COVID-19 and its Impacts on Child Abuse and Neglect
Policy Brief
Carter, D, Odama, A, Obi, N, & Lang, H. (2021). COVID-19 and its Impacts on Child Abuse and Neglect. Report submitted for TPS Child Maltreatment class, Brown School. St. Louis MO: Washington University.
Executive Summary
With the onset and continual rise of the COVID-19 pandemic came an influx of societal issues. As schools, jobs, and other essentials shut down, the concern of children and families became a conversation in child welfare. The loss or reduction of job and financial stability, health, housing, and child care, which are closely related to an increase in parental stress, became a national concern during COVID-19 as parental stress is strongly associated with increases in child abuse and neglect (CAN). Families also lost access to social support systems heightening parental stress and increasing mental health issues such as anxiety and depression. All of this combined adversely impacted parental behaviors and parent-child conflicts which are associated with CAN. Additionally, increased proximity of families to neighborhood violence, drug, and alcohol abuse as well as being young parents increased the risk for parental aggression and violence. Many states witnessed a 20-70% decline in reporting as COVID-19 hit. However, this decline could be misleading and reflects the heavy reliance of the child welfare system on reports from mandated professionals such as teachers, physicians, and other professionals who lost contact with children due to COVID-19 restrictions.
Given the limitations that COVID-19 presented, we predict that once COVID-19 has been reduced or cleared it is likely that there will be a large spike in cases reported, substantiated, and services required since CAN reports decreased from diminished community interaction. Additionally, we predict parents will have an increased risk of committing CAN if they experience one or more risk factors that increased in magnitude during COVID-19. We also predict children who are young in age or have parents who experience one or more risk factors that increased in magnitude during COVID-19 will be at an increased risk of being victims of CAN.
Lastly, since policies and procedures prior to the COVID-19 pandemic relied on in-person interaction and services, there are many policy and system recommendations to implement in order to reduce the potential for CAN to occur during COVID-19 or during pandemics. These include prioritizing at-risk families for services and investigations, increasing funds to welfare and family services, increasing community understanding and ability to report CAN, shifting child welfare from a reactive system to a surveillance and preventative system, and advocating for all changes stated prior.
Problems of COVID-19 Related to CAN
Introduction
The COVID-19 pandemic created a conglomeration of risk factors for both parents and children which increased the likelihood of CAN. The public health measures used to reduce the spread of COVID-19, including stay-at-home orders and social distancing requirements, reduced contact of children with professionals, mandated reporters, and social support systems who would otherwise have been the first line of support and protection for these children. (What COVID-19 Means for America’s Child Welfare System, n.d.) Therefore, many states saw a reduction in the number of CAN reports. However, despite the decrease in reporting, there is evidence that the pandemic created an environment for CAN rates to increase. (Rodriguez et al., 2021)
Parental Stress
During the COVID-19 pandemic, many parents lost the ability to work due to health concerns, were let go from their jobs due to workplace budget cuts, were placed on leave as their workplaces sometimes had to shut down, or had to stop working to provide childcare for their children. Parental job loss during the pandemic increased parental stress from financial instability, housing, and feeding concerns since many also experienced a decrease in the ability to rely on social support systems. (Herd et al., 2020) This parental stress was associated with a nearly five times increase in cases of CAN compared to parents who did not experience job loss (Lawson et al., 2020).
Lack of Available Resources
Additionally, the closure of childcare centers and schools meant that parents either had to stay home and take care of their children all day or work but leave their children home alone or with an older sibling incapable of taking care of a child. The unavailability of childcare may have led to the increase in CAN, particularly supervisory neglect, especially among preschoolers given their dependency at this age. Also, since sexual abuse is perpetrated commonly by people familiar with the victims, the incidence of sexual abuse was likely to increase as parents left their children with other relatives or friends (Herd et al., 2020).
Mental Health Issues
With the combination of increased financial pressures, lack of available resources, and lack of ability to rely on social support systems, many parents encountered an increase in health issues such as anxiety and depression (Katz et al., 2021). These mental health issues combined with unmanaged parental stress may have led to adverse parenting behaviors and parent-child conflicts, including CAN (What COVID-19 Means for America’s Child Welfare System, n.d.; Schneider et al., 2017; Bullinger et al., 2020).
