Emotional abuse can be a repeated pattern of caregiver behavior or an extreme incident that conveys to a child that he or she is worthless, flawed, unloved, unwanted, endangered or only of value in meeting another’s needs (American Professional Society on the Abuse of Children, 1995). The emotionally abusive act(s) can be grouped into the categories of spurning, terrorizing, exploiting/corrupting, isolating and denying emotional responsiveness.
Kentucky defines an emotionally abused or emotionally neglected child as one whose health or welfare is harmed or threatened with harm, when his parent, guardian or other person exercising custodial control or supervision inflicts or allows to be inflicted an emotional injury or creates or allows to be created a risk of emotional injury upon the child (KRS 600.020 (1)(a)).
The statutory definition of emotional injury was modified by the 1998 General Assembly. Kentucky now defines an emotional injury as an injury to the mental or psychological capacity or emotional stability of a child as evidenced by a substantial and observable impairment in the child’s ability to function within a normal range of performance and behavior with due regard to his age, development, culture and environment as testified to by a qualified mental health professional (KRS 600.020 (26)).
Makes a determination, in consultation with the FSOS, as to whether or not emotionally abusive behaviors have occurred, utilizing the emotional abuse criteria; 1
Offers services to the family, even if no abusive behaviors have occurred, when other concerns exist, or an aftercare plan negotiated with the family has deemed that services are appropriate;
Staffs the referral with the regional emotional injury gatekeeper if emotionally abusive behaviors have occurred;
Makes a determination of findings, as outlined in SOP 2.12 Completing the Assessment and Documentation Tool and Making a Finding;
Can offer services to the family if no emotional injury is found by the Qualified Mental Health Professional (QMHP), but other concerns remain;
And family develop an aftercare plan, as needed, if there are no other risk issues that would lead to a case being opened;
Can substantiate risk of harm or find the family in need of services due to neglect if no injury is found, but the QMHP finds the victim is at risk of emotional injury if the abuse continues;
Files a petition, if the family is resistant to services, to ensure that recommendations made by the QMHP and P&P are followed by the family;
Consults with the FSOS, if an injury is present or the child is found to be at risk of harm, to make a determination as to whom the perpetrator is, based on the information collected during the investigation including, but not limited to, the information obtained in the emotional injury assessment report;
Sends a notification letter, as outlined in SOP 2.13 Notification of Finding and Case Disposition, indicating a substantiated finding of emotional injury or if the family is found to be in need of services;
Includes information in the letter that:
Supports the determination of perpetration, as well as results from the emotional injury assessment report conducted by the QMHP;
Reflects that the Cabinet made the determination regarding the perpetrator, and that the QMHP made the finding of emotional injury to the child;
Completes an assessment when a QMHP makes a report of suspected emotional abuse/ emotional injury that meets criteria for an investigation. 2
The P&P emotional injury gatekeeper:
Reviews SSW/FSOS request for an emotional injury assessment and provides feedback regarding whether or not moving forward with the assessment is warranted; and Contacts
Assists SSW/FSOS in locating an objective QMHP (a provider with no prior involvement/interaction with the family).
- In order for a report of emotional abuse to be substantiated in Kentucky, the Department for Community Based Services and regional mental health/mental retardation boards must work collaboratively by:
- DCBS investigating the allegations of emotional injury; and
- Obtaining information to share with the qualified mental health professional (QMHP) to determine whether an emotional injury has occurred.
- It is the role of:
- DCBS to investigate the report of emotional injury and determine a perpetrator; and
- An objective QMHP to determine whether or not:
- The child has an emotional injury; or
- There is a risk of emotional injury to the child.
- Outlined in the Partnership for Services: A Manual of Collaboration for Kentucky’s Social Service and Mental Health Agencies are procedures for both agencies to use in addressing emotional injury assessments to include:
- Designating individuals as gatekeepers in each region by the community mental health center and DCBS respectively to review a SSW’s request for an emotional injury assessment;
- Determining if in fact an assessment is warranted by the designated gatekeepers; and
- Utilizing the emotional abuse assessment referral form and emotional injury checklist as determined by how each region will implement the assessment protocol, which are located in the appendix of the Partnership for Services: A Manual of Collaboration for Kentucky’s Social Service and Mental Health Agencies.
- DCBS requests an emotional injury assessment through an objective QMHP, who has no prior involvement with the family, for a determination as to whether or not the individual has suffered an emotional injury as a result of the abusive behaviors.
- The QMHP performs an assessment that includes, but may not be limited to:
- Demographic information;
- Statement of chief complaint/allegation;
- Background information/review of available records/phone consultation with the investigation SSW for information found during collateral contacts;
- Clinical interview with alleged victim (including mental status exam);
- Interview with alleged victims, family/caregiver(s) when possible;
- Objective measures–such measures as are deemed appropriate by examiner and are consistent with the practitioner’s field of study;
- Review of emotional injury criteria for emotionally abusive behaviors acceptance criteria; and
- Consideration of recommendations for treatment.
- The QMHP will make one of the following findings:
- No emotional injury exists;
- No emotional injury exists but the victim is at risk of an emotional injury if the abuse continues;
- Emotional injury exists, but unable to determine the act(s) that resulted in the identified injury; or
- Emotional injury exists as a result of the reported/alleged abusive behaviors.
- The QMHP submits the emotional injury assessment report in writing to SSW within thirty (30) days of receiving the referral from SSW along with recommendations for services for the child and family if needed.