Serious harm

What constitutes serious harm?

Harm can have a varying degree of impact on te tamaiti or rangatahi.

Sometimes a single traumatic event, for example a violent sexual or physical assault, can have a significant impact on te tamaiti or rangatahi and may constitute serious harm.  However, in many cases, a one-off incident, unless extremely severe and traumatic, is unlikely to have a long-lasting and serious impact on te tamaiti or rangatahi. Often serious harm is the cumulative impact of events or circumstances, both acute and long-standing, which interrupt, change or damage the physical and/or psychological development of te tamaiti or rangatahi.

“Is likely to” be harmed means:

• the harm has not happened yet, but  there are concerns regarding the likelihood of events or circumstances (an incident, incidents or actions or inactions) which may result in serious harm in the future, or
• there is a concern that serious harm has already occurred and may reoccur.

Not all harm is deliberate. It can result from an act of omission, a failure to do something, or can be the result of circumstances outside the control of the parent/caregiver, for example prolonged homelessness or an assault by a third party perpetrator.  

A number of factors will influence how strongly te tamaiti or rangatahi will be impacted by an event/incident(s). It is important to build and deepen our understanding of the individual tamaiti or rangatahi to understand how they are impacted by an event/incident or series of incidents.

In some cases, it is easy to determine that te tamaiti or rangatahi has suffered serious harm – for example, when a tamaiti or rangatahi has been sexually abused or physically attacked. There is likely to be clear first-hand evidence of harm to te tamaiti or rangatahi. The more difficult cases involve issues of chronic neglect, ongoing exposure to family violence and emotional abuse where it is hard to find one particular incident that makes people worried. Rather, it is the long-term, cumulative impact on te tamaiti or rangatahi of the ongoing exposure to the same kind of harm that is concerning. 

When considering whether te tamaiti or rangatahi has suffered, is suffering or is likely to suffer serious harm, it is important to consider the impact of the harm on the oranga of te tamaiti or rangatahi.

Consider and analyse the following:

• The nature and severity of the incident or incidents and their impact on te tamaiti or rangatahi. This includes the actual, or potential impact on the health, development or wellbeing of te tamaiti taking into account their age and stage of development
• Extent, duration and frequency of the harm – how long the abuse or neglect has gone on and how severe it is. Remember, if abuse has occurred in the past, the impact of further abuse on te tamaiti or rangatahi can be more significant.
• Whether more than one type of harm is/has occurred; the co-existence of several types of harm can have a cumulative impact on te tamaiti or rangatahi.
• The age and vulnerability of te tamaiti or rangatahi, including whether there is any medical condition, communication impairment or disability that may affect the development of te tamaiti or rangatahi, make them more vulnerable to harm or influence the level and type of care provided within the whānau or family.
• The extent to which te tamaiti or rangatahi is likely to suffer repeated harm; whether it is likely that it will recur, meaning the impacts on te tamaiti or rangatahi are not isolated incidents and are more than just temporary.
• The background of the alleged incident – the extent of premeditation, the presence of degree of threat or coercion.
• What does this event/harm mean within the context of the individual tamaiti or rangatahi. Every tamaiti and rangatahi is different, and they will experience an event or incident individually; seek to understand the vulnerabilities and resilience of te tamaiti or rangatahi to help assess what impact an event has had on them and their oranga.
• The view and reaction of te tamaiti or rangatahi – the reactions, perceptions, wishes and feelings of te tamaiti or rangatahi should be ascertained and their views taken into account as far as is practicable, safe and in their best interests. This includes consideration to any behaviour or behavioural changes that may indicate te tamaiti or rangatahi is seriously impacted by their experience of or exposure to the harm (for example, changes in eating, sleeping, toileting, or the presence of self-harm/suicide risk).
• The role (in the abuse/harm) of the significant adults in the life of te tamaiti or rangatahi – is the abuse/harm perpetrated by someone in a key caregiving role, from whom te tamaiti or rangatahi should have expected protection and safety?

The perceived seriousness of an event does not necessarily equate to the impact of the harm on te tamaiti or rangatahi. It is complex – there are a number of features that require consideration. Take time to deepen your understanding and analysis with others, discuss in supervision and ensure you involve te tamaiti or rangatahi and their whānau or family in seeking to understand the impact on them. Using Organising my Practice can support reflection and the deepening of understanding about the seriuous harm to te tamaiti or rangatahi.

