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Interview

“In recent years the state has given weight to issues of child protection”

The Director of Operations of the National Centre for Social Solidarity (EKKA) speaks about the centre’s role in child protection and her belief that improving the system is possible.

Athens
Giota Manthou speaking at a conference on child abuse, Veria, November 2017

Giota Manthou speaking at a conference on child abuse, Veria, November 2017

© Verianet.gr

When did the National Centre for Social Solidarity (EKKA) become involved in child protection?

It has always been involved, in the sense that we are here to serve children. Before the current helpline, there was the 197 helpline, and we used to receive child abuse reports there too. Our refuges have always provided shelter to mothers with children who are victims of abuse. We were no strangers to this field. Our systematic involvement, however, began in 2010, when the attempt to create a network with the municipalities unofficially began. At the time, we had researched state child protection institutions, collecting personnel data and resident data. We had also recorded the significant difficulties of institutionalised care.

Back then, there was no Social Welfare Centre, all the welfare institutions were independent. In other words, the Mitera Center for the Protection of the Child of Attica was an independent body, as was Pedopolis “Agios Andreas” (St. Andrew Children’s Town) and so on. We held meetings and partnership meetings with the then managers and proposed a system providing ad hoc updates on accommodation availability. We also proposed the creation of a committee made up of representatives from all those bodies that would directly manage accommodation requests, to deal with the problem of children’s prolonged accommodation in hospitals. Our efforts were unsuccessful, there were objections on the part of the institutions.

In 2011, the ministerial decision establishing the Juvenile Protection Teams (OPA) at many municipalities was issued. That is when our systematic involvement with the Juvenile Protection Teams began. We ran training sessions for them, in collaboration with the Institute of Child Health and the Children’s Ombudsman. We sent, we still send, educational material. We consult colleagues at the municipalities on the handling of cases. That has been happening continuously since then.

What responsibilities did EKKA have until that time, in the field of child protection?

We were responsible for carrying out the orders of the public prosecutor for a start. For example, here in Athens, EKKA would carry out the prosecutorial investigations for suspected abuse. Since 2011, the Juvenile Protection Teams have been responsible for these inspections. In Thessaloniki, EKKA continued to perform this role because some of the municipalities had not set up a Juvenile Protection Team. There were times when we had up to six public prosecutor orders to investigate.

Did you have the staff needed to do so?

There has been a gradual decline. We had staff losses in general, and, from 2010 onwards, our numbers diminished even more because many people resigned, and recruitment was frozen. We are no different from other bodies in this respect, everyone was faced with the same problem. I just wanted to point out that we carried the burden of prosecutorial investigations for many years.

EKKA is different from other organisations in an important aspect: its intervention department is staffed with highly qualified personnel. In other words, many of our colleagues here have two degrees, postgraduate degrees, doctorates. When we were hired, because this new staff was highly accredited and qualified, they stood out in comparison with other bodies whose scientific personnel might comprise a couple of people. Moreover, our teams worked well, no incident was handled by a single professional on their own.

At the time, we ran a study in hospitals, which we repeated in 2015, to see how many children were being accommodated in hospitals in Attica, pending their placement in other forms of accommodation. In 2015, we recorded 67 children in both children’s and maternity hospitals, residing there from four to six months on average.

What was Mr Altani’s involvement in the creation of the Juvenile Protection Units?

It was his initiative as president of EKKA. Efforts to set up a network had begun in 2010, and one year later, a great number of municipalities, nearly sixty per cent, had responded to the ministerial decision establishing the Juvenile Protection Teams. That’s when we saw that there is a need to act in a coordinated manner.

The new law did not provide for the recruitment of new personnel to staff the Juvenile Protection Teams, nor did it establish them as a distinct legal entity within the municipalities, not even as a separate legal service. But it placed municipalities under the obligation to set up a Juvenile Protection Team. As we speak, 236 municipalities have obliged, participating with specified employees.

