Welcome to this first blog hosted by the NOTA Prevention Committee. The aim of this and future blogs is to stimulate discussion and debate, to inform and to facilitate networking.
Over the last few decades we have seen an increase in reporting, recording and prosecution of Child Sexual Abuse in the UK & Ireland, as well as internationally (UNICEF, 2014; World Health Organization, 2014). This increase in cases does not necessarily mean that Child Sexual Abuse is on the increase, this is difficult to determine given its hidden nature and baseline recording problems, cases are coming to the fore more often and we are starting to see a more realising picture of the overall prevalence of sexual abuse but it is difficult to know if we are experiencing a real terms increase in sexual violence. Add to this increased reporting the diversified nature of the offences that are recorded included more online offending, more cross border offending, peer on peer abuse and historical reporting; all of which means that the already complex and multi-faceted nature of child sexual abuse is getting more complicated. Therefore it is timely to raise the question of how we respond, rather than simply react, to child sexual abuse? Traditionally in the UK & Ireland, as well as other countries we have adopted a criminal justice approach whereby someone reports being a victim of child sexual abuse or a third party signals a concern and then the system reacts and the identified, suspected perpetrator gets investigated. The issue with this approach is that it is reactive, after the fact and the sexual abuse has already taken place by this point; which is problematic and means that we can only deal with the fallout. There is a growing recognition in the UK & Ireland that although the criminal justice approach is important to respond to cases were child sexual abuse has happened it does not allow us to prevent it or work with at risk populations, victims or perpetrators, in a cohesive way. Additionality, there is a growing recognition that the numbers of registered sex offenders is growing year on year (MAPPA annual report, 2015), that the cost of child sexual abuse is significant (UK, Saied-Tessier, 2014; Fang et al., 2012; Talyor et al., 2008) and that we cannot arrest our way out of online child sexual abuse (The Telegraph, 2014); therefore do we need a change of direction, policy and practice?
One solution that is gaining momentum in the UK, Ireland, Australia, USA, Canada, the Netherlands and Germany (to name a few locations) is a public health approach to child sexual abuse. A public health offers a unique insight into ending sexual violence by focusing on the safety and benefits for the largest group of people possible, meaning that it talks about and to the individual as well as the overall population (Centers for Disease Control and Prevention [CDC], 2004; Laws, 2000; Smallbone, Marshall, & Wortley, 2008; Wortley & Smallbone, 2006; McCartan, Kemshall & Tabachnick, 2014; Tabachnick, McCartan & Panero, 2016). A public health approach involves reframing child sexual abuse from a criminal justice issue dominated by debates grounded in the victim-offender paradigm discussing the personal impact that the offence which gives the impression of isolated and individualised instances of sexual violence, instead moving it to a health issue which involves discussions of a more systematic, embedded culture present in society focused around personal health, societal structures and development (McCartan, Kemshall & Tabachnick, 2014). A public health approach is proactive and is usually based around three levels of intervention;
- Primary Prevention: Broader approaches that take place before sexual violence has occurred in order to prevent initial perpetration or victimization (e.g., educating parents how to reduce the risk of sexual victimizations in their children). For Instance, Bystander intervention projects, safe touch, upstream.
- Secondary Prevention: Targeted approaches with “at risk” populations (e.g., providing an anonymous helpline for men who are concerned about their sexual interest in children). For Instance, inform plus, Project Prevention Dunklefeld.
- Tertiary Prevention: An immediate response after sexual violence has occurred to deal with the immediate consequences of violence (e.g., targeting detected offenders through treatment groups). For instance, Circles UK, Multi Agency Public Protection Arrangements, sex offender treatment programs for those convicted offenders within the Criminal Justice System.
In the UK & Ireland most of our resources are focused on primary and in particular tertiary prevention; there is a growing recognition that we could invest more in secondary prevention as it would have the potential to prevent the sexual abuse from occurring; therefore reducing victimization as well as the related emotional, psychological and social costs. Some initial findings from the inform plus (Sheath, presentation, NPSCC 2016; Gillespie, Bailey, Squire, Carey, Eldridge & Beech, 2016) and Project Prevention Dunklefeld (Beier, et al., 2009; 2015) While a shift towards a public health approach to sexual harm, epically secondary prevention, is welcomed by both professional organizations (for instance, NOTA, ATSA, NSPCC, Lucy Faithful Foundation, Safer Lives Foundation) there is still a distance to go in regard to national policy, practice and societal support.
The aim of this blog and future prevention blogs on the NOTA website is to highlight the work that is being done in the UK & Ireland, as well as internationally, on child sexual abuse prevention so that we can have an informed, cohesive debate and make sure that it prevention work is moving forward coherently in this arena.
We would be interested to hear your comments in relation to the prevention of sexual abuse by adopting a public health approach. Do you think this is the right approach? Does it over or under emphasise anything? Where should we be heading next in our efforts to prevent sexual abuse?
Kieran McCartan, Ph.D, & Jon Brown, MSc