Mental Health and Growing Up
Factsheet
Child abuse and neglect - the emotional effects:
information for parents, carers and anyone who cares for young
people
About this factsheet
This is one in a series of factsheets for
parents, teachers and young people entitled Mental Health and
Growing Up. These factsheets aim to provide practical,
up-to-date information about mental health problems (emotional,
behavioural and psychiatric disorders) that can affect children and
young people. This factsheet looks at what child abuse is and the
harm it can cause, and offers practical help about how to detect it
and where to get help.
What is child abuse?
All parents upset their children sometimes.
Saying ‘no’ and managing difficult behaviour is an essential part
of parenting. Tired or stressed parents can lose control and can do
or say something they regret, and may even hurt the child. If
severe or if it this happens often, it can seriously harm the
child. That is why abuse is defined in law. The Children Act 1989
states that abuse should be considered to have happened when
someone's actions have caused a child to suffer ‘significant harm’
to their health or development.
‘Significant harm’ means that someone is:
- punishing a child too much
- hitting or shaking a child
- constantly criticising, threatening or
rejecting a child
- sexually interfering with or assaulting a
child
- not looking after a child – not giving them
enough to eat, ignoring them, not playing or talking with them or
not making sure that they are safe.
Who abuses children?
Children are usually abused by someone in
their immediate family circle. This can include parents, brothers
or sisters, babysitters or other familiar adults. It is quite
unusual for strangers to be involved.
How can you tell if a child is being
abused?
Children may present with a variety of
difficulties and behaviours depending on where, when and the type
of abuse they have experienced.
It can be hard to detect long-standing abuse
by an adult the child is close to. It is often very difficult for
the child to tell anyone about it, as the abuser may have
threatened to hurt them if they tell anybody. A child may not say
anything because they think it is their fault, that no one will
believe them or think they will be teased or punished. The child
may even love the abusing adult. They want the abuse to stop, but
they don't want the adult to go to prison or for the family to
break up.
Some of the signs of abuse are described
below.
Physically abused children
may:
- be watchful, cautious or wary
of adults
- be unable to play and be
spontaneous
- be aggressive or
abusive
- bully other children or are
being bullied themselves
- be unable to concentrate,
underachieve at school and avoid activities that involve removal of
clothes, e.g. sports
- have temper tantrums and
behave thoughtlessly
- lie, steal, truant from
school and get into trouble with the police
- find it difficult to trust
other people and make friends.
Sexually abused children
may:
- suddenly behave differently
when the abuse starts
- think badly of
themselves
- not look after
themselves
- use sexual talk or ideas in
their play that you would usually see only in someone much
older
- withdraw into themselves or
be secretive
- under-achieve at school
- start wetting or soiling
themselves
- be unable to sleep
- behave in an inappropriately
seductive or flirtatious way
- be fearful, frightened of
physical contact
- become depressed and take an
overdose or harm themselves
- run away, become promiscuous
or take to prostitution
- drink too much or start
using drugs
- develop an eating disorder,
such as anorexia or bulimia.
Emotionally abused or
neglected children may:
- be slow to learn to walk and
talk
- be very passive and unable
to be spontaneous
- have feeding problems and
grow slowly
- find it hard to develop
close relationships
- be over-friendly with
strangers
- get on badly with other
children of the same age
- be unable to play
imaginatively
- think badly of
themselves
- be easily distracted and do
badly at school.
What can I do to help?
First and foremost, the child must be
protected from further abuse. If you suspect that a child is being
abused, you may be able to help them to talk about it.
Social Services will need to be involved to
find out:
- what has happened
- if it is likely to happen
again
- what steps are needed to
protect the child.
Your local Social Services Child Protection
Adviser will be able to offer more detailed advice. It is helpful
to speak to them even if you are not sure. Remember, all of us need
to protect the child from further harm.
Child Protection
After investigation, Social Services may be
satisfied that the problems have been sorted out, and that the
parents can now care for and protect the child properly. If so,
they will remain involved only if the family wants their help. If
Social Services are concerned that a child is being harmed, they
will arrange a child protection case conference. The parents and
professionals who know the child will be invited. A plan will be
made to help the child and family and ensure that there is no
further harm.
Help to look after the child
When a child has been abused within the
family, the person involved is sometimes able to own up to what
they have done and wants help. They can then be helped to look
after their child better. Occasionally, the child may have to be
taken away from the abusing adult because the risks of physical and
emotional harm are too great. This can be for a short time, until
things become safer, or may be permanent.
Specialist treatment
Many children need specialist treatment
because of the abuse they have endured. Some receive help from
family centres run by social services. If they are worried,
depressed or being very difficult, the child and family might need
help from the local child and adolescent mental health service.
These specialists may work with the whole family or with children
and adolescents alone. Sometimes they work with teenagers in
groups. Individual therapy can be especially helpful for children
who have been sexually abused, or who have experienced severe
trauma. Children who have suffered serious abuse or neglect can be
difficult to care for, and the service can offer help and advice to
parents and carers.
Further information
Barnardo's
Works with families and children in many ways,
including counselling, fostering and adoption, support for young
carers, training and disability inclusion.
ChildLine
Provides a free and confidential service for
children. Helpline 0800 1111.
NSPCC (National Society for the
Prevention of Cruelty to Children)
Has a number of useful publications. If you are worried about a
child, call the NSPCC Helpline on 0808 800 5000.
The Hideout
A website offering support and advice to
children whose lives are affected by domestic abuse.
Young Carers
A website offering support, information and
advice for children who also act as carers.
References
Rutter’s Child and Adolescent Psychiatry,
Fifth Edition (2008). Publisher: Wiley-Blackwell.
HM Government (UK).
Working together to safeguard children: a guide to inter-agency
working to safeguard and promote the welfare of children. March
2010.
Gilbert R, Spatz Widom C, Browne K, et
al.,(2009). Burden and consequences of child maltreatment in high
income countries. Lancet; 373:68-81.
Understanding the behavioral and emotional
consequences of child abuse. Amaya-Jackson L (2008). Committee
on Child Abuse and Neglect and Section on Adoption and Foster Care,
Pediatrics. 2008 Sep; 122(3):667-73.
- Revised by the Royal College of
Psychiatrists’ Child and Family Public Education Editorial
Board.
- Series Editor: Dr Vasu Balaguru
- With grateful thanks to Professor Ann Le
Couteur.
This leaflet reflects the best possible
evidence at the time of writing.
© March 2012. Due for review March 2014. Royal College
of Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
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