It is not that man who tries to tempt children with some candy, nor the one who waits for his moment in a dark alley: 85% of the aggressors of children and adolescents are people known to the victims and most of them are socially integrated. The established image that the family is a protective element per se is also not real: half of the attacks occur in the family environment.
The data from the unit for attention to violence against children and youth at the Vall d’Hebron hospital (EMMA team) dismantles a series of myths about this scourge, such as that the victims are marked forever. It is not true, says Mireia Forner, clinical psychologist at the unit. The longer the delay in the victims’ disclosure of the facts, the more complicated the treatment is, “but when one is able to reveal a situation of violence, if one has good support from the social environment and receives good treatment, “It can be recovered.”
This is what the EMMA team, a reference device for addressing violence against minors under 16 years of age in the city of Barcelona, has been dedicated to since its creation three years ago. In the last year, the staff of paediatricians, psychologists, social workers, administrators… has doubled, caring for 314 patients, a figure similar to previous years, and very far from reality.
“It is a difficult, hard reality, often not very visible because it occurs in the family environment or in an environment close to the victim. That is why we want to present to society what is happening with boys and girls who suffer violence and often suffer psychological consequences,” argued José Manuel Domínguez, assistant director of care at Vall d’Hebron.
“We are only seeing the tip of the iceberg,” concluded pediatrician Anna Fàbregas, team coordinator. “We are facing a very serious public health problem because violence causes physical and mental illnesses, and we are facing a social problem because it originates in a society that must take care of its children and adolescents.”
The 314 cases attended to in the last year are a tiny fraction of a reality that, according to EU estimates, affects one in five minors. But they provide a scaled x-ray of the problem. For example, 80% of victims have suffered sexual violence, the most widespread modality ahead of physical violence (14%) and neglect of child care (2%).
A girl with an average age of 10 years who reveals the events to her mother continues to be the characteristic profile of the patient treated for sexual violence, who in 87% of the cases was between 8 and 12 years old at the time of the events. Fàbregas specified.
Girls (79%) are more victims of childhood violence than boys, and even more so as they grow, according to social worker Giuliana Ríos: 61% in the 0-7 year old age group, 84% in the 8-12 year old age group. and 91% in 13-16.
Regarding the profile of the aggressor, he is a man in 97% of the situations, normally an adult, but 26% are under 18 years old and 13% are of a similar age to that of the victim, data on which the specialists draw attention. When the aggressor belongs to the family, which happens 49% of the time, it is usually the father (30%), followed by the mother’s partner 19%), a cousin (17%), a grandfather (11%). %) or a brother (6%).
Six of the adolescents treated in the last year had become pregnant as a result of sexual violence. 60% of the victims of this modality present psychopathology that requires specialized treatment. More than a third (36%) suffer from post-traumatic stress, and the rest have disorders such as depression, self-harming behavior or anxiety.
The impact of violence on mental health is important, according to Mireia Forner, clinical psychologist on the team, and the average duration of treatment is one year. In the therapeutic process, the emotional support of family members or guardians is important.
Forner celebrates the results of the first cognitive-behavioral therapy applied in a group for these cases in Spain. 7 girls and members of their family caregivers, mainly mothers, participated in 16 sessions that have contributed to the reduction of post-traumatic stress symptoms.
The mother (50.5%) is the trusted figure to whom victims of childhood violence reveal the facts for the first time. Behind them, professionals from the school environment (11.7%), mental health (3.7%) or leisure (3%). “Victims do not verbalize these types of situations when they want, but when they can. Feelings of shame and guilt keep them silent, and disclosure is an act of courage and an unprecedented demand for help,” say the professionals.
Most of the patients treated in Vall d’Hebron (204) were referred from other health centers, mainly primary care, 46 came from their family; 31, from the Catalan system of protection for children and adolescents and 21, from educational centers.
