Effects of a Citizens Review Panel in Preventing Child Maltreatment Fatalities

Michigan Public Health Institute

The rate of child maltreatment fatalities – deaths resulting from parental abuse or neglect – has remained relatively the same nationwide for the past several years, despite the fact that child abuse rates have been decreasing. Using data collected from death certificates, obituaries, and case studies, the authors of this study evaluate the effectiveness of a Michigan citizen review panel designed to assess the errors that may lead to the misdiagnosis and misclassification of maltreatment fatalities in order to correct past data and provide policy recommendations to prevent future homicides.

Federal mandate required that states implement Citizen Review Panels (CRP) as part of the 1996 re-authorization of the Child Abuse Prevention and Treatment Act. Many states have also developed CFRTs (child fatality review teams) to provide an outside analysis of maltreatment fatality cases. The two differ in that a variety of CRPs exist; only some are specially designated to focus on fatalities, and even then, fatality CRPs review only the cases of those children who were known to the governmental child protective services agency at the time of their death.

Michigan has three CRPs, one of which is fatality-specific. In the authors’ study, this CRP looked at 356 total child fatalities dating from a six-year period. The team found a 35 percent decrease in “findings,” or errors that could have prevented or recognized maltreatment, and a 9 percent decrease in deaths resulting from those findings between the first measured time period (1999-2001) and the second (2002-2004). The most common findings occurred because of failures during case investigation, abuse and neglect reporting, and problems during court petitions.  Almost all of the findings resulted from non-compliance with existing procedures designed to protect the child and identify potential cases of abuse or neglect.

The study also examined changes in state policy between the two time periods that might explain the decrease – including new programming and training for medical and childcare professionals – and could be further strengthened to decrease the number of maltreatment fatalities.

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