It is important to have front-line teams dealing with such a serious matter. I will not say that they are needed in all municipalities. I think we have the flexibility and a flexible structure could be found and configured accordingly. For example, take adjoining municipalities where the frequency of incidents may be low or some mountain municipalities, where the ratio of the population is different, say three children in a community of five hundred people. In these cases, you may not need a team dealing exclusively with juvenile protection. In the municipality of Athens, however, the team is rushed off their feet dealing with prosecutorial investigation orders. There are just two people assigned to this task.

In 2015, when we collected the data for the previous year, around 50 municipalities responded. That is one-fourth of the municipalities: 50 municipalities out of the 235 and 84 professionals out of a little over 400. But theoretically, we had one fourth. It could be considered a representative sample of a quantitative survey. At the time, the professionals surveyed replied that they had carried out approximately 583 investigations in matters of child protection concerning 886 minors. We had 73 instances of child removal. That says something. It says that they cooperated, that they tried to support the family. Of course, a small percentage is attributable to false reports.

Are false accusations common?

Yes. Usually, they arise in the context of family disputes. Or neighbour disputes, say one tenant in a block of flats being spiteful because a neighbour did not allow them to lay a pipe under his parking spot. It could be an argument over an inheritance, a dispute about anything. Sometimes we can tell that’s the case from the call. When you receive a report, you try to filter it. To understand. But it is not always easy over the phone, and the public prosecutor is always, always, ultimately notified whenever an accusation is made. We must make certain that a child is definitely not being abused.

There is a basic numbers problem. Some areas are understaffed, I suspect there is a surplus of public prosecutor recommendations. There are municipalities without a social worker, and public prosecutor orders are carried by the Region, or sometimes the hospital might take charge. The issue is not the surplus. The issue is that if the prosecutor marks the order “urgent”, our colleagues charged with executing it will do everything in their power to at least make the first visit to the family to see what is happening. No order goes unexecuted. It cannot, child protection is at stake, you do what you must. But when you use the same staff to deal with five hundred different objectives, you end up burning them out.

What are the registers that were established at the time?

The adoption register pre-existed them and had been fully operational since 2004. A ministerial decision of 2011 established the national child protection register, where everything relating to minors would be recorded. In other words: reports of abuse, investigation results, accommodation at a care unit, whether they will go into foster care or up for adoption. In theory, it described a register where you would be able to follow the child’s course through the welfare system.

 “In theory” as you say.

Yes, because attempts with the Greek Supreme Court public prosecutor’s office to issue a circular to all public prosecutors requesting them to notify EKKA of prosecutorial orders and their outcome failed. That would have allowed us as a country to have data about how many children have been reported as at-risk, how many are abused. To this end, we only have the results of the latest BECAN study, an exceptional study by the Institute of Child Health. Beyond that, we only have the data that the various bodies collect separately. For example, how many incidents are reported through the EKKA helpline, how many through The Smile of the Child helpline or other helplines. We have the data from the 2014 Juvenile Protection Team study, but we don’t have data yearly, even though the ministerial decision stated that all bodies involved in the handling of these issues must share the data they collect.

Of course, the ministerial decision made no provision for penalties. It did not say that if an organisation failed to share data there would be consequences. Many of the municipalities that we cooperate with via the helpline send us this data. But that only happens because we cooperate on the reports that we receive. As to the reports made to other bodies that reach the municipalities via the prosecutor’s office… we have no idea. As a country, all we can possibly rely on are records from the public prosecutor offices. Find out in how many instances the Athens prosecutor’s office issued an investigation order. Or all the public prosecutor offices in the country. But even then, we would only have data about the cases that reached the public prosecutor’s office.

Respectively, there is also the register for children in institutions. In 2015, the Welfare General Secretariat addressed a request to both Regions and institutions to inform EKKA the following: which institutions, starting with private institutions, are established and active in their area and ask them to complete our documents concerning each child. Even then, not all bodies responded, such as shelters and most of the institutions run by the church. Some of the state institutions also did not respond. Consequently,  where the latest Roots Research Centre study estimates that 3000 children reside in institutions, this register and the attempt made in 2015 record 984 or 985, in any case, less than 1000 children, which means we have records for 1/3 of the population estimated by the study.

Do you raise this issue with the country’s political leadership?

