The Gazette 1979

GAZETTE

SEPTEMBER 1979

The Child and the Law —The Child Psychiatrist's viewpoint

Dr. Jerry O'Neill, Child Psychiatrist, Warrenstown House Residential Centre

Warrenstown House Residential Home I am talking to you today from my own experience as a Child Psychiatrist in a community setting for the past ten years, and I would like to share with you some practical clinical problems which I have experienced in child psychiatry in regard to the law over this period. I am not sure of the answers to these various problems and will probably be asking more questions than giving a solution. As one Of the earlier speakers in this conference I thought it might be appropriate to present some factual clinical material as I anticipate later speakers will be talking more expertly about the law and its implications in regard to children. Placing a child In care: The first problem I would like to deal with is the difficulties I have found in trying to place a child into care. Child guidance clinics, social workers, childrens' hospitals, and many other agencies dealing in child care often have to make this extremely difficult decision. It arouses in those involved in the decision much heart- searching, as none of us went willingly into child care viewing our role as one of taking children away from their parents. Secondly it is sometimes extremely difficult to find a suitable placement for these particular children and the paradox exists that the most difficult and most needy children are the hardest to place yet these are the ones that need the most help. Thirdly, parents are usually extremely sensitive to their children obviously progressing satisfactorily away from them, being cared for by other people and may tend to sabotage these placements, expecially if foster placements. Residential care may be much more acceptable because of its more impersonal in nature. You may say, quite rightly, that surely one should first of all try and work with the family to try and improve the unsatisfactory situation; that we should make every effort to give support to deprived parents, who themselves were possibly battered and deprived, and try and break the vicious circle of deprivation and prevent another generation of damaged adults emerging. This certainly sounds fine in theory but in practice may prove to be an exhausting, time consuming, task for a clinic, social worker, or various caring personnel, and over a long period the mothering or fathering qualities of the parent concerned may only improve marginally. It is also true to say that if one particular worker in the field of child care has to deal with or handle too many of these extremely difficult unrewarding cases, that it can be very hard to maintain an optimistic, positive approach to one's work. I feel much more frequently we should see the writing on the wall in time and consider

alternative measures, such as a group home placement, foster care, or some good residential setting etc., before it is too late. Irish tradition, culture and religion have in the past very much emphasised the importance of family life and of families staying together at all costs. How often has a submissive, ill-treated wife, or a totally dominated, hen-pecked husband been advised to turn the other cheek and offer it all up. I wonder has it ever occurred to people who give this sort of advice to ask them what is happening to the children of the marriage in the meantime. We all know that physical evidence of abuse, neglect, or deprivation has been needed in the past to safely secure a child care order and less importance has been attached to psychological factors, although I am sure we would all agree that these can be as damaging to a child if not more so. I believe and hope that this is now changing. Pointers to Psychological Damage What sort of pointers might suggest a child was living in a psycholgically damaging situation whether from neglect, deprivation, rejection or abuse. Of course any symptoms of emotional disturbance or delinquency may be relevant but there are more specific indicators worth watching for. (a) Excessive clinging behaviour suggesting fear of abandonment. (b) Frozen watchfulness: A very specific sign, where the child remains extremely still and quiet in the abusing parents presence never taking his eyes off his parents; looking for the slightest and earliest sign of the parents wriath so as to take quick avoiding action. Failure to thrive with ravenous appearance, but thrives when away from home. (d) The child who seems to be constantly provoking adults to punish it. (f) The young child with very shallow superficial attachments, who is instantly extremely friendly to everyone, with the whole world as his parent. . The child who is cruel to animals. He is behaving to animals as his parents behave to him. The Law is weak The biggest dilemma and the greatest frustration can arise in our sort of work when it is known a child is living in an ongoing, damaging situation, yet we are aware that we can do very little intervening to improve the situation. This can be due to lack of co-operation from the parents concerned or lack of firm evidence available to secure a (c) (0

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