Giving Voice to the Survivors of Childhood Institutional Abuse

Introduction

Institutional abuse of children was first conceptualised in the 1980s, when a public enquiry was launched to focus on institutional abuse as a named social problem in the United States (Daly, 2014a; U.S. Department of Justice, 1979). Since 2000, many more national enquiries have been launched or completed in Australia, Belgium, Canada, Denmark, England, Wales, Finland, Germany, Iceland, Italy and many other countries (Roth et al., 2019). In addition, in 2012 and 2013, two large enquiries were launched in Northern Ireland and Australia (Wright, 2017; Wright et al., 2017).

The book The Country of Celestini (Serra & Santanera, 1973) described many cases of violence in orphanages in Italy and identified the relevance of external social and institutional settings, in which such violence was somehow facilitated by neglect of service interventions, social inequalities in the institutions and the fact that child victims had a lower social status.

Institutional abuse refers to ‘abuse occurring against children living in institutions or in out-of-home care (foster care and foster homes)’ (Daly, 2014a, p. 6). It has no single cause, and it is not only the responsibility of the direct perpetrator; it is often the result of the entire system, which colludes, covers, justifies and sometimes motivates violence against children. Gil (1982) identified three distinct forms of institutional child abuse: (1) direct institutional maltreatment: i.e. physical, sexual or emotional abuse committed by individuals directly responsible for the child's care; (2) procedural maltreatment, i.e. programme abuse that occurs when programmes operate below acceptable standards or rely on aggressive or unacceptable methods to control the child's behaviour and (3) system maltreatment, i.e. system abuse that is not committed by a single individual or agency but occurs when the childcare system is stretched beyond its limits and is also related to inadequate control by the agencies responsible for the care of children.

Survivors involved in this participatory research process shared experiences of abuse related to all three categories. They discussed the implications of being victims of violence in places that should have protected them. They faced the researchers with the dramatic powerlessness of being victimised by authoritative and affectionately significant adults in institutions with guardianship and protective responsibilities. The voice of survivors makes clear how institutional abuse is typically an ongoing process rather than an isolated incident in which an abuse of power and breach of trust occurs and which may involve severe physical, sexual or emotional maltreatment.

The survivors of institutional abuse involved in the framework of Project Oltre and the European project Support to Adult Survivors of Child Abuse in Institutional Settings (SASCA) clearly identified institutional abuse as an important social problem that has long been ignored, denied or minimised. Adults who spent their childhoods in care have come forward through public enquiries, truth commissions and the media to allege physical, emotional and sexual abuse and neglect while in the care of governments, nongovernmental agencies, religious institutions and out-of-home care programmes. Their courage has forced society to face painful realities about trusted community leaders, established organisations and cherished institutions. Slowly, international concern has emerged about the trauma they endured and its significant lifelong impacts. Society has been – and still is – slow to acknowledge such acts of abuse (Wolfe et al., 2001).

Participatory Research With Adult Survivors of Institutional Abuse

This participatory research with adult survivors was developed by Associazione Artemisia using the framework of Project Oltre, which was implemented with the support of Regione Toscana to respond to the needs of the adult survivors to the violence suffered in the Forteto, and through the European SASCA Project. Forteto was a residential childcare community, close to Florence (SASCA, 2018). Hundreds of victims were directly or indirectly involved in this case of very serious institutional abuse: more than 80 out-of-home children and adolescents, their original families and about 60 adults with disabilities. The maltreating nature of the life rules adopted in ‘Il Forteto’ is proved by two final judgements of the Court of Florence of 1985 and 2020, which ascertained the repeated and systematic damaging acts that violated the fundamental human rights.

Both projects addressed events in which an institutional system ignored what happened, colluded or actively participated: Il Forteto and I Celestini in Italy (and single experiences of mistreatment not included in this group), the Magdalene Laundries in Ireland and the abuses in institutes in Greece and Romania.

In addressing this issue, the SASCA Project adopted the perspective of the victims, former boys and girls. The participatory research in SASCA involved 101 survivors of abuse and maltreatment in institutions. The data were collected by a self-administrated questionnaire and an interview. The questionnaire gathered demographic data and used scales to measure the physical effects of the trauma. We recruited a sample based on the snowball method, mainly through contact with associations and informal groups of survivors, contact with local social services and advertisements. Institutional abuse was also analysed through a survey with 390 social and health workers and 40 judges and other legal operators at a European level. This chapter mainly focuses on the results of the interviews with 33 survivors of child protection institutions in Italy, as the first fundamental step in the process underway in our country to promote the leading role and participation of survivors of institutional abuses (Bucarelli & Filistrucchi, 2019) in a path of regaining awareness and promote change in the civic, professional and political community on the issue.

