Families – Private and sacred : How to raise the curtain and implement family support from a public health perspective

Internationally, best practice in child abuse prevention is grounded in a public health approach – identifying risk factors (such as parental substance misuse, mental health problems, or family violence), and putting in place wide-reaching strategies to reduce the ‘burden of disease’ by altering the risk profile of the entire population (not just sub-groups identified as ‘at risk’). Families can play a crucial role in protecting children by providing a safe and supportive environment. Although family life and parenting activities are often framed as ‘private’ and ‘sacred’, and there is reluctance to tell parents what they should do (or for parents to seek help to improve their parenting capacity), there is considerable evidence that providing evidence-based supports at a population level can achieve significant benefits in reducing the likelihood of child maltreatment, while also enhancing the well-being of the greatest number of children. The greatest investment should be in primary prevention services, as they reach the largest number of families. If successfully implemented, primary prevention services will shift the “risk profile” positively for the entire population, which translates to fewer children and families in need of more intensive secondary or tertiary services. Policies that improve family access to services and supports that reduce stressors related to poverty, addiction and ill health will assist with prevention of child maltreatment. The broader availability of such whole-of-population strategies also helps with early identification of families ‘at risk’ or in need of additional supports. However, if strategies are only targeted to the most vulnerable families, the vast majority of parents experiencing difficulties with parenting will be ignored and it will be very difficult to impact on the prevalence of child maltreatment. Success should be measured by the engagement of universal service delivery platforms (which most children and their families encounter) in the task of protecting all children