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Published in CenterView on November 19, 2012
CJC staff, standing from left, Shetavia Campbell, Wendi Nopper, Chris Haynes, Rebecca Mansell and Rachael Daniels, and seated from left, Regan Doleac, Dr. Scott Benton and Stacey Carter
CJC staff, standing from left, Shetavia Campbell, Wendi Nopper, Chris Haynes, Rebecca Mansell and Rachael Daniels, and seated from left, Regan Doleac, Dr. Scott Benton and Stacey Carter

Children’s Justice Center staff battle child abuse with comprehensive care, community education

By Jen Hospodor

The photographs are horrifying.

Destine Daniels receives a comprehensive forensic medical examination from Stacey Carter, left, and Regan Doleac, nurse practitioners.
Destine Daniels receives a comprehensive forensic medical examination from Stacey Carter, left, and Regan Doleac, nurse practitioners.

Tiny faces branded by hot cigarette lighters. Little torsos covered with burns from a clothes iron. Bruises. Scars.

Last year, tens of thousands of cases of child abuse were reported in Mississippi. The staff of the Children’s Justice Center at Batson Children’s Hospital is battling the crisis on two fronts:

comprehensive care for the abused and maltreated children that walk through its doors and education for the communities of the ones that don’t.

“Our goal is prevention, but it is one that requires an army of intervention,” said Regan Doleac, a nurse practitioner in the CJC.

And so, between clinic visits and hospital consults, the CJC staff sets out to build that army.

Created in 2007 by the Mississippi Legislature as a safe haven for abused and maltreated children, the CJC cared for more than 2,000 victims last year from across the state. This number is more than six times the number seen in 2007.

“If someone calls us and says they have a child we need to see, we will move heaven and earth to get that child in,” said Rebecca Mansell, CJC director.

Before the CJC, there was no place in the state that focused solely on abused and neglected children. Ideally, after a report of alleged abuse, the child is brought straight to the CJC or to Batson Children’s Hospital, where Dr. Scott Benton, CJC medical director and the sole physician at the center, can be consulted.

Once at the CJC, Benton and nurse practitioners Doleac, Stacey Carter and Wendi Nopper, who are all trained in forensic interviewing, talk with the child and perform a medical examination, documenting each step, recording every word and photographing every mark.

“The CJC is the only place in the state where a forensic interview and forensic medical examination can happen at the same time, making the process easier on everyone involved, especially the child,” Mansell said.

For the other reported cases that the CJC never gets involved in, they continually look for ways to educate the public on recognizing, reporting and treating child abuse and maltreatment.

Benton, who came to the Children’s Justice Center from a similar facility in New Orleans where he also served as medical director, believes educating physicians, allied health care providers, social workers and teachers on how to recognize abuse is crucial to prevent and intervene in it.

“It’s not as simple as what the public wants it to be,” he said. “You can’t simply look at most children and know that they’ve been abused.

“We have a lot of mythologies that we carry with us about what is and what isn’t an abused child and how children can or cannot disclose their abuse and that biases us in terms of recognizing things.”

Benton’s first priority is to reach out and provide support to the clinicians in Mississippi. The CJC has affiliations with health-care providers in McComb, Grenada and Oxford and is working to establish others across the state. These affiliations allow the practitioners to use telemedicine to document their exams and to speak directly with Benton regarding the care of patients who they suspect are being abused.

Next on Benton’s list is educating future clinicians in Mississippi. Before his arrival in 2007, there was no formal education on child abuse at the Medical Center. Benton now teaches a one-hour class on forensic medicine to medical students.

Benton and Doleac also are looking to develop a forensic medicine course for the nursing and allied health schools.

Doleac, who formerly worked in the PICU at Batson Children’s Hospital, said she always has had a passion for preventing child maltreatment.  

“In the PICU, I saw many families dealing with the issue of maltreatment within the home, but it was always on the tail end of an event and, more often than not, ending tragically,” Doleac said. “In my position at CJC, I have an opportunity to help with these issues on a different level.

“I have direct contact with the problem in its entirety, from the child to the parent to the system in itself.”

Mansell spends January through March lobbying the state legislature to secure funding for the CJC as well as legislative mandates on issues related to child maltreatment and abuse, such as mandated reporter training. The rest of the year, she looks for ways to get information out to the rest of the state about how the CJC can help or how to recognize the symptoms of child abuse.

“We’re tasked to train, to make sure that people in the state of Mississippi know that we’re a resource,” she said. “My goal is to make sure that all clinicians in Mississippi know that we’re here as a resource for them.”

Mansell is developing a web-based training program for all mandated reporters in the state. Participants needing continuing education credits would access the course through the umc.edu website for free.

For now, the course would only be available to health-care providers, but Mansell is looking at making it available to others in the future. She also is looking for a similar web-based program to train teachers on child-appropriate boundaries that can be made available to school districts across the state.

“Our best reporters are our teachers,” she said. “That’s why we want some type of program for the state’s schools.”

Mansell focuses on education because she knows that abuse and neglect are preventable. She also knows Benton and the other CJC staff do everything in their power to make sure that the children they see are safe and healthy.

“Now can we prevent all of it? No, but can we treat the kids we do see with the best possible care they can receive anywhere? Yes,” she said. “And I frankly don’t think these kids deserve anything less.”

Recognizing Child Abuse

Rachael Daniels, social worker, interviews Grace Mansell in the Children’s Justice Center.
Rachael Daniels, social worker, interviews Grace Mansell in the Children’s Justice Center.

The following signs may signal the presence of child abuse or neglect.

    In the Child:

    •    shows sudden changes in behavior or school performance;
    •    has not received help for physical or medical problems brought to the
         parents’ attention;
    •    has learning problems (or difficulty concentrating) that cannot be attributed
         to specific physical or psychological causes;
    •    is always watchful, as though preparing for something bad to happen;
    •    lacks adult supervision;
    •    is overly compliant, passive, or withdrawn; or
    •    comes to school or other activities early, stays late and does not want to go
         home.

    In the Parent:
    •    shows little concern for the child;
    •    denies the existence of – or blames the child for – the child’s problems in
         school or at home;
    •    asks teachers or other caregivers to use harsh physical discipline if the
         child misbehaves;
    •    sees the child as entirely bad, worthless or burdensome;
    •    demands a level of physical or academic performance the child cannot achieve; or
    •    looks primarily to the child for care, attention and satisfaction of emotional needs.

    In both the Parent and the Child:
    •      they rarely touch or look at each other;
    •      they consider their relationship entirely negative; or
    •      they state that they do not like each other.

(Source: Child Welfare Information Gateway)