Environmental Factors
At the community level, the increased proximity of families to neighborhood violence, poverty, unemployment, and drug and alcohol abuse from the shelter-in-place orders, put families at risk of aggression and violence. Domestic violence reports increased during COVID-19 as a result of lockdowns and research has shown that children exposed to domestic violence in the household are at an increased risk of experiencing maltreatment (Herrenkohl et al., 2008). Additionally, younger parents were more likely to be the perpetrators of CAN while younger children were more likely to be victims of physical and mental abuse during COVID-19 (Lawson et al., 2020).
CAN Reporting Rates
Given all these factors that could potentially affect CAN incidence during the pandemic, there was speculation that there would be a huge increase in CAN and CM rates after the start of COVID-19. Interestingly, the data presented by multiple states showed a decrease in CAN & CM reports.
States like Michigan, Kentucky, New Hampshire, and Louisiana also reported double-digit decreases in CAN reports but the exact magnitude was not given (The Hunt Institute, 2021). Although not every state presented data on its CAN/CM reporting rates post-pandemic, we predict that they too observed significant decreases in their reporting rates. Based on current data, there seems to be no difference based on geography.
Not just reporting rates, but hospitals also noted a decrease in CAN-related emergency room visits and hospital admissions during the pandemic (Leigh, 2021). A study from Benioff Children’s Hospital and Children’s Mercy KC (Leigh, 2021) theorized that financial stipends and eviction protections might have played a part in buffering the risks of child neglect and maltreatment hence leading to a reduction in CAN incidence but there is very little evidence to show. Data suggests that these decreases in reporting and hospital admission rates are more likely due to mandated reporters and other professionals having less contact with children and thus being unable to report suspected cases.
Per AP News analysis, the national rates of CAN and CM reports and investigations decreased by 18% in 2020 compared to 2019. These rates fell sharply as schools pivoted to online learning and a 59% drop in CAN reports from school sources was noted (AP NEWS, 2021). The United States child welfare system is heavily reliant on reports from teachers, doctors, and other professionals to detect CAN. With the stay-at-home orders minimizing contact of children with these professionals, the system was rendered helpless in carrying out its mandate. Also, other aspects of the child welfare system such as home investigations, court appearances, and home-visiting-based parenting programs were cut off. (What COVID-19 Means for America’s Child Welfare System, n.d.).
Current Policy and Deficits
Most policies surrounding CAN prior to COVID-19 were tailored and reliant upon in-person services, financial stability of clients (to a degree), and operations of services without major restrictions. This included the ability to access daycare, schooling, health visits, and child welfare as well as the ability to work. Additionally, while already underfunded and overworked, child welfare functioned as a reactive system that relied on mandated reporters in order to initiate investigations.
However, due to the nature of how COVID-19 spread, many in-person services decreased or ceased which limited mandated reporters’ ability to report, reduced the ability to utilize services that reduce CAN, and child welfare itself failed its clients as reporting was reduced, funds further strained services, and in-person services and investigations could not take place. Thus, the current policies related to CAN saw major failure with COVID-19 due to the modes of organization and lack of contingency plan if a pandemic of such scale and spreadability occurred.
Predictions and Recommendations
Predictions
Reporting
It is more than likely that CAN reports and investigations greatly decreased during COVID19 but did not accurately reflect CAN incidents that were taking place. Given the reduction of preventative services, limitation of mandated reporter access, and reduced ability of child welfare to investigate and provide services, it is more than likely that rates of CAN increased during COVID-19. Thus, once COVID-19 has been cleared, or more normalcy is regained, it is likely that there will be a large spike in cases reported, substantiated, and services required (The Hunt Institute, 2021). Additionally, those impacted during COVID-19 by CAN but were unable to be screened or provided aid will more than likely need additional services as the length of time exposed to CAN may have increased during COVID-19.
