Primary prevention of child sexual abuse

The primary prevention of sexual abuse consists of a set of measures taken to prevent child sexual abuse (CSA) before it happens.[1][2][3] According to American professor David Finkelhor, primary prevention differentiates itself from tertiary prevention, where preventive action is taken only after sexual abuse has already happened.[4][5]

Proponents of primary prevention advocate that allocating resources towards preemptively preventing child sexual abuse is more efficient in the fight against CSA than investing resources into incarceration and criminal procedures.[6][2][3]

Primary prevention can also be seen as a crime prevention initiative focused on wide-scale public health.[5]

Etymology

The term primary prevention of child sex abuse can be dated as far back as 1993.[7]

Background

According to Johns Hopkins University's Moore Center for the Preventon of Child Sexual Abuse and the World Health Organization, child sexual abuse is a preventable public health problem. Offering pharmacological treatments, as well as community-based programs, to minor-attracted people (pedophiles, hebephiles and ephebophiles) and also those who are not attracted to children but are still at risk of sexually offending are key prevention strategies against child sexual abuse.[5]

Since at least 1992, mental health professionals have been attempting to provide mental health treatments for people at risk of abusing children. In 2005, the Prevention Project Dunkelfeld, a German mental health institution focused on primary prevention was founded.[2]

Primary prevention as opposed to other forms of prevention

Secondary prevention

Secondary prevention is a set of initiatives focused on preventing child sexual abuse while, or almost immediatelly before, it happens. Similarly to primary prevention, these measures are usually focused on mental health services.[4][5]

Tertiary prevention
Incarceration. a criminal justice approach, is a form of tertiary prevention.[5]

Tertiary prevention, on the other hand, involves taking action only after sexual abuse has already happened. This is the most usual approach taken by governments worldwide.[5]

The societal preference to prioritize tertiary prevention methods over primary prevention has been criticized by academics due to the fact that the recidivism rate for sex offenders is already much lower than those of other types of offenders. A research from 2005 stated that while property and drug offenders had recidivism rates above 80%, child sex offenders had a recidivism rate lower than 14%.[5]

Usual measures

Measures related to primary prevention may include providing mental-health support to people who are attracted to minors and educating children about sex. Anonymous hotlines for people who feel attracted to children have been used in Germany, United Kingdom and India.[2][8][9]

Organizations that actively work, or have noticeably worked, on the primary prevention of child sexual abuse include: the Prevention Project Dunkelfeld (Germany),[10] the Berlin Institute of Sexology (Germany),[6] the KEM Hospital Research Centre (India)[6] and Stop it