A Need For Help

 Child abuse

The Legislative Task Force on Abused and Neglected Children was created through legislation during the 86th Arkansas General Assembly – Act 1035 of 2007.  The task force identified children’s safety centers (CSC) as an essential resource for victims of child sexual abuse. 

 

Currently, ten CSCs in Arkansas (four fully accredited, five associate members and one non-member) serve abused children and their families. There are also two CSCs under development in Craighead and Faulkner Counties. In 2007 (the most recent year complete figures are available), 1,751 forensic interviews were completed by the nine fully accredited or associate CSCs, the majority of which were completed in Hot Springs (362), Springdale (429), Rogers (434), and Lonoke (214).  Support of children and families by CSCs is a basic expected service.  This is accomplished through child advocates and mental health services provided on-site or by referral to other agencies.  However, because only four CSCs provide on-site counseling (Rogers, Texarkana, West Memphis and Green Forest), fewer than 10 percent of the children or families seen in these CSCs received any therapy onsite (Arkansas Commission on Child Abuse, Rape and Domestic Violence, M. Snowden director, personal communication, Feb. 24, 2009).

A telephone survey of all nine CSCs by Dr. Jerry Jones and Dr. Karen Worley of the Department of Pediatrics assessed the mental health resources and needs of the CSCs. The survey was implemented by a trained volunteer who utilized a questionnaire developed by the UAMS/ACH Center for Children at Risk.  The survey was performed in response to the inclusion of medical and mental health roles of a professionally defined entity in Arkansas Act 703 of 2007. 

 

This survey determined that seven sites provide pre-counseling support or crisis intervention, but only four sites are satisfied with their services. Only three have written protocols, and the National Children’s Alliance (the credentialing body for CSCs) apparently provides no written procedures for child and family support/crisis intervention. Currently no standards or training is available for advocates. Needs for statewide enhancement of child advocate services identified by the survey included funded training of new staff training on assessments and crisis intervention; continuing education; peer support of child advocates; development of protocols for supportive services; and increased funding for support positions for coordination and tracking of cases. 

 

A second survey also determined that the CSCs are attempting to provide quality mental health support within their centers with limited external financial and professional support.  Most centers are able to obtain reasonably prompt appointments by referral to mental health entities within their primary catchment areas but not to ones outside of them. 

Based on the survey results, it was recommended that CSCs have therapists within their catchment areas who have been specifically trained in mental health services for traumatized children and their family members. Arkansas has an extensive array of services provided through community mental health centers (CMHC) and their satellites located in 69 counties throughout the state to provide such services.  Moreover, there are other private providers in both urban and rural communities who would be willing, but may not be fully trained, to address the emotional and behavioral needs of such children. 

No formal system currently exists to train advocates or the limited number of mental professionals in CSCs, nor is there any systematic training program available for other mental health professionals in the state working with traumatized children. In addition, no systematic database exists to provide information on mental health professionals trained to provide therapeutic services to abused children for referral purposes and quality improvement processes.