The interviews were realised with the following objectives: to (1) understand and address the problem of child abuse in institutional settings, particularly in residential care, from the perspective of adult survivors; (2) understand the long-term effects of such events; (3) understand how and if the survivors of these crimes may find protection and compensation in the existing legal framework and (4) understand how their experience may enlighten prevention strategies for the protection of children in residential care today.

The interviews with adult survivors gave voice to their stories and pain, and by listening to their opinions, we confirmed the need to identify key characteristics of possible intervention and prevention efforts.

Lessons Learnt on Child Abuse and Neglect in Out-of-Home Care From the Perspectives of Survivors: Disclosure, Responsibility and Prevention

The participatory process allowed a focus on issues that sometimes are already known to professionals but lack the complexity that emerges from the voices of people directly involved. Sharing the burden of building a common understanding represents, for all the actors involved (survivors, researchers and professionals), an extraordinary opportunity to gain access to new insights and information on the dynamics and impact of institutional maltreatment.

Restorative Value and Power of Taking and Giving Voice

Being abused in institutional settings that were supposed to provide protection causes a sense of ‘institutional betrayal’ (Higgins, 2001; Morrison, 2005; Parkinson et al., 2009; Smith & Freyd, 2013), linked to the complicity of institutions in allowing and not detecting abuse and making the victim accessible to the abuser. This amplifies the psychological and psychosocial impact on survivors and often finds yet another confirmation when the surviving child, adolescent or adult tries to disclose what happens.

At a broader systemic level, institutional abuse involves the failure of the system that is supposed to protect children (Bianchi et al., 2018). The abuse suffered by survivors could have been prevented if there were adequate legislation for the protection of children's rights, if supported by appropriate child protection policies and practices, if each social worker had correctly exercised their role and responsibilities, if the context were not influenced by the prestigious reputation of the institution in which the abuse occurred, etc. (Aversa et al., 2021). From the research available and these interviews, it seems particularly damaging to know that what was needed and could have been done to prevent abuse was not realised due to negligence (Smith & Freyd, 2013).

It could have been different … if only one had gotten in the way. And instead … all these “I don’t know,” these slight – these “I don’t remember” to us, they ruined our lives.

(Survivor, personal communication, 2020)

Lessons Learnt From the Perspective of Child Abuse and Neglect

The results of the survey indicate the need to move along two complementary dimensions, one individual and another collective or communal. Damage caused by institutional maltreatment cannot be elaborated and repaired exclusively by victims on individual paths. Victims of institutional maltreatment are also, inevitably, victims of the state, which placed them in institutions that betrayed their original mandate and which the state did not adequately supervise.

Leaving aside in this description the specificity of the healing process and therapeutic elaboration, it is important to consider the reparative value of ‘giving a voice’ for the survivors as an experience of reassumption of power and credibility and the construction of an opportunity to be heard in the professional, social and political context.

No less important is the transformative value of the process of ‘giving voice and listening’ that also involves institutions and professionals. In dealing with institutional abuse, all survivors, institutions and legal and social operators are seized by shame, helplessness and despair that sustains the belief that tomorrow will be identical to today.

Giving voice to survivors shows that looking, recognising, questioning, regaining awareness and going through helplessness and shame is the only way for all – survivors and social workers – to recover the power of change. Acknowledging that ‘it could have gone differently’ is very painful, yet that means it can go differently.

Developing a voice to disclose, tell and denounce, in alliance with professionals of the system to be changed, is a different level of the healing path, in which the individual story becomes part of a wider strategy for change and prevention. It is a more challenging step, different from courageous complaints or survivors' participation in TV broadcasts, although they are important in the initial phase of disclosure for counteracting the negation and collective removal. These actions have often exposed survivors to attacks, blame and discredit for broken silence because when someone becomes a bearer of the testimony of crime, others share the responsibility of restoring justice (Herman, 1997).

Much of the general public's current understanding of child abuse that occurs in institutions and organisations is derived from high-profile media reports of investigations, arrests and court outcomes. The public often is presented with an incomplete picture of the circumstances surrounding the institutional abuse reported. The result can be a backlash towards survivors, who may be seen as responsible for the troubles experienced by the institutions, rather than the institutions or perpetrators being held accountable (Daly, 2014b; Wolfe et al., 2001). They become traumatised people who have not conquered their demons, who make demands for money because they are unable to build a life for themselves (Aversa et al., 2021).

The path of participation that we offered has given the possibility of creating connections between survivors and the system of services, mainly social workers. It opens an alliance that leaves room for testimony and recognises the role of the interlocutor, forcing the professional to engage in authentic listening. It is a new alliance, a pact that recognises differences but shares the path and goal: that suffering can serve someone and prevention is possible.

Conclusions From the Perspective of Participatory Research

In the framework of this participatory research, the interview and its many questions have often been the first opportunity for survivors to experience being credible interlocutors, carriers of a practical and subjective competence that is necessary to understand what happened and draw new horizons. It is the first step of the possibility of building participation, trust and protagonism with the world of professionals (Herman, 1997).

With SASCA, the parallel journey of a scientific–professional community has started, too. The answers of survivors, indicating the gravity of institutional abuse, forced professionals to question their strategies and efficiency in addressing children who experienced abuse.

Sharing between professionals and survivors raised awareness of the phenomenon and its dynamics, expanding the possibility for breaking the silence around institutional abuse. The different settings and formats alternated among focus groups, conferences, training for social workers and consultation tables with professional bodies, allowing us to jointly face this issue, give voice to survivors and strengthen the capacity of professionals to listen and work together.

The valorisation of survivors as experts by experience and involvement, when possible, in the group has favoured the possibility of reasoning together about their experience and stimulated the passage from individual experience to the acquisition of an awareness of their transformative power as experts who can assume an active role as builders of collective knowledge, as bearers of not only suffering but also transformation and improvement in a professional community that can hopefully learn to listen and question itself. Survivors are no longer a social problem to be addressed, but a resource to be valorised. In this framework, the Committee of Children Abandoned at Forteto by the State took action. These survivors are among the more than 90 children, boys and girls, who have been placed in the Il Forteto Children's Home by the juvenile court or social services during more than three decades. Their objective, above all, is to transform their lived experience into the starting point for reflections, doubts and changes, including legislative ones. This expresses the desire to bring the attention of the state back to the protection of children, who absolutely need more resources than they currently have (Aversa, 2020).

They are now an actor in collaboration with institutions to transform pain into hope. They are recognised as a stakeholder. Members of the committee were involved in a focus group aimed at collecting information and proposals on the experience of being removed for a periodic report to the Parliament on the implementation of laws and norms related to the protection of children in need.

The integration between competence by experience and formal competence is also valuable with respect to the information and training activities of professionals. The ‘experts of experience’ help professionals recognise their enormous professional responsibility and impact on the life trajectories of victims.

Education and training need to be directed at institutions (e.g. staff, volunteers, board members) and community professionals who provide services to survivors. Many survivors describe the legacy of their abuse being compounded by lack of intervention and prevention programmes, despite their efforts to break the silence. Listening to survivors' voices can be a way to enter the complexity and pervasiveness of institutional mistreatment and understand how much we have to learn to ensure effective protection of boys and girls when they are in conditions of vulnerability due to the fragility of their families of origin. This may allow a culture characterised by blame and moralistic judgement to be overthrown, leading to the development of a generative approach (Bertotti, 2020).

The effort to view what happened from a perspective of prevention and generous attention to children who are today at the centre of the removal and protection measures motivates enhancement of the protagonism and participation of survivors in contexts of reflection on professional practices. The search for connections between past and present, for example, creates a fertile link between these survivors and the experiences of the Care Leavers, which in the Italian and European network have created a movement capable of influencing public policies and advocacy.

Last, as the motto says, ‘the union makes strength’; thanks to shared work in Italy and at the European level, the experiences of these survivors led to a formal declaration on this issue by the Committee of the Parties to the Council of Europe Convention on the Protection of Children Against Sexual Exploitation and Sexual Abuse (Council of Europe, 2007), which has recognised the institutional abuse that takes place in residential communities, particularly violence and sexual exploitation (Lanzarote Lanzarone Committee, 2019). In particular, the Lanzarote Committee asked state parties to ensure that all types of out-of-home care settings feature comprehensive screening procedures for all people taking care of children; specific measures to prevent abuse of children due to their increased vulnerability and dependence; adequate mechanisms for supporting children to disclose any sexual violence; protocols to ensure that in the event of disclosure, effective follow-up is given in terms of assistance to the alleged victims and investigation of the alleged offences by the appropriate authorities; clear procedures to allow for the possibility of removing the alleged perpetrator from the out-of-home care setting at the onset of the investigation; effective monitoring of practices and standards to prevent and combat child sexual abuse; provision of long-term assistance in terms of medical, psychological and social support and legal aid and compensation to victims of sexual abuse in out-of-home care settings; assurances that professionals working in the public, private or voluntary sectors who either commit or fail to report offences occurring in out-of-home care settings are held liable; and guarantees that legal professionals who fail to protect children in their care are held liable.

At the same time in Italy, survivors and experts continue on a path that, starting from the story of Il Forteto, which is now the subject of a parliamentary commission, overcomes the specificity of and identification with the Forteto affair to strengthen and make concrete the possibility of influencing the community (political agenda, professional world, etc.) with a theme as uncomfortable as that of institutional mistreatment.