The recent news that Indiana has the second-highest rate of child abuse victims in the nation, according to the "Child Maltreatment" report is sobering, but an IU Health physician cautions that the numbers don’t tell the whole story.
The report, produced by the Children's Bureau of the U.S. Department of Health and Human Services, said Indiana had a reported 29,198 child abuse cases in 2017, a 34 percent increase from the number identified in 2013. That represents 18.6 victims per 1,000 children.
Only Kentucky had a higher rate, with 22.2 victims per 1,000 children. For both states, the number is more than double the national average of 9.1 victims per 1,000.
As division chief of the Child Protection Program for Riley Children’s Health, Dr. Roberta Hibbard is an expert on child abuse. She is active in efforts to improve communication and coordination of services when child abuse or neglect is suspected.
And while she will use the report as a call to action to protect young lives, she warns that interpreting the data requires more context than mere numbers.
“We have to be cautious in interpreting data in comparison to other states because reporting laws and requirements vary from state to state,” she said.
What is considered maltreatment, what gets investigated, who does the investigation (child protection or law enforcement or both) and who is required to report – all might differ from Indiana to Florida to California.
For instance, in Indiana, any adult who sees a suspected case of abuse is obligated to report it to authorities. In many other states, only professionals (teachers, medical staff, etc.) who interact with a child as part of their job are required to report suspected abuse.
“Based on this report, the trend for investigations is upward over the last several years for Indiana,” Dr. Hibbard said. But, she adds, maybe we’re doing a better job of educating the public and identifying abuse.
“Are more cases assigned to assure safety of especially young children, are we doing a better job of identifying and serving children, or do we need to further build up prevention activities? The answer is likely all,” she said. “You must read the report in detail to understand the nuances and variations across the country.”
Indiana Gov. Eric Holcomb allotted $25 million to the Department of Child Services to address recommendations to improve child welfare put forth last year by a state-led task force. Indiana reported 78 child abuse deaths in 2017, up from 28 in 2013.
Each state has its own definition of child abuse and neglect based on standards set by federal law, but most states recognize four major types of maltreatment: neglect, physical abuse, psychological abuse and sexual abuse. Across the nation, the greatest percentages of children suffered from neglect (74.9%) and physical abuse (18.3%).
While the Maltreatment Report doesn’t specifically address the opioid epidemic, the number of children entering foster care began to rise in 2012. Hardest hit have been six states whose foster care populations rose by more than 50 percent from 2012-2016. Indiana is among those six states. Someone is sent to an Indiana hospital with an opioid overdose every 2 ½ hours. Many in the child welfare field point to parental substance abuse – especially opioids – for this increase in foster care placements.
IU Health has made expanding access to behavioral health services one of its five-year strategic goals. Two IU Health addiction treatment and recovery centers are currently open – one at IU Health Methodist Hospital and one at IU Health Bloomington, which opened last year. Centers at IU Health Ball Memorial Hospital and IU Health West Hospital are scheduled to open this spring.
– By Maureen Gilmer, IU Health senior journalist