon. "Just meeting with professionals, experiencing people and ideas outside their normal social set, can sometimes open the eyes of individuals to their own potential as people. Mentoring programs are hugely successful in bringing former users back to life," she says.

"Our community must speak up and say this (child abuse and neglect) is not acceptable behavior!" says Don Bebee, Executive Director of FSSWH. "But our community must also provide the assistance our families need to refrain from the behaviors that lead to this cycle of violence. And while we condemn the behavior associated with child abuse and neglect, we must also be accepting enough of the person to offer our help. At FSSWH, we try to achieve a balance between educating the public about the problem of child abuse and neglect with a more positive message to celebrate family life."

The word discipline means "to teach," says Andres Rosally of FSSWH. "A parent who is a disciplinarian is a teacher and a guide who helps children to learn. Discipline promotes positive behavior, self-control and response to lack of control. Discipline is never violent, does not intend to make children feel badly about themselves and does not instill feelings of guilt and shame. All of these things are 'punishment,' not discipline."

That police report stemming from the hospital visit was the first of many. Something had changed in Michele and she became defiant. She refused to be beaten. When she went to Chaplain Hospital in Oahu to have her second child, she was offered the services of Healthy Start. Her outreach worker gave her the encouragement and resources to change and her young children gave her the inspiration. Jim threatened to beat her if she went to court, but she went anyway.

With the help of Healthy Start, Michele moved into a homeless shelter for seven months. She tried it with Jim once more but to no avail. She had broken the psychological bond that had held her captive. Soon she met her present man, Neil. "He is very loving to the children," she says. She recognizes how breaking the cycle opened her up to finding a partner not tied to that same cycle of violence and abuse.

Today Michele is dedicating her life to helping women in the same position she was in. She works for Family Support Services' Healthy Start Program, the HIPPY Program, as well being involved in the after-school A Plus program.

Dr. Wendy Wagner is a Clinical Specialist with FSSWH. "Michele's story is about the cycle of abuse and how she broke it, " says Wagner. "She is a remarkable person and an inspiration to all of us."

The wearing of a dark blue ribbon during the month of April signifies your commitment to help prevent child abuse and neglect. The ribbons, as well as some solid help if you feel your own children might be in danger of becoming child-abuse victims, are available from:

Family Support Services of West Hawai'i, 326-7778;
Friends of the Children's Justice Center, West Hawai'i, 331-2425: East Hawai'i, 935-8755;
Neighborhood Place of Kona, 331-8777; Puna, 965-5550;
Chaplain Child Protection Center,
329-4020;
PARENT'S Inc., 934-9552.