Establishment of Interdisciplinary Child Protection Teams in a Traditional Society: Experience in Turkey 2001-2010

R. Oral MDUniversity of Iowa, Child Protection Program

Contributors: A. Akin, S. Aksit, C. Aydin, A. Balseven, A. Baransel, U. Beyazova, F. Beyastas, O. Bezirci, B. Buken, E. Buken, A. Camurdan, A. Celik F. Cuhadaroglu, T. Dagli, B. Demirel, O. Derman, Y. Ersahin, N. Gazioglu, B. Gökler, S. Gulnar, M.A. Inanici, E. Iseri, A. Karaoglan, F. Koc, F.S.

Orhon, C. Özbesler, D. Ozdemir, F. Pasli, F. Sahin, U. Tiras, A. R. Tumer, B. Ulukol, R. Uslu, F. Yagmur, S. Yalcin, S.

Yaylaci, C. Yorulmaz, K. Yurdakok

ISPCAN 12th European Conference

Tampere, Finland 2011

Glossary

TSPCAN: Turkish Society for the Prevention of CAN

ICCR: International Convention on Children’s Rights

TMA: Turkish Medical Association

MDT: Multi-disciplinary team

PA: Physical abuse EA: Emotional abuse HS: High school

SA: Sexual abuse CAN: Child abuse & neglect UMSH: University Medical

School Hospital CH: Children Hospital UI: University of Iowa CPP: Child Protection

Program CAC: Child Advocacy Center NGO: Non-governmental

organization CPT: Child Protection Team

Problems in CAN in Turkey

Lack of structured national prevention program

Lack of comprehensive child protection law Lack of comprehensive definition of CAN Professionals lack:

Awareness, knowledge, willingness to recognize & report CAN

Inadequate resources for CAN Lack of collaborative mind-set

University of Iowa Child Protection Program

Mission : … Professional education International education in developing countries

Focus on Turkiye Portugal Pakistan Greece

University of Iowa (2001-2011)

National Collaboration established involving UMSH/CHs in Turkiye Establish culturally competent,

interdisciplinary training activities annually on CAN

To train the trainers: 5 faculty trained in USA To motivate establishment of

multidisciplinary teams:~ 30 MDTs established in 17 provinces

Training Activities (2002-2011)

National conference every year, 2-6 in-service courses/symposia/workshops annually

Focus: Ankara (most advanced teams and policy makers/government)

Secondary focus Izmir & Istanbul Tertiary focus: Peripheral small

provinces

Training Activities (2002-2011)

~8000 professionals participated Medicine, mental health, nursing,

public health, social work, education, law enforcement, prosecution, NGOs, government, policy makers, prevention…

Outcome of Training Activities (2002-2011)

Regional MDT organizations improved

5 faculty trained at the UI CPP for 1-6 months

Hospital CPPs are establishing databases

Numerous international peer reviewed publications

Clinical Research in CAN & system response to professional developments

1990 1995 2000 2005 2010

Research

Clinical translation

Outcome of Training Activities (2002-2011)

Regional MDT organizations improved 5 faculty trained at the UI CPP for 1-6

months Hospital CPPs are establishing databases Numerous international peer reviewed

publications Policy makers and government

involved Bill on CAC-based child protection

response to sexual abuse being debated in parliament

Clinical Research in CAN & system response to professional developments

1990 1995 2000 2005 2010

Most structured Child Protection Teams and Centers at metropolitan universities Other CPTs established as a result of UI CPP activities Other international semi-structured CPTs established independent of UI CPP’s activities

ANKARA

Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) in Turkey.

One case can make a difference…

* Newspaper columnist,

supporting government

* Sexually abused a 14 y/o

* Government tried to cover it up

* Child psychiatrist exposed government

* Two parliamentarians reached out to collaboration

* Collaborative drafting of a bill for CAC model

Child Psychiatrist A. Erdogan

Policy makers

UI MDTResmiye Oral

Ankara U MDTBetul Ulukol

Ministry of Health

MoHealth MoJustice MoInterior MoSocialSMoEducation

MoLaborCourtofAppealsMoCommunication

Ankara UniversityUniversity of Iowa

INTERMINISTERIAL HIGHER COUNCIL

ANKARA

Figure 2. Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) in Turkey.

Ankara CIM=CAC: 11/2010

Ankara CIM=CAC

Higher council meets every 3 months Provincial government established

regional child abuse task force similar to higher council

Task Force meets every 2 months to refine protocols and emerging needs, reports to higher council

Ankara CIM=CAC

CIM staff consists of 1 forensic med physician, 1

pediatrician, 1 child psychiatrist 3 psychologists (forensic interviewers) 2 social workers (child advocates) 1 secretary and 1 security staff

Ankara CIM=CAC Ankara prosecutor’s office, Regional

Social Services, law enforcement each has a staff during hours on site To contribute to forensic interview To guide psychosocial evaluation To be part of decision making To initiate community case-management on-

site

Ankara CIM=CAC

Ankara population= 4.5 M Child population ~ 1-1.5 M

Ankara CIM/CAC is receiving 4-5 cases a day

Still the tip of iceberg!

Current goals for 2010-2015 Integration of the pilot Child

Advocacy Center Model into Child Protection Law

Disseminating the model to all provinces (2013-2014)

Development of a National Database for case and offender tracking

Enhancing government efforts on implementing ICCR

ANKARA

Figure 2. Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) and proposed CACs.

Ankara CAC: 11/2010

… Pilot CACs: 2011-12

Certified personnel Ankara UMS and MoHealth staff

are working on developing a licensing program to train and license Physicians Forensic interviewers Child advocates

Ankara CIM will become national educational center

Pts 03 Hzr 2002, 05:15   Türkiye iller haritası

                                                                                                                                                                                                                                         

In 2013-2014: Nationwide dissemination of the model

Future implications Integrate university CPCs into

MoHealth network of CACs Collaboration between University

CPCs and CACs to conduct research Assess efficacy and issues Re-evaluate model and improve

cultural competency

Thank you. Resmiye-oral@uiowa.edu