Why is reporting so hard? Barriers to fulfilling the duty to report among community nurses in Israel
| DOI | https://doi.org/10.1108/JCS-02-2022-0009 |
| Published date | 29 November 2022 |
| Date | 29 November 2022 |
| Pages | 265-280 |
| Subject Matter | Health & social care,Vulnerable groups,Children's services,Sociology,Sociology of the family,Children/youth,Parents,Education,Early childhood education,Home culture,Social/physical development |
| Author | Yael Sela Vilensky,Keren Grinberg,Yael Yisaschar-Mekuzas |
Why is reporting so hard? Barriers to
fulfilling the duty to report among
community nurses in Israel
Yael Sela Vilensky, Keren Grinberg and Yael Yisaschar-Mekuzas
Abstract
Purpose –This study aims to identifythe barriers that prevent community nursesin Israel from reporting
cases of childmaltreatment.
Design/methodology/approach –A qualitativestudy included interviews of 20 communitynurses using
questionsthat focused on the following subjects:knowledge of the law and reportingmethods, barriers to
reportingand the nurses’ outlook on child abuse.
Findings –Nurses felt they have a lack of the professional knowledge needed to identify suspicious
signs. Furthermore,finding indicates that there is a lack of understandingregarding the term ‘‘reasonable
suspicion’’ under the law amongnurses, and a lack of familiarity with the postreporting procedure. The
duty to report is not, by itself, sufficient to increase the rate of reporting. The training in this area is
insufficient.
Practical implications –Policymakers must formulate clear rules to identify various forms of harm in
children anddetermine the existence of a ‘‘reasonablebasis’’ to believe that a crime has been committed
among communitynurses in Israel so that they can fulfilltheir legal and moral duty.
Originality/value –Reporting abuseis a professionalduty enshrined in law. The enactment of this law in
Israel in 1989 created a new reality, designating a legal and moral obligation, on the part of society in
general, as well as professionals, to break the code of silence surrounding child abuse. However, the
present findings suggestthat the rates of reporting among community nurses remainlow. As of yet, no
research has been conducted asto why nurses are not reporting suspected cases of abuse in Israel,
despitethe continued existence of this law.
Keywords Child maltreatment, Community nurses, Abuse, Nurse training, Mandated reporter,
Reporting abuse
Paper type Research paper
“C hild maltreatment” is the accepted term worldwide to describe various types of
abuse, neglect and harm to children. Israel has yet to adopt any unanimous
term. It is customary to distinguish four types of abuse, which Israeli law also
recognizes: physical abuse, sexual abuse, emotional abuse and neglect. Neglect can be
physical or emotional (Arazi et al.,2017). These four types of abuse have common
conceptual definitions as follows:
According to the World Health Organization (WHO; 2006), physical abuse is –“The use of
physical force by a parent or caregiver against a child that causes injury, harm, pain, or
breach of dignity, or has a high likelihood of resulting in injury, harm, pain, or breach of
dignity, where the act is either motivated by an intention to injure, harm or cause pain, or is
done without this intention but has this effect or likely effect.” Regarding sexual abuse,
Mathews and Collin-V
ezina, (2019), defined it as “Any sexual act inflicted by any adult or
other person on a child, including contact and non-contact acts, where true consent by the
child is not present.”
Yael Sela Vilensky,
Keren Grinberg and
Yael Yisaschar-Mekuzas all
are based at Department of
Nursing Sciences, Faculty
of Social and Community
Sciences, Ruppin
Academic Center,
Emek –Hefer, Israel.
Received 22 February 2022
Revised 28 August 2022
9 September 2022
Accepted 19 October 2022
DOI 10.1108/JCS-02-2022-0009 VOL. 17 NO. 4 2022, pp. 265-280, ©Emerald Publishing Limited, ISSN 1746-6660 jJOURNAL OF CHILDREN’S SERVICES jPAGE 265
The third type is emotional abuse which defined as “Non-physical, harmful interactions with
the child by a parent or caregiver, which include acts of both commission and omission,
which breach cultural and societal standards. These interactions convey to a child that she
or he is worthless, flawed, unloved, unwanted, endangered, or only of value in meeting
another’s needs” (Kairyset al.,2002).
In addition, Neglect, which is one of the most common forms of child maltreatment defined
as “The failure by a parent or caregiver to provide the child with the basicnecessities of life,
as suited to the child’s developmental stage, and as recognized by the child’s cultural
context” (Dubowitz et al.,2005).
Child maltreatment is a difficult and complex social phenomenon, both in terms of
identification and treatment, and its implications for the individual, family and society
(Daniel, 2015;Gilbert et al., 2015;Gilbert et al.,2009). In recent years, attention has been
drawn to this issue among professionals from various disciplines, policymakers and the
public (Arazi et al., 2017). Although each type of abuse has a different definition, it can be
difficult to delineate their boundaries, and in many instances of maltreatment, there are
cooccurring distinct types in the same event/incident. For example, physical abuse may
cooccur with emotional abuse, and sexual abuse intersects with physical abuse (Goldstein
and Laor, 2010). Child abuse can take the form of direct or indirect harm, suchas exposure
to incidents of domestic violence, witnessing the abuse of another or social and emotional
isolation (Green, 2020).
Child maltreatment is rampant both in Israel and worldwide (Eisikovits et al.,2015;
Herendeen et al.,2014;Lee and Kim, 2018).It is estimated that one in seven children in the
USA experienced abuse or neglect in the past year (Centers for Disease Control and
Prevention, 2021). In Israel, according to estimates by welfare authorities (Haddad and
White, 2020), one in five children has been maltreated by an adult, and the number of
children experiencing direct violence or exposure to violence at home stands at about
600,000, or 20% of the country’s total number of children. This phenomenon cannot be
ignored or suppressed.
All types of child abuse have immediate and long-term consequences that can adversely
affect the entire lifespan on all levels, physically, psychologically, emotionally and even
financially (Dahlbo et al., 2017;Van der Hart et al., 2006). The WHO estimates that about
40,000 children die annually, as a direct result of maltreatment. Furthermore, this figure
does not reflect the full scope of mortality, which is apparently much greater (World Health
Organization, 2020). No data on childmortality due to maltreatment in Israel was available.
Studies show that children may develop severe feelings of guilt stemming from a sense of
responsibility for the abuse, resorting to drugs, alcohol, prostitution or attempted suicide
(Gilbert et al.,2015). In the long term, abuse leaves emotional scars that, if left untreated,
undermine the victims’ interpersonal relations as adults (Green, 2020). The greater the
duration and frequency of the harm, the more intense the consequences, even if the acts
themselves were not particularly severe. Adults who experienced maltreatment as children
have a high probability of developing physical health problems and are twice as likely to
develop severe depression. Child maltreatment is associated with a markedly higher risk of
developing major psychiatric disorders (including depression, bipolar disorder and
posttraumatic stress disorder), substance and alcohol abuse and medical disorders
(including cardiovascular disease, diabetes and asthma, among others; Nemeroff, 2016).
Early detection leads to a greater likelihood of successful treatment and minimization of
harm. However, abuse is rarely discovered immediately or quickly (Everill et al.,1995;
Finkelhor, 1987;Finkelhorand Dziuba-Leatherman, 1995).
To address the problem, many states have enacted laws and developed procedures to
prevent and deal with child abuse (Mathews et al., 2015). Among other measures,
professionals who come into contactwith children are obligated to report incidents of abuse
PAGE 266 jJOURNAL OF CHILDREN’S SERVICES jVOL. 17 NO. 4 2022
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