Arguably the most taboo and controversial topic covered in the newly released Santa Cruz Community Assessment Project for 2006 is the issue of a rise in the rate of "Substantiated Cases of Child Abuse," from 1998 to 2005, from 13.2 per 1,000 children, to 14.2 in 2005, leaving Santa Cruz County above the 11.3 state average. Matched in nature only by elder abuse (which also showed a significant increase in reported cases), child abuse is often considered an issue "invisible" to the general public--a nationwide problem that, in many ways, remains a ghost.

There are also many sides to the issue: While most respond with dismay to the statistics presented in the report, some point fingers at the county's Child Protective Services agency as not doing enough, perhaps blaming the Band-Aid for the cut. Representatives from the county and independent organizations that deal with the issue suggest that the statistics may not indicate a rise in child abuse specifically, but rather an increased education and effectiveness of the community to report suspected abuse. Others draw attention to how little the given statistics indicate about important questions, including the reasons why abuse may have increased.

Though the numbers remain distressing, child protection advocates interviewed for this story view the report, which was released last week by United Way of Santa Cruz County, as an opportunity to help educate the public concerning the dangers and effects of child abuse and encourage further exploration into one of the most critical issues facing our community.

A Substantiated Case

Because child abuse most often occurs within walls of the most private sort--the home--the full extent of the problem can never be entirely quantified. Instead, the Community Assessment Project's statistics address the rate of "substantiated cases" of child abuse.

"When we get a report, it's a 'report of suspected abuse or neglect'; we [have to] decide if it needs to be investigated, and that decision is made using some standardized tools, by trained social workers," says the Santa Cruz County Human Resources Agency's Judy Yokel, noting that some reports go no further than the initial phone call.

"If we decide to investigate it, then there's a comprehensive investigation conducted by trained social workers in our emergency response unit, which is available 24 hours a day, seven days a week, to investigate child-abuse reports. And one of the primary goals of that investigation is to determine whether in fact abuse or neglect did occur, and we use the definitions of abuse and neglect that are in the penal code," explains Yokel, who is assistant division director of the HRA's Family and Children's Services division. "The investigation can sometimes take up to 30 days, sometimes much shorter, and if we determine according to those penal code definitions, that the incident meets the definition of child abuse or neglect, then the report is considered substantiated."

According to the Community Assessment Report, the substantiated cases of physical abuse have taken a downward trend, while substantiated cases of neglect have gone up significantly, as have cases of emotional abuse.

If a report of abuse becomes substantiated through this process, steps are then taken to assess whether the child needs to be removed from the home. A case's substantiation may be a child's first step into "the system," but the problem usually begins much earlier, involving the intersection of numerous components that can add up to volatile domestic stress.

Nancy Sherrod, executive director of Santa Cruz County's Court Appointed Special Advocates (CASA), believes the significant rise in neglect may be associated with other issues also on the forefront of concern in Santa Cruz County, including housing and drug use.

"It's always a somewhat complex issue," says Sherrod. "If we knew, we would hopefully be able to make it go away. But I think some of the factors are the difficult situation of people living paycheck to paycheck. That puts a lot of strain on families. The housing cost being so high contributes to that."

Santa Cruz County's unemployment rate has been consistently higher than state and national unemployment rates, according to the Community Assessment Project, and only 11 percent of households in Santa Cruz County were able to afford a median-priced home in 2005.

Yokel and others highlight substance abuse as the main contributing element in the rise in neglect.

"So the typical picture is a parent who's using," says Yokel, "and is neglecting his or her children in the sense of failing to provide adequate food, clothing, supervision, health care and other basic needs for the child. That's general neglect, a parent who's not doing those things for their child, and it's a very, very common scenario for us. So, substance abuse has increased, and hand in hand with that, general neglect has increased."

Santa Cruz County Public Information Officer Linda Kerner, who also spends time involved in child abuse prevention campaigns, says it's not just up to child protection agencies to solve the problem.

