Estimating the Social Costs of Child Abuse in Residential Care for Children with Disabilities Using the Japanese Survey on the Interactions of Adverse and Positive Childhood Experiences toward Adulthood.

We sought to calculate the extra social costs resulting from child abuse in residential care facilities (RCFs) for children with disabilities (CWD) in Japan. We distributed a survey to 260 residential facilities for CWD in 2020 and obtained responses from 91 facilities. Among the children placed in these facilities, our estimates by four different criteria determined that 23-67% were affected by child abuse. We also estimated extra costs for each of the four criteria, which we estimated to average USD 647.7 million. This study is meaningful in that there are no existing official statistics or research findings on the extra costs of residential care due to child abuse in Japan.

Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis.

BACKGROUND: Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. METHODS: The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. RESULTS: About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). CONCLUSIONS: Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be proactive in prevention or intervention for adults with perpetration risk.

Job stress and mental health of child-counseling office workers.

In Japan, consultations concerning child abuse cases are increasing rapidly, and the mental health of child-counseling office workers, who must deal with them, has emerged as an issue. To measure the state of mental health of these workers, and to clarify the characteristics of their job-related stress, we sent a questionnaire to 69 workers of child-counseling offices in Ibaraki Prefecture and obtained responses from 45. (1) Their job environment was characterized as high demand/low control/low reward. (2) The mean score of GHQ-12 of the subjects was 5.9 +/- 3.6, indicating a very poor state of mental health. (3) Stress due to physical and verbal assaults by the parties involved in the cases and the psychological burden of intervention were found to be related to their poor mental health. Along with measures to prevent such assaults, training in intervention techniques, supervision, and care for psychological trauma are needed for child-counseling office workers.

How great is willingness to pay for recovery from sequelae after severe traumatic brain injury in Japan?

OBJECTIVE: To evaluate the burden on families with a family member suffering traumatic brain injury sequelae in Japan. DESIGN: Cross-sectional study. METHODS: Family members' burden from the sequelae of traumatic brain injury was estimated by use of willingness-to-pay models and the contingent valuation method. A national survey among 1707 members of the Japan Traumatic Brain Injury Association was conducted by postal questionnaire with open-ended questions. A total of 509 (29.8%) of the family members responded (405 men and 104 women). Mean age of patients with traumatic brain injury was 33.4 (SD 14.3) years and of responding family members 53.3 (SD 14.5) years. RESULTS: Willingness-to-pay for the family member's recovery from sequelae of traumatic brain injury (8,694,502 Japanese yen; 79,134 US dollars/year) was similar to that reported for a family member's survival from incurable terminal disease (8,342,953 Japanese yen; 75,934 US dollars/year). CONCLUSION: The data indicate that family members perceive the burden of a family member with traumatic brain injury sequelae as similar to what would have been caused by an incurable terminal disease.