Those Impacted
Parents who encountered job loss, loss of childcare services, loss of social support systems, young parents, and/or experienced an increase of risk factors that were already established as predictors of CAN, were more likely to encounter parental stress which has been associated with an increase in CAN incidents. Thus, parents falling into any or multiple of the mentioned categories would be predicted to have an increased risk of committing CAN during COVID-19. In terms of children, young children who are unable to take care of themselves alone, children having to rely on family members or friends for childcare, and children having parents of any of the mentioned categories above are predicted to have an increased risk of encountering CAN during COVID-19. This is mainly due to the fact that services that were normally available became limited in scope and practice which left children vulnerable environmentally, physically, and mentally.
Recommendations
In response, policy recommendations include prioritizing at-risk families for services and investigations, increasing funds for welfare and family services, increasing community understanding and the ability for reporting CAN, shifting child welfare from a reactive system to a surveillance and preventative system, and advocating for all changes mentioned above.
Currently, while some prioritization takes place in services selection, COVID-19 presents even further risk factors which need to be evaluated and prioritized including those who are facing increased parental stress, increased financial hardships, younger parents, and those with younger children. By prioritizing at-risk families during pandemics for services and investigations, both in virtual or alternative in-person meetings, families are not lost within the system which could increase the likelihood for CAN to occur since services and investigations are being utilized (The Hunt Institute, 2021).
Secondly, a general increase in funds for welfare and family services will ensure that infrastructure is in place for families through continuing services, programs, and educational resources so that CAN during particularly straining times are avoided (The Hunt Institute, 2021). Since child welfare already has a strained budget, an increase in funding during pandemic times is fundamental so that CAN cases do not increase due to a lack of availability of services, programs, and educational resources. Funds also ensure that there is a workforce that is able to distribute such services, programs, and educational resources. Since the workforce within child welfare is already strained, due to high turnover rates and high caseloads, workforce stability could see an even greater labor shortage which would limit services, programs, and educational resources that can increase CAN if not monetarily protected (The Hunt Institute, 2021).
Third, since the pandemic limited many mandated reporters from being able to see children in person to report CAN, reports and investigations decreased. However, this does not mean that CAN also decreased. With mandated reporters being the majority of persons to report to child welfare, the system lost a huge portion of those identifying and reporting CAN. Thus, the job must shift to community and family members as they are more likely during pandemics to see children in person (Herd et al., 2020). However, without proper education and knowledge as to what CAN is, how to report it, and what happens when it is reported, reports among the community and family members are likely to decrease. Thus, by educating the community and family members on how to report CAN, the child welfare system may not lose as much in reporting and investigating during COVID-19 or pandemic times (Herd et al., 2020).
Fourth, while the current child welfare system is a reactive system, it needs to switch to both a proactive/preventative and reactive system (Herd et al., 2020). Since reports decreased due to limited in-person interaction with mandated reporters, child welfare lost much of its leverage in being able to aid CAN. Thus, it must also identify families which are at a higher risk for CAN and link services between families and needs prior to cases of CAN (Herd et al., 2020). In doing so, if another pandemic were to occur limiting mandated reporters, families may at least have services that would aid in reducing the risk for a case of CAN, especially under times where parental stress levels are escalated.
Lastly, advocating to the public, policymakers, and stakeholders on all recommendations listed above is highly necessary. Without such entities being aware of the following deficits and how to repair them, actions cannot take place. Thus, child welfare and auxiliary systems will perpetually not function during pandemics or similar times if such systems are not restructured.
Conclusion
The importance of reducing CAN incidents cannot be emphasized enough. With the onset of COVID-19, reports of CAN have reduced since there is limited accessibility to spot and report CAN in addition to the limited resources for reporting or investigation. Though, given the increase in the magnitude of risk factors associated with CAN; such as parental stress from job loss, financial stability, health, housing, child care, access to social support systems, and
increases in mental health issues; it is likely that CAN rate increased. Since systems and policies prior to COVID-19 were centered around in-person abilities, and in-person abilities are strongly diminished under COVID-19, it is recommended that policies and systems adapt towards working around or with COVID-19 public health measures. This includes altering prioritizing and prevention methods, reporting measures, funding measures, and advocacy efforts.
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