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Child to Parent Abuse is largely hidden yet has a profound impact on a significant proportion of society. We need to work together to bring CPA out of the shadows and better support those living with abusive and violent behaviour, and healthcare professionals are a vital part of that work” – says social enterprise director Michelle John from PEGS.

“Child to Parent Abuse wasn’t even referenced in the Domestic Abuse Bill until the latest updates were passed just months ago. Now, there’s a section in the statutory guidance, sent out to authorities including healthcare bodies, which specifically details CPA.

There’s not yet a legal definition – but the Home Office and other Government departments are moving towards updating their policies.

Research began around 15 years ago, but there are still relatively few studies in comparison to those looking into other forms of abuse.

Voices are beginning to speak up about the extent and impact of CPA but, until recently, there was a real silence around the topic – as if it was taboo that there were parents being abused by their own children.

Because of this under-researching, under-reporting, and societal silence, we have no way of knowing exactly who’s impacted by this type of abuse, but experts currently predict at least 3% of UK households are affected.

A study recently released revealed that in Lancashire, 10% of the domestic abuse incidents police were called out to in a period of just over two years were cases where a parental figure was being targeted.

Why does this relate to healthcare professionals?

There’s a real gap when it comes to support for parents, carers and guardians – to overcome this, we need to ensure professionals across a wide variety of sectors have a real knowledge of CPA in order to effectively listen, signpost and assist.

Healthcare staff are vital to this process – we know from PEGS research that 75% of parents who’ve sought support have spoken to their GP (or their child’s GP) about what’s going on at home. 72% have chosen to speak to a CAMHS team and 17% to a health visitor.

We know a number of things can happen if the parent doesn’t get a supportive response: they may not try to speak to a professional again (80% have changed their mind about reaching out for support at least once). And the severity and frequency of the incidents will increase over time, therefore escalating the risk to the parent – one person every 19 days is killed by their child in England and Wales.

There’s no magic solution, of course, but being able to signpost and refer to the right services (such as Forensic CAMHS) and then keep advocating for that family if support is refused, is hugely impactful. So too is simply knowing what to say – and what not to say – being listened to non-judgementally, believed, and having a safe space to talk is hugely powerful.

What about the staff themselves?

CPA doesn’t discriminate, and with a workforce of 1.4million in the NHS we know there will be sadly many thousands who are experiencing abuse from their own child. So, it’s not just about who you may come into contact with professionally, it’s about your colleague sat next to you at lunch or working on the desk opposite yours.

An overwhelming 70% of working parents have to reduce their hours or leave their job altogether as a result of CPA – and those who stay are juggling physical, emotional, financial and even sexual abuse at home with the demands of a busy healthcare job.

Being able to spot the signs among patients as well as peers could see families being able to access support at a much earlier stage.

What are the early signs?

CPA does tend to be hidden by parents for fear of judgement, repercussions for their child (or their other children being considered unsafe to stay in the home) or a variety of other reasons.

It could be the person has financial stresses relating to their child’s spending (some even take out credit cards or run up debts in their parent’s name) or they may be physically hurt or struggling to eat, sleep or relax. They may try to justify unreasonable behaviour from their child in an attempt to cover up the severity of the abuse; or they may often be absent, late or need to leave work early.

Parents may be pushing for a diagnosis for their child in an attempt to explain why they are showing abusive behaviours (understandable in the situation, but in reality CPA sometimes has no obvious cause, and there are plenty of neuro-typical children who are abusive or violent to their parental figures).

If they open up about what’s going on, they may talk about ‘walking on eggshells’, living in fear, changing their behaviour or ignoring minor incidents to avoid escalating the situation. They may talk about behaviour displayed to other children in the home, and even pets or animals.

Knowledge is power:

The more you understand, the more you’re able to support patients and colleagues who may be experiencing CPA. Collectively, the more we talk about CPA, the more we can bring it out of the shadows and show parents, carers and guardians that they will be supported, listened to, and empowered if they choose to speak up about their experiences.

There are too many people living in fear right now, locking themselves in a home at night with someone who is violent and abusive towards them. Someone they still love despite their behaviour. Someone they still have parental responsibilities towards. Someone they don’t want to criminalise, marginalise or walk away from until the situation hits breaking point.

I call on all healthcare professionals to be aware, be knowledgeable, and be supportive – you may be the first person that parent has ever opened up to, and your response could make them feel safe enough to continue accessing support and maybe even start seeing the light at the end of the tunnel.

About the author:

Michelle John is the Founding Director of PEGS – she has lived experience of CPA and a background in family law and domestic abuse work. Named one of the WISE100 in 2020 just months into launching her social enterprise, Michelle has gone on to influence national policy, speak at multiple regional and national events, support more than 2,000 parents and train frontline professionals across the UK.

Visit www.pegsupport.co.uk or search PEGS Support on social media for more information.

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