Addressing the Ultimate Root Cause: Child Sexual Abuse Prevention & Intervention in Georgia Tiffany Sawyer Director of Prevention Services Georgia Center for Child Advocacy

2 Facts About Child Sexual Abuse Statistics are shocking  1 in 4 Girls and 1 in 6 Boys will be sexually abused before the age of 18  The median age of a child who is sexually abuse is 9 years old  Most never tell – Only 1 in 10  39 Million survivors of sexual abuse in America today

3 Facts About Child Sexual Abuse Children are at a higher risk than adults for sexual victimization  Nearly 70% of victims of sexual assault are under the age of 18  1 out of every 7 victims reported to law enforcement is under the age of 6  In roughly 90% of sexual abuse cases the child is familiar with the offender  Offenders intentionally seek out organizations that provide programs to children and adolescents

4 Root Cause  Drug and alcohol dependence (70-80%)  Teen pregnancy (60% preceded by sexual abuse) and sexually transmitted diseases, including AIDS  Commercial Sexual Exploitation of Children (>90% have been previously sexually abused)  Homelessness (>50% of homeless women sexually abused)  Delinquency and incarceration (60% of women in prison were sexually abused)

5 Economic Impact  The annual direct and immediate costs of child sexual abuse are:  $83.4 million in Georgia  $6.0 million in Fulton County  $2.3 million in Chatham County  $.3 million in Lumpkin County

6 Long-term Economic Impact  The annual long-term costs and losses caused by child sexual abuse are:  $858.8 million in Georgia  $62.1 million in Fulton County  $23.5 million in Chatham County  $2.7 million in Lumpkin County

7 Georgia’s Prevention Initiative  The statewide initiative is led by The Georgia Center for Child Advocacy and emphasizes community and organizational involvement.  Train responsible adults in Georgia to prevent, recognize, and react responsibly to child sexual abuse using Darkness to Light’s Stewards of Children program  Eliminate the opportunity of sexual abuse in organizational environments by creating policies & procedures that will keep children safe while protecting the organization

8 Partner Organizations  Schools and Educational Programs  Sports and Recreational Leagues  Faith Communities  Youth Serving Organizations  Medical Community  Legal Community  Higher Education  Parent Clubs  General Public  Pedophiles seek out places where children are. They take advantage of the taboo nature of the subject, something that no one wants to discuss. They thrive on the silence.

9 Tipping Point  Theory that when 5% of a population changes their behavior a cultural shift is created and a momentum builds that, with continued work, will change societal beliefs  Training 5% of a population is referred to as reaching “tipping point”  Our goal throughout the state is to bring the Stewards of Children program to every county and city in Georgia, ultimately training 5% of the adult population in each of these communities.

10 As of February 2012… Nearly 450 facilitators have been trained Almost 25,000 adults have received training in the Darkness to Light program

Minimizing The Risk of Long Term Harm From Child Sexual Abuse Jordan Greenbaum, MD Stephanie V. Blank Center for Safe and Healthy Children Children’s Healthcare of Atlanta

12 Short-Term Sequelae of Abuse  Fear, phobias  Sleep and eating disturbances  Guilt/shame  Anger, depression  School problems, antiscocial behavior  Inappropriate sexual behavior  Running away

13 Long-Term Adverse Effects  Depression, anxiety, PTSD  Eating disorders and obesity  Poor self-esteem  Problems with sexual function  Revictimization

14 More Long-Term Effects  Substance abuse  Suicidal Behavior  Chronic pain  Somatization problems

15 High-Risk Behavior  May contribute to Viral hepatitis Infertility Heart disease and stroke HIV Diabetes Cancer/emphysema/bronchitis

16 Prevention Is Key, But What About Existing Victims?  Increased awareness and vigilance will increase number known cases  Victims need medical, mental health assistance  Georgia: Grossly inadequate resources

17 Telemedicine

Pilot  Services provided: Real-time consultations Second opinion photo/case review Distance-learning lecture series for community professionals Monthly peer review for medical providers

