Cumulative harm

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This content will be strengthened so it more completely reflects our commitment to practice framed by te Tiriti o Waitangi, based on a mana-enhancing paradigm for practice, and drawing from ​Te Ao Māori principles of oranga to support mana tamaiti, whakapapa and whanaungatanga. We each need to consider how we can apply these principles to our practice when reading this policy. The following resources provide support:
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What is cumulative harm

There is often a co-existence of different circumstances that create patterns of events in the life of te tamaiti that impact on their sense of safety, stability and wellbeing through cumulative harm.

Repeat episodes of abuse can have a profound impact on the development of a tamaiti. A chronology is important when considering the impacts of cumulative harm and enables identification of patterns of events, over time, that are impacting on te tamaiti. Patterns may show us things are improving but also may indicate a more worrying situation for te tamaiti.

When considered individually, each episode of abuse or neglect may not be deemed to be significantly harmful but cumulative harm is the result of several incidents where the collective effects are serious enough to be described as harmful, and this needs our attention.

Serious harm

• The cumulative effects of minor harm over time can be detrimental in the same way that a single major event of harm is experienced.
• Cumulative harm is traumatic because over time, and with many incidents of harm or abuse, even at low levels, the resilience and mana of te tamaiti is diminished and this will have an impact on their self-esteem and development.
• Consider the pattern, the frequency, the severity and the source of harm. For example, several reports of family violence over time demonstrate a pattern — consider the impact on te tamaiti and what this tells you.

Tamariki who have experienced multiple events of abuse, neglect or exposure to family violence from those who are responsible for their care, protection and nurture can suffer complex trauma.

Complex trauma is the cumulative experience of multiple, chronic, significant and prolonged developmentally adverse events most often of an interpersonal nature and occurring from early life.

Cumulative harm is more likely to be evident in situations where there are multiple interlinked problems and risk factors such as:

• family violence
• substance use
• disability
• intellectual and mental health problems
• a lack of protective factors including being unwilling or unable to access support networks and ongoing social exclusion and isolation.

Reports of concern about whānau or family issues may have been seen as discrete events, even when the reported concerns are similar in nature, with each event in and of themselves not warranting further intervention by Oranga Tamariki. Seeing the concerns together, as a pattern over time, will show us the cumulative result. Harm may be occurring that warrants statutory intervention or help from our partners.

Tamaiti in care

Repeated changes and transitions of care placements have a cumulative impact. If tamariki have experienced one or more change of placement, the impact on their sense of safety and their wellbeing must be carefully considered.