"It's a community problem," says Kerner. "We may be the agency designated to respond to these reports, but it is truly a community problem and we look to the community for their help. We need them to be our eyes and ears for these kids who can't speak up for themselves."

Unfair Comparison?

In addition to the rise in substance abuse, Yokel offers another possible reason for the rise in overall reports of substantiated child abuse: Child welfare and law enforcement procedures aren't standardized from county to county.

"There are areas of interpretation," says Yokel. "In talking about why Santa Cruz County's number is higher than the state's, one factor in that, I think, is substance abuse. Another [involves] how we substantiate a certain category of case and how other counties do, and that area is domestic violence."

In 1997. a special agreement was made with law enforcement agencies in Santa Cruz County, one which was neither mandated by the state nor commonly held in many counties in California.

"In fact I think most other counties don't have this agreement," explains Yokel. "When law enforcement responds to a report of domestic violence, if there are children in the home, law enforcement automatically reports that to child welfare. It becomes a report of suspected child abuse. And that's not legally required. When we're talking about domestic violence between the parents, where the child has not been physically harmed, the law does not require that to be reported to child welfare services. But in this county we've made a decision to do that, because we believe domestic violence is very harmful to children and that those families may need the attention of the child welfare agency."

After a case is reported, Family and Children Services investigates the case, and if it is determined that domestic violence did take place within the home, the child's case is then substantiated in the category of emotional abuse.

"We consider it emotional abuse of the child to be exposed to harmful domestic violence on the part of the parents. What that means is, in Santa Cruz county, we have families coming to our attention that are not coming to the attention of other counties in the state. And in fact, I looked at our statistics ... and for the year 2005, I looked at all our substantiated reports, 30 percent of them had domestic violence as an allegation," says Yokel of the reports, which may cite a number of allegations. "So, that's almost a third of our substantiated reports "And I think as a community we should be really proud of the fact that we are coming to the aid of children who are exposed to parental domestic violence, but it also makes our numbers look higher than they would otherwise."

That's not to say that Yokel doesn't acknowledge significant problems in the Santa Cruz County system. And her main concern is the budget.

"It's not enough," says Yokel. "And this is a problem statewide. Child welfare agencies are woefully underfunded. In the year 2000, the state commissioned a study [under] S.B. 2030, a law that mandated that a workload study be done of statewide child welfare agencies, and it involved having every worker keep track of their activities, every 15 minutes, what they did on what kinds of cases, and there was a whole automated way of collecting that data. The conclusion of this study, the 2030 workload study, was that case loads [per social worker] in California should be half of what they are. The state funds us to have half the number of social workers we need."

Because the county Board of Supervisors allocated additional funds to Santa Cruz County child welfare agencies, the number of social workers specifically devoted to child-abuse cases will increase from 53 to 63 in the near future. But the problems don't end there.

"We struggle a bit to find qualified social workers, to tell you the truth,," says Yokel, "because public child welfare doesn't pay great."

The First Five Years

Both county and independent nonprofit organizations continuously collaborate to aid abused children and families in trouble. But First Five, with funding from California's cigarette tax, specifically focuses on improving and maintaining the health of children aged 0 to 5 years.

"The state doesn't get involved in families because of a difference in parenting practice or a difference in philosophy," explains Susan True, First Five's executive director. "When we're talking about abuse and neglect, we're talking about suffering that can really last a lifetime."

The early lives of children, explains True, are critical for all forms of mental and emotional development, which is why First Five focuses its attention on children of these ages.

"The years between birth to 3, our brains are developing at rapid, rapid speed, and the way that our neurons connect in those early years effects everything later: how we develop empathy, how we are able to love other people, how we are able to be successful in school and in cognitive development," says True. "So what parents do to build a healthy bond or attachment to their kids is critical, because basically if infants and toddlers are responded to and parents are able to give them what they need, and children feel secure, the chance that they'll grow up as a healthy, productive, successful, meeting their optimum potential, is great. It's a huge predictor. That's why [with] abuse and neglect in those early years when kids don't have that secure attachment, things are really hard for them later. So we really want parents to know the importance of the first five years of life so they can parent those young ones in ways that make success."