19 How can we make this cheaper?

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21 Child Advocacy Centers & Telemedicine Sites 1: Scottish Rite, Atlanta 2: Synergy Health, Hiawassee 3: A Child’s Voice, Loganville 4: Sunshine House, Swainsboro 5: Power House for Kids, Toccoa 6: Sadie’s House, Douglas 7: Crescent House/Medical Center of Central Georgia, Macon A: Firefly House, Albany B: Children’s Advocacy Center of Grady County, Cairo C: Gwinnett Sexual Assault Center & Children’s Advocacy Center, Duluth D: Appalachian Children’s Center, Ellijay E: Child Advocacy Center of the Lookout Mountain Judicial Circuit, Ft. Oglethorpe F: Helen’s Haven, Hinesville G: Children’s Advocacy Center of Troup County, LaGrange H: Harbor House, Rome I: Satilla Advocacy Services/Satilla Regional Medical Center, Waycross J: Children’s Advocacy Center of Lowndes County, Valdosta K: The Gateway Center, Cordele L: The Cottage Children’s Advocacy Center, Athens M: Hero House, Moultrie N: Edmonsdson-Telford Center for Children, Gainesville O: Coastal Children’s Advocacy Center, Savannah P: Harmony House, Royston Q: Safe Path CAC R: Rainbow Connection CAC S: Golden Aisles/St Simmons Pediatrics T: The Tree House Atlanta Macon Augusta Savannah Gainesville Columbus 2 D E H N P L 3 C 1 G 4 K A Albany M B J Valdosta 6 I F O Existing GPT Sites Future Lync Sites Non-Telemed CAC Athens Waycross Telemedicine Hub 7 Swainsboro 5 S R Q T LaGrange Rome

22 Child Advocacy Centers & Telemedicine Sites 1: Scottish Rite, Atlanta 2: Synergy Health, Hiawassee 3: A Child’s Voice, Loganville 4: Sunshine House, Swainsboro 5: Power House for Kids, Toccoa 6: Sadie’s House, Douglas 7: Crescent House/Medical Center of Central Georgia, Macon A: Firefly House, Albany B: Children’s Advocacy Center of Grady County, Cairo C: Gwinnett Sexual Assault Center & Children’s Advocacy Center, Duluth D: Appalachian Children’s Center, Ellijay E: Child Advocacy Center of the Lookout Mountain Judicial Circuit, Ft. Oglethorpe F: Helen’s Haven, Hinesville G: Children’s Advocacy Center of Troup County, LaGrange H: Harbor House, Rome I: Satilla Advocacy Services/Satilla Regional Medical Center, Waycross J: Children’s Advocacy Center of Lowndes County, Valdosta K: The Gateway Center, Cordele L: The Cottage Children’s Advocacy Center, Athens M: Hero House, Moultrie N: Edmonsdson-Telford Center for Children, Gainesville O: Coastal Children’s Advocacy Center, Savannah P: Harmony House, Royston Q: Safe Path CAC R: Rainbow Connection CAC S: Golden Aisles/St Simmons Pediatrics T: The Tree House Rome LaGrange

23 Future Directions  Continue statewide expansion of telemedicine program  Mental Health mentoring/consultation  CSEC multidisciplinary teams  Psychiatric consultation (evaluation for medication)

24 Telemental Health  Mentoring and Consultation Increase workforce of qualified professionals Increase skills, expertise of professionals Increase access to care in rural Georgia Targets evidence-based practice for treatment of all types of abuse/neglect Public/Private partnership Successful pilot in NE Georgia

Bringing Child Sexual Abuse Prevention Local Steve Collins Founder/President, Adults Protecting Children Regional Coordinator, Georgia Center for Child Advocacy

26 Region 2

27 What Can You Do Today?  Encourage local organizations to implement Stewards of Children by training staff, volunteers and parents  Work with the surrounding community to promote awareness and prevention of child sexual abuse  Talk to children and adults about child sexual abuse  Commit to share what you learned today with at least three other people. Encourage them to get involved.

Jordan Greenbaum, MD Stephanie Blank Center for Safe and Healthy Children Children’s Healthcare of Atlanta Tiffany Sawyer Georgia Center for Child Advocacy Steve Collins Adults Protecting Children/Georgia Center for Child Advocacy