Te Puna Oranga

Oranga-framed practice prompts

Organising my practice

Tiaki Oranga

Forming a belief: determining when a child or young person is in need of care or protection

Finding that te tamaiti or rangatahi may have experienced serious harm does not automatically mean that they are in need of care or protection. This decision must be based on whether serious harm is currently occurring or is likely to occur and therefore that te tamaiti or rangatahi is in need for care and protection. In making this decision, it is necessary to consider the harm/maltreatment alongside the strengths of the whānau or family and the views te tamaiti or rangatahi has about their own safety and wellbeing. Forming a belief that te tamaiti or rangatahi is in need of care or protection provides the legislative grounds for a care and protection family group conference and if necessary further state intervention in the life of the whānau or family.

Although state intervention is a significant intrusion in the life of te tamaiti or rangatahi and their whānau or family, it is also a legitimate action in the pursuit of oranga.

Use Te Puna Oranga and the oranga-framed practice prompts to guide your thinking and assessment of the needs, strengths and risks that exist for te tamaiti or rangatahi and within the whānau or family. The ongoing use of models, tools and resources supports the building and deepening of our understanding of the situation for te tamaiti or rangatahi.

Determining whether te tamaiti or rangatahi is in need of care or protection it is important to consider:

• Is the harm/abuse an isolated incident or ongoing and/or likely to reoccur in the future?
• The level of understanding that the whānau or family has regarding the concerns for te tamaiti or rangatahi and their understanding about what needs to happen in order for te tamaiti or rangatahi to be safe moving forward.
• The willingness and ability of at least one parent and/or the whānau or family to protect te tamaiti or rangatahi in the future. Do they have the ability to act protectively? Are they committed to taking the necessary steps to ensure the safety and wellbeing of te tamaiti or rangatahi?
• The presence of any factors that would offer protection to te tamaiti or rangatahi – for example, protective whānau or family, hapu and iwi or others that may be able to offer support and help. What resources and capabilities do the family, whānau, hapū and iwi have that can support te tamaiti or rangatahi and their parents, mitigate risk and provide for the needs of te tamaiti or rangatahi?
• Parents or carers capacity to parent, including their history of parenting and ability to maintain safety. How have they responded to any concerns in the past? Are there factors surrounding the parents/caregivers history and/or current circumstances that continue to place te tamaiti or rangatahi at risk? Can these concerns be mitigated sufficiently to ensure the safety and wellbeing of te tamaiti or rangatahi?
• Who may be able to provide support or assistance and/or bolster the ability of the whānau or family to provide safe care moving forward? What role can family, whānau, hapū and iwi play? What agencies are present in the community that te tamaiti or rangatahi and the whānau or family can work with to meet future needs?
• What does this event/harm mean within the context of the individual tamaiti or rangatahi? Every tamaiti and rangatahi is different, and they will experience an event or incident individually. Seek to understand the vulnerabilities and resilience of te tamaiti or rangatahi to help assess what impact an event has had on them. What level of support and protection does te tamaiti or rangatahi need moving forward and how can this be achieved?
• The view and reaction of te tamaiti or rangatahi – the reactions, perceptions, wishes and feelings of te tamaiti or rangatahi should be ascertained and their views taken into account as far as is practicable, safe and in their best interests. This includes consideration to any behaviour or behavioural changes that may indicate te tamaiti or rangatahi is seriously impacted by their experience of or exposure to the harm (for example, changes in eating, sleeping, toileting, or the presence of self-harm/suicide risk).
• The most effective form of intervention to ensure the safety and needs of te tamaiti or rangatahi are met.

In considering whether te tamaiti or rangatahi is in need of care or protection, it is important that you also:

• Act with supervisory oversight and support. Take the opportunity to explore with your supervisor and colleagues the key factors that are influencing your decision. Use the child and family/young person and family consult process to help you think critically about the circumstances for te tamaiti or rangatahi and what may need to happen to ensure their ongoing safety and wellbeing.
• Talk with the whānau or family and te tamaiti or rangatahi about what you are seeing, your worries and how you are interpreting what you are seeing. Do they see and think the same way, and if not, how do they see things? Seek to understand the perspective of the whānau or family and provide an opportunity for whānau or family to understand and input into your assessment.
• Bring the whānau or family together, hold a hui ā-whānau or a family meeting, and provide the whānau or family an opportunity to explore options to resolve the concerns and plan for the future safety and wellbeing of te tamaiti or rangatahi. Do the same for key professionals that have a role with the whānau or family and te tamaiti or rangatahi. Ask the whānau or family who they want involved in this process.
• Understand the history of the case, and locate the current risks, issues and concerns within that context.
• Communicate and record the rationale for your decision clearly, so that the whānau or family, other professionals and importantly te tamaiti or rangatahi can understand why further action is or is not occurring. If te tamaiti or rangatahi has expressed views regarding what they would like to have happen and this does not occur, it is important that the rationale for this is recorded.