Why are they reluctant to report? A study of the barriers to reporting to child welfare services among public dental healthcare personnel

Abstract

This study is a national cross-sectional survey, conducted in November 2014, of 366 dental hygienists and dentists who had suspected maltreatment but did not report it to Norwegian Child Welfare Services (CWS). The aims of the present paper are to identify the reasons why public dental healthcare professionals are reluctant to report suspected child maltreatment to CWS and to determine whether there are differences in the identified barriers according to socio-demographic variables. The questionnaire was based on earlier studies and was adapted to fit the Norwegian context. The most frequently chosen reason for not reporting was "unsure of own assessment" (90.4%). Thirteen items pertaining to not reporting were factorised into three factors of barriers. These factors were "insufficient knowledge of child maltreatment and reporting", "fear of the consequences for oneself and the dental clinic", and "fear of the consequences for the patient and their family". A t test revealed that public dental healthcare personnel who had not received training on maltreatment and reporting to CWS during their professional education scored significantly higher on the barrier "insufficient knowledge of child maltreatment and reporting" than did dental personnel who had received such training. Furthermore, dental personnel with more years of experience (11+) scored higher on this barrier than did dental personnel with less experience. No other significant differences in barriers were observed. Public dental healthcare personnel have a mandatory obligation to report to CWS if they suspect child maltreatment. Despite this obligation, the present study reveals that several barriers to reporting exist. This study underscores the importance of strengthening knowledge among dental hygienists and dentists about when and how to report, both during education and in clinical practice. K E Y W O R D Sbarriers, child welfare services, fear of consequences, insufficient knowledge, mandatory reporting, public dental healthcare personnel

Reasonable suspicion in reporting child maltreatment: a survey among German healthcare professionals

“…Uncertainty regarding potential maltreatment is known to be a major risk factor for inconsistent reporting to CPS by healthcare professionals. [ 18 , 19 ].…”

“…In line with these findings, even if participants reported suspicion for maltreatment, only 80% chose to report to CPS. Even though 80 % seem to be a high percentage in a system without mandatory reporting, it has to be considered that known barriers for reporting, such as familiarity with the family [ 20 ], fear of negative consequences of a report for oneself, the patient or the family [ 19 ] and uncomfortability with addressing the issue of maltreatment with the family [ 21 ] may be a minor obstacle in a theoretical case vignette compared to real life.…”

Child Maltreatment: Mandated Reporting

“…Moreover, most of the nurse assistants in the study never made a maltreatment report out of concern that they might not recognize signs of maltreatment. In a Norwegian study of dentists and dental hygienists, over 90% of respondents identified uncertainty about their assessment about child abuse and neglect as a reason for not reporting, followed by not having enough knowledge about child maltreatment and not being sure how to report (Bjørknes et al 2019).…”

“…Often professionals are reluctant to report out of fear of damaging their relationships with children or parents, anxiety for their own safety, or concerns about involvement in legal proceedings (Alvarez et al 2004;Bjørknes et al 2019;Falkiner et al 2017;Flaherty 2015;Golomb et al 2016;McTavish et al 2017;Svärd 2017). Mental health professionals and counselors face the dilemma of violating clients' trust or confidentiality when they make a report (Golomb et al 2016).…”

“…They worry about the emotional effects on the child and family, particularly if they believe that reporting will lead the family to terminate a relationship with a helping professional that they need. They worry about the effects of family disruption from out-of-home placement or prosecution of a family member and the possibility of the family retaliating against a child for disclosing maltreatment (Alvarez et al 2004;Bjørknes et al 2019;Flaherty 2015;McTavish et al 2017;Svärd 2017). Another concern is the possibility of stigmatizing families (McTavish et al 2017).…”