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Consultation centers, local gov'ts facing challenge of increased child abuse cases

The Central Government Building No. 5 in Tokyo's Chiyoda Ward that houses the Health, Labor and Welfare Ministry is seen in this file photo taken on Oct. 14, 2015. (Mainichi)

Child welfare consultation centers and municipalities are struggling to cope with a surge in child abuse cases, as they lack sufficient staff and expertise to properly protect and care for the victims.

According to the Ministry of Health, Labor and Welfare, a total of 133,778 reports of child abuse -- a jump of 9.1 percent from the previous year and a historic high -- were received by child welfare consultation centers across Japan during the 2017 fiscal year. It was the 27th consecutive year that reports of child abuse increased from the previous year.

"We are really understaffed and face the risk of missing serious abuse cases," said lawyer Kenji Kubo, who heads the emergency support section at a child welfare center called Egao-kan in the city of Fukuoka in southern Japan. Cases that are particularly worrisome for center officials are those reported by police in which guardians cause children psychological trauma by making them witness domestic violence.

Of the 1,457 abuse reports that the Fukuoka center received last fiscal year, 881 reports, or 60 percent, came from police, and about 500 of them were psychological abuse -- primarily the type in which children are witness to domestic violence. Some of the cases are mere spousal quarrels, but checking on the safety of children is necessary regardless. "It's really overwhelming our workload," Kubo said.

In April 2017, the health ministry made it possible for child welfare centers to refer abuse cases to local municipal governments in a bid to ease the burden on the centers' stretched resources. According to ministry guidelines, referable cases include indirect domestic abuse that have caused no direct damage to the child, and have a low chance of recurrence. Actual referrals, however, are not taking place as often as was hoped.

A child welfare consultation center in the city of Kitakyushu in southern Japan referred just 57 of 1,377 abuse reports it received to the local government in fiscal 2017. Those referred cases included reports of crying children.

Yasuhiro Kikuhara, who heads the center's section for child abuse prevention, explained that officials there are cautious about making referrals, as they know the municipal government is not ready to handle them. "We receive hundreds of indirect domestic abuse reports, and handing them over all of a sudden to local government officials when they are not prepared is just irresponsible."

Director of a child welfare center in the western Japanese city of Akashi, Hyogo Prefecture, Hiroaki Kinoshita, said that unlike child welfare centers, local governments do not necessarily have experts on staff who can handle abuse cases. "It's not easy to increase referrals," he emphasized.

There's yet another new situation to worry about on the horizon. The health ministry plans to make a 24-hour child abuse hotline managed by child welfare centers across the nation free starting fiscal 2019. The new policy will be useful in preventing abuse cases from falling through the cracks, but it may stop functioning properly if the number of phone calls surge, as they are expected to.

Kubo, of the Fukuoka center, proposes three countermeasures: Beefing up measures for handling child abuse at local governments; unifying reporting and counseling routes for child abuse, now handled by both child welfare centers and municipal governments; and the establishment of a triage organization that determines the seriousness of a situation, and hands over serious reports, including those from the police, to child welfare centers, and refers less serious cases to local governments.

In September, the health ministry will resume expert panel discussions on issues including the triage of child abuse reports. But many hurdles still stand in the way of realizing a triage body, due to a plethora of still unanswered questions, such as who will establish the organization and how experts will make judgments about the emergency level of reports.

(Japanese original by Ai Yokota, Medical Welfare News Department)

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