They are informed, and I think that is why penalties were introduced in the latest legislation. Because that was a weakness in the law. At some point, the legislation must be complied with and a register needs to exist. Not so that EKKA knows, we are an executive body of the ministry. The ministry must know how many children live in institutions, how many are in foster care, so that it can plan policy. Without that information, it can’t plan policy. We, as an executive body, are called upon to execute that.

But all this is currently under construction. In the summer, when the legislation was passed, all the relevant bodies were calling us because the law included a provision that if they failed to forward the information concerning the children in their care within ninety days of the law being passed, there would be serious repercussions on their operation. The phones were ringing off the hook. We reported to the ministry that the institutions were anxious about what would follow. It is an indication that the penalties caused concern and exerted pressure to move forward with this. I prefer to be optimistic that it will work.

How does the 1107 helpline work?

Firstly, the calls are anonymous, no personal details are given unless someone calls and tells us “I can hear a child being abused next door”. In that case, obviously, we will ask for the family’s details; otherwise the public prosecutor cannot issue an order to investigate. Another circumstance where this confidentiality might be superseded is when we are called by a child or a parent. Or if there is a suicide threat. In such instances, confidentiality does not apply, and we ask the caller to give us details. We try to obtain that information in every possible way so that we can send the relevant bodies there on the spot. And we have done so, there have been cases, thankfully not many, where an ambulance was dispatched, or the police in another city in Greece was alerted and responded.

The helpline also provides counselling. Parents, children, teachers call us. Especially during university-entrance exam time, there is a spike in phone calls. But it is not a very well-known helpline.

Supposing someone calls and says, “I suspect my neighbour is abusing his children”. What happens from that point onwards?

Initially, you try to investigate the content of the accusation as much as you can, to verify that it is not a false accusation. You ask how they know, what they hear, if the child appears to attend school regularly. The caller might say they noticed bruises on the child or describe incidents that only someone inside the home would know.

In many instances, a relative will call and make a report and be reluctant to reveal the relationship, fearing that the abuser might find out. There, I will reassure them that we will respect confidentiality but that it is important to understand how they have such detailed knowledge. This is most difficult in sexual abuse cases, because when someone tells you something, evidently their knowledge comes from inside the home.

Of course, we also receive phone calls where the caller might say, “I heard shouting in my neighbourhood ten days ago.” You can’t move ahead with just that. Going back to the other cases I mentioned, we examine how the caller knows, if they can go to the public prosecutor themselves. If the caller refuses or says they are afraid or something along those lines, we inform them that we will ask the public prosecutor to instruct municipal social services, the Juvenile Protection Team, to investigate. Often, they will call again to find out what happened. We tell them that the public prosecutor has been informed, but we cannot give them any details because of confidentiality. That is the process.

Our next move is to contact the municipality to see whether they are aware of the case or not. In some instances, they will tell you, “Yes, I am monitoring the case, I have already made a couple of visits following a public prosecutor’s order,” because another report has already been made to another helpline. In that case, we simply send a notification to the public prosecutor that we have also contacted the municipality, so that the case file can note the existence of a second report. Such details must be shared. Maybe the municipal workers have not yet picked up the case, maybe it has not come to their notice. So, we tell them that we received this report, here is what the caller said, this is the information that we investigated and that a public prosecutor’s order is on the way.

It has its uses because often the public prosecutors do not send a copy of the report to the municipalities. They simply address an order: please carry out a living conditions investigation into minor X residing at Y. The social worker does not know the reason for the investigation, nor is the prosecutor, who is permanently busy, on-call to explain.

And they are all overworked, especially here in Athens. In the rest of the country, many places do not even have public prosecutors for minors. There is no reason for all this to be happening. If you have the content of the report and the chain of transmission, you can contact the recipient of the initial report, where the abuse was first alleged. We ask public prosecutors to forward our initial report to the municipalities, but it does not always happen.

The documentation concerning allegations made to EKKA is usually forwarded. But if the abuse has been reported to another line, the prosecutors tend not to forward the details, but it is essential that they do. We had a case where the young girl called us and said she was being sexually abused by her mother’s partner. If we had not informed the colleague charged with the investigation that it was a sexual abuse case, they would not have known. 

