Study: Few EMS Workers Report Child Abuse

by Kelsey Sturman

EMS_worker_David_Tan_flickrAs the first to respond when tragedy strikes, emergency medical services (EMS) workers can be critical witnesses to instances of child abuse and neglect. Yet many of North Carolina’s front-line medical workers are unaware of mandatory child abuse reporting laws or think such reports are someone else’s responsibility, says a newly published study by a recent Duke graduate.

Ellen Grace Lynne, an English and public policy major who graduated from Duke in December 2013, was interested in EMS workers because of their unique role in children’s lives. EMS workers often underreport child abuse, sometimes with tragic results. According to one report by the N.C. Child Fatality Task Force, in nearly half of N.C.’s child fatality cases, EMS professionals noted suspicion of child maltreatment but did not report those suspicions to authorities.

Lynne decided to investigate the reasons for that underreporting with the help of Joel Rosch, Elizabeth Gifford and Kelly Evans, researchers at the Center.

“We realized EMS workers weren’t filing child abuse reports and we wanted to know why,” Rosch said. “What exactly was the problem and where was the problem occurring? We wanted to give them a picture of the problem so they could try to improve their jobs.”

Lynne surveyed  more than 400 North Carolina EMS professionals and found big gaps in their knowledge of child abuse laws and policies. Her findings appear in the January/February issue of the North Carolina Medical Journal.

North Carolina law requires individuals and institutions to report suspicions of child maltreatment to county departments of social services. In addition, the North Carolina Office for Emergency Medical Service, which oversees the state’s EMS system, requires EMS professionals to report potential abuse or neglect to local officials.

Lynne found 38 percent of EMS respondents were not aware of their agency’s written policies mandating reports of child abuse and neglect. Another 25 percent knew of the protocol, but incorrectly believed it was someone else’s duty to file child maltreatment reports.

Workers on the front lines were particularly unclear about the requirements. Some 24 percent of line staff claimed they didn’t know if their agency required them to report child abuse suspicions. Leaders were more aware of the requirement, with only 7.3 percent of that group claiming no knowledge.

The findings serve as a reminder that policies alone often aren’t enough to effect change, Rosch said.

“When we think about public policy, we often think about how we create policy but not about how it’s being implemented and whether or not it’s altering behavior,” he said.

Lynne’s report calls for improved training for EMS professionals on how to report suspicions of child abuse. Specifically, a more streamlined system of rules should guide professionals on identifying abuse and neglect and understanding the process of reporting maltreatment suspicions. Lynne and Rosch said they are hopeful EMS officials will put the findings to use.

In designing the survey, Lynne had assistance from the North Carolina Child Fatality Task Force, Prevent Child Abuse North Carolina, Child Protective Services and other agencies. Lynne said the project helped bring her public policy coursework to life and  gave her a competitive edge in the job market.

“It’s an invaluable experience,” Lynne said. “It’s not just for a grade, you get really personally invested, you grow.”

Lynne now works as a research associate at Raines International, an executive search consulting firm in New York City.