Child sexual exploitation (CSE) is a form of child abuse that has only been fully recognised in recent years. The issue of CSE has gone from being largely hidden and rarely acknowledged to the being subject of significant media and political attention and concern.
The impact of CSE can have a devastating effect on the lives of victims. It is known that children and young people who have experienced sexual exploitation have poor health outcomes. The health impact is varied, with victims experiencing many forms of physical, psychological and emotional health difficulties.
The 18th March 2015 is National Child Sexual Exploitation Awareness Day this day aims to highlight the issues surrounding CSE encouraging everyone to spot the signs and support young people appropriately.
Currently I work as Specialist Safeguarding Nurse for CSE within ‘The Engage Team’. The Engage Team was set up to provide a multi-agency response to tackling CSE within the East Lancashire area. The Engage Team strives to ensure that children and families suffering the effects of CSE are fully supported. Through effective partnership working, the team also works to reduce children’s vulnerabilities to sexual exploitation by undertaking preventative work with this vulnerable group of young people. The team consists of representatives from various agencies, which include; social workers, Police staff, Health staff and workers from charitable organisations.
Recent research has highlighted that children and young people who have experienced sexual exploitation have poor health outcomes. All children and young people receiving a service from Engage receive input from health, by means of a holistic health assessment. Part of my role as CSE Specialist Nurse is to co-ordinate a health response and to ensure adequate health care is afforded to this vulnerable group of young people; by assessing, planning, and implementing packages care and support for children and young people experiencing or at risk of CSE, in relation to their health and safeguarding needs.
Whilst improving outcomes for young people is rewarding in itself. Working within the CSE arena can at times be challenging. Young people experiencing CSE are hard to reach and it is sometimes difficult to encourage them to accept support. However, these young people are amongst the most vulnerable in our society and working with them requires us as professionals to invest time in building relationships with them, which requires determination and perseverance.
The recent publication of the Health Working Group Report has provided recommendations for health agencies which will affect the delivery of health services in relation to CSE, which will in turn; contribute to the improvement of health outcomes for young people experiencing CSE. As specialist nurse for CSE I am eager to take forward this agenda by, raising awareness across the health economy by providing leadership, developing good practice and strengthening relationships.
As Health Professionals we have a key role to play in raising awareness and recognising the signs of Child Sexual Exploitation. You can help by knowing how to spot the signs and you can do this by being aware of the vulnerabilities and indicators.
Considering these findings from recent reports, we know that young people experiencing CSE are attending health settings, and Health Professionals are ideally placed to recognise the signs. There are a number of signs which may be noted by Health Professionals that would indicate a child is at risk or experiencing CSE, these include:
- Physical injuries/repeated A&E attendances
- Drug and Alcohol misuse
- Self-harm and suicidal ideation
- Repeated sexually transmitted infection, pregnancy and terminations
- Frequently reported missing from home
- Deterioration in behaviour
- Rapid change in appearance including self-neglect
- Decline in school attendance
Some factors may make a child more vulnerable to CSE these need to be considered as part of your assessment. Some of these vulnerabilities include:
- Learning disabilities
- Confusion around sexual orientation
- History of abuse eg neglect, familial sexual abuse, physical, emotional abuse.
- Low self esteem
- Young people in foster or residential care
- Gang association
- Missing from home and homelessness
Remember; concerns highlighted in relation to CSE should be followed up as you would any other Safeguarding concern.