If the abuse victim calls and states that they are being sexually abused, what is the process followed?

The same intake process that takes place at every social service, but at the same time, you will give the child counselling support. You will inform the child of the process. Meaning you will ask if they have any questions about the process, anything they wish to ask—this is all part of counselling. Nevertheless, all allegations are passed on. Every single one of them, because you never know. Because a child is involved. You try to understand because there is also a basic evaluation process to assess the risk level of a situation. You must understand precisely what the caller is trying to tell you.

How many people work at the EKKA helplines?

The same people answer calls to both helplines, 1107 and 197. Right now, there is a staff of nine, if I am not mistaken, all social workers and psychologists. The combined number of calls is recorded, so we do not know how many calls each helpline receives. But it is not just a case of counting the number of calls. We do receive prank calls. Same as the police, or the ambulance service or the fire brigade, or radio stations. You might end up receiving a sexual harassment call and you have to answer the phone. Obviously, you can’t curse anyone, that’s a given. You answer the phone and you hear what’s at the other end of the line, but you might end up having to repeat this for the next two hours until the harasser calms down and stops calling. That means someone can tie-up the helpline, one of the helplines. As we speak, there is a shift of three colleagues handling calls.

You also get psychiatric incidents, people who may call 150 times, that number is no exaggeration. In some instances, they make repeated calls, and they could be people receiving treatment, they have no reason to call the helpline. But they keep calling, again and again.

I remember once incident when I came in for my shift at 6:00 am and the phone rang non-stop until 8:30, a sexual harassment call. It is an important issue because it demands that the professional remain calm enough to handle the harassment they are receiving so that the next time they pick up the phone and it is a genuine call they can respond with the presence of mind needed, unshaken by what previously happened.

We try to keep the functions of the two helplines separate. We ask people to call 1107 to this end. Calls to 197 are free by ministerial decision, but 1107 is not a free helpline yet. A decision needs to be made, someone must pursue this end, demand it. The phone companies need to agree too, it does not just rest with the ministry. Obviously, we will not refuse to take down details and the report if the caller wishes to use 197, regardless of whether the call concerns a reported abuse or any other matter.

Are nine people enough for both helplines? And if they are enough now, will they continue to be enough when the helpline becomes more widely known?

It’s a complex answer. Say the ministry decides it wishes to give greater support to this helpline. This would translate into constant publicity and promotion, which in turn would lead to a vast surge in calls and informing the public what the helpline actually does, and it can do for them. What I mean is, you will also get that kind of calls, from people who will not have something specific to report but request information. That always happens with helplines.

So there, when you burst into society, to put it another way, you will need the staff to handle it. When the social solidarity income legislation was passed, 197 was flooded with calls. When the weather turns bad, when there is a sharp drop in temperature, we get calls from citizens to inform us that they have seen a homeless person at a given spot, and the call centre dashboard turns bright red with all the calls on hold.

So, you may be so rushed off your feet for five days, during the bad weather spell, that you don’t even have time to catch your breath. Obviously, there is not enough staff. Also, we need to realise that we are talking about shift-work, all year long, even during public holidays and at some point, the staff need to take their leave.

Does 1107 operate in a complementary or competitive manner towards the helpline operated by The Smile of The Child?

Not in competition. In fact, we get referrals from them because EKKA does not just run the helplines but the refuges too. Some people tell us that they have been told by the Smile helpline to call us. I don’t see it as being in competition. There is just this paradox that both the EKKA and the Smile helplines are national helplines by ministerial decision. So, people don’t just call the Smile of the Child arbitrarily, they are guided in a manner of speaking. And they are right to call, in any case. It did not happen in a vacuum, there was a time when all of welfare fell under the Ministry of Health. The then Minister of Health, this was many years ago when 1107 did not even exist, decided that the national helpline would be the 1056 helpline set up by the Smile of the Child, which is competently run by colleagues.

Besides, there have been collaborations. I recently participated, along with colleagues from the Institute for Child Health, at a training workshop we held for Smile employees. We have exchanged know-how. Relations between us are not competitive.