According to many child welfare workers, including Beth Love of the Santa Cruz County Child Abuse Prevention Council (CAPC), the problem of child abuse spans across all ethnicities and socioeconomic backgrounds. Because of increased levels of privacy in the living situations of upper-class families, the general public most commonly associates child abuse with lower-class homes.

But in studies done of adult survivors of child abuse, reports suggest that abuse is not limited to the stereotype of lower-class, single-parent homes.

According to Yokel, the locations of children when they first entered into the system are spread more or less evenly throughout the county, not focused particularly in one specific area.

"It's spread pretty well throughout the county, it's about 40 percent South County, Watsonville and Freedom area, about 30 percent Santa Cruz and Live Oak, about 9 percent Capitola and Soquel and Aptos, about 10 percent Scotts Valley and San Lorenzo Valley, and about 8 percent out of county," says Yokel. "It's definitely a countywide problem."

Yokel attributes the higher percentage in Watsonville to a higher relative population of children in that area.

A study called the Adverse Childhood Experience Study, associated with Kaiser Permanente in San Diego, was designed to find correlations between childhood experiences of abuse and trauma, and mental and physical health conditions in adults.

According to the ACE study, almost two-thirds of study participants reported at least one "adverse childhood experience," including childhood abuse, neglect and exposure to other traumatic stressors.

The study shows that as the number of adverse childhood experiences increases, the individual's risk for the following health problems increases: alcoholism and alcohol abuse, chronic obstructive pulmonary disease, depression, fetal death, health-related quality of life, illicit drug use, ischemic heart disease, liver disease, risk for intimate partner violence, multiple sexual partners, sexually transmitted diseases, smoking and suicide attempts.

According to Love, creating a community mind-set that does not automatically associate difficulties in child-rearing with other stigmatized groups, such as drug users and dealers, is extremely important in developing a community where people feel comfortable seeking help when they need it.

"I'm not saying it's not a crime--there's criminal statutes that regulate it--but it doesn't support the resolution of this very hidden issue when the public response is seen as punitive, and where people who are identified as having this challenge of abusing their children are also associated with stigmatized groups like substance abusers, or people who sell substances, or people where there's other challenges, perhaps mental illness," says Love.

"What happens when we do have this criminal justice response and this punitive system response to parenting challenges, is that when people do get in trouble, and when people do start crossing the line in their own parenting behavior, they're not very likely to seek help."

Differential Response: A Preventative Approach

Standards and approaches in child-care services are changing all the time. One such change is a "differential response" initiative, implemented by such local programs as Families Together and Primeros Pasos.

"Basically it's prevention and early intervention services for families that have not yet entered the child welfare system," says Yokel. "They've been referred to us, but we're not going to open a case, because the situation isn't severe enough for us to open a case. In the past, no system really focused on child abuse prevention and child well-being to provide to those families to try to prevent them from having to come into the child welfare system."

The belief that family services should be tailored specifically to each family is the foundation of the "differential response" approach.

"That name is funny,," says Yokel, "but it has to do with the idea that one size doesn't fit all, and that the full-on welfare child service system is what you need for families who have reached the level of severity where there is documented abuse and neglect but other families are just at risk of abuse and neglect, and are having problems and have been reported to the system but are not at the level where we need to provide them full on child welfare response, and for them we need a different way of responding, and not just us, but the community."

Yokel points out how the Families Together organization has only been active since September, yet has met with positive responses and shows great potential.

"It's a voluntary program, so we're not court-ordering the family into this. But we're encouraging them, and trying to engage them in services to strengthen their family, to help them to function better as a family and to develop skills and resources to parent their children safely," says Yokel, "so they will not end up entering the child-welfare system."