Maltreatment of children in The Netherlands: an update after ten years.
Governmental consultation and advice on child abuse and neglect in the Netherlands started in 1972 as a two-year experiment with four offices for "confidential doctors" in four major cities of the country. After these two experimental years, a governmental institute for prevention of child abuse and neglect was organized. Over the ensuing decade the number of offices increased to ten, covering the whole country. The State Department of Welfare, Public Health, and Environment collected data from the confidential doctors and their coworkers every year. This study compares the data of the first year 1974 with those of 1983 in order to detect changing patterns over a 10-year period. The major changes are as follows: a threefold increase in cases, an extraordinary increase in cases of emotional maltreatment, an increase in detection of child fatalities but decrease in severity of physical abuse. Sexual abuse was hardly recognized in 1974 but gradually was recognized more frequently during the study decade and accounted for an alarming 7.2% of detected cases of maltreatment in 1983. No change was found in the social conditions of the family and the identity of the perpetrators--primarily fathers and/or mothers. A decrease was noted in the percentage of married parents. The increased percentage of single parents was primarily represented by mothers alone. An increase in the numbers of victims residing at home and a decrease in the need for children's homes as a temporary or permanent residence is attributed to aftercare. The discrepancy between the results of this voluntary notification system in the Netherlands and the results of a mandatory reporting system as used in the U.S.A. is still very high. The hope is that the government will decide to make reporting of maltreatment mandatory for everyone.