But there could be a single, merged line, which would fall under EKKA, be nationalised in a way.

I do not know if they would consent to it, in the sense that as an organisation, they have a strong presence in people’s consciousness, whether we like it or not. In any case, these are political planning decisions, it is a legal entity, it promotes its helpline. And it does not just run this helpline, it also runs the helpline for missing children. Again, it’s not like they woke up one day and said, “The missing children helpline, that should be us.” They took all the legal steps to set up and run the line. You can’t turn around tomorrow and say, “close it down”. It is a body that forms part of our national social welfare system. In fact, EKKA has granted it two of its buildings under programme agreements; that is state support in some form. 

What effect did the helpline publicity campaigns have?

For a start, on television, all public awareness campaigns, not just for the EKKA helplines, were broadcast after three or four in the morning, even on public television. On private TV channels, in particular, they aired after midnight. Whenever they are asked to air this kind of social message, they do it very late at night, at three or four a.m. — followed by adverts for phonelines of another kind.

So, the fact that the Smile helpline is somewhat better known than the EKKA helpline has to do with how much promotion it received?

There is an age difference for a start. I think that the Smile of the Child helpline has been in operation for around 25 years. The EKKA child protection helpline has been around for just six years. Of course, it also has to do with the extent to which it was publicised. But I want to stress again that greater publicity means having the capacity to handle the increased volume of calls. I remember that every time a politician, for example, said “call 197 now”, we were flooded with calls. You need the personnel to man the lines because if a citizen calls a line and is kept on hold for an hour, you’ve lost them. I might be dealing with a suicidal caller at the time, or a panic attack, I cannot instantly hang up. I have to give the caller time. But what happens if there is a second and a third such caller?

How much staff would the helpline need to be fully operational?

I think the initial planning called for sixteen to seventeen people. Moreover, every incident necessitates contact with the municipality, the public prosecutor, the police and others as needed. We had instances where we cooperated with the school the child was attending and the teacher was telling us that they would be lodging a complaint with the public prosecutor, as teachers have a duty of care. But we also had to keep it in mind and follow up to check that she did indeed lodge the complaint, find out when it happened, to know what followed. It extends beyond receiving a call. Especially in abuse cases, we bear in mind that a follow up is needed to see how it is progressing.

In other instances, an order arrives at a municipality where the worker handling the case is not very experienced. In that case, we will act in an advisory capacity, there will be cooperation and constant feedback. It’s the only way forward. If you have the know-how, why not support a colleague in handling a case?

Most calls for such instances are from the victims themselves or…

Mostly from their entourage. From neighbours, relatives, not many cases arrive at 1107. We do not get many of these reports. More are made to 1056, as I said. Mrs Demetriou recently reported that the Athens Public Prosecutor’s office handled around 1000 cases in 2018, not counting the cases of unaccompanied minors. We realise that very few of these arrive at the public prosecutor via the EKKA line.

You mentioned “service chauvinism” among professionals in this field. Is EKKA’s recent collaboration with Lumos, the Institute of Child Health and the Greek Association of Social Workers (SKLE) the first cooperation of this kind?

No, it is not the first. As I already mentioned, when the Juvenile Protection Teams were starting out, we ran educational cooperation meetings with the Team personnel, also with the collaboration of the Institute and the Ombudsman. There was also the first training programme for foster parents organised by the Region of Attica, which we also ran together: the Region, EKKA and the Ombudsman. The networks in existence, such as the network against corporal punishment or BECAN, are the collaborative actions of various bodies. It’s just that as far as agreeing to cooperate without the bodies entering into conflict or becoming territorial, “this is mine, I do it better”, we have some way to go. The failure of the registers in the past is proof of this attitude. But they will succeed this time around, I believe that.

There is this sense that most professionals in this field are unanimously in favour of deinstitutionalisation. How did this unanimity come about?

It’s not recent, I think that in the past two or three years there is more talk around the subject. But there were always voices advocating deinstitutionalisation. EKKA had spoken about it in its attempt to collect data from institutions in 2010. Preceding research also spoke of it as a necessity.

You cannot be a social worker and be pro-institutionalisation, it goes against the grain of the very profession. You have seen and studied the research that demonstrates the harm institutionalised life does to a child’s development, so what has happened in recent years is that these voices have grown louder. And they have become more of a mass demand.

We are in the 21st century now. It is also a natural evolution, in my view. When you have seen how other neighbouring countries, countries whose economy is similar to ours, removed over ten thousand children in ten years from institutions and into foster care, they act as an example to follow. You tell yourself, they could do it, so can we.

Do you believe it will happen?

If I did not believe it, I would have to resign and go home. I should not be doing this job. If I did not believe something will change, I could not carry on. I just think it needs time. Besides, past gaps in the law are being covered by the new legislation. I am not saying the new law is perfect, I have expressed reservations on some matters. In many aspects, it is a return of the previous statutory framework, but I cannot disregard the fact that we are finally talking about penalties for institutions failing to provide data. The way I see it, it is an indication that the state is saying enough, no more kidding around, I want to know what is going on, and I want it done properly. 

The register of prospective adoptive parents is being established for the first time. It is an attempt to control private adoptions, because things were not good as they stood. Professional foster care is being established for the first time. I am not saying that we will wake up tomorrow and have fifteen, twenty, five hundred professional foster parents who could provide care to disabled or delinquent children. I am not saying that will happen but going from a place where you could not see it ever happening to being able to foresee it is a huge step.

For the first time, foster care benefits are being regulated and will be given to all foster parents. Until recently, the benefit was given only to foster care arranged through the Centre for Social Welfare of the Region of Attica, meaning the Child Care Service “Anarrotirio Pentelis”, the Pedopolis “Agios Andreas” and Mitera. But we had instances of foster care being arranged by the Regions for the children in non-state institutions, and those foster parents received no benefits. We had a two-tier foster parent system. The issue is not the actual benefit, it is the inherent symbolism, namely the acknowledgement by the state that it bears the responsibility for those children that cannot be looked after by their families.

So, it is important to see the upside too. I repeat, if I believed the landscape could not change, then I would leave. I would not be fighting for it. I would turn into a civil servant waiting to punch out. In other words, I would be dead, and I would not even know it.

There does seem to be a lot of activity around this issue these past two years.

Although I have pointed out existing gaps and shortcomings, I want to be fair. In recent years the state has indeed given weight to issues of child protection. For example, it passed the law for the guardianship of unaccompanied minors, for which we had no framework as a country. That is important. I will not go into an overall evaluation of the legislation, every stature has its pros and cons and you must see how it works in practice and evaluate it, see if it needs any amendments, but the fact is that attention has been paid and I cannot disregard that.

And it happened when we had a huge surge in demand for child protection. In the year 2018 alone, EKKA handled more than 5900 demands for the accommodation of unaccompanied minors. That is a massive volume. At the same time, requests addressed to social services concerning the protection of children not due to abuse or neglect, but due to parental incapacity also increased, because the families went through a crisis, because the parents could no longer provide care. They were unemployed. They had no money to feed their child. Psychological issues have always been present, but now they have intensified. We receive requests to support families and children, which we did not get in previous years.

So, with demands rising, you see that an effort is being made to deal with a large number of issues. At the same time, we have been dealing with the understaffing of services. Many colleagues retired from 2010 onwards, their posts were not filled, so all the services are understaffed.

The protection system for unaccompanied minors has been described by professionals in this field as a “parallel system” to the child protection system in place.

That is not always useful, and everyone says the same thing: having a system that is deficient and creating a parallel system, I don’t know how useful that can be. The goal is to merge the two. 

Are we moving in that direction?

Of course. But change does not happen overnight. The system for unaccompanied minors, the services and institutions, was created out of necessity. How? It was set up because the procedure for refuges was fast-tracked and they could be set up. Because we received funding from abroad; because the European Union gave money to set them up. To receive the funds, a ministerial decision was issued stating that all requests will be handled by EKKA. EKKA will know on any given day what the accommodation availability is, EKKA will decide which child goes where. We don’t have an equivalent legislative tool for the mainstream child protection system like we do for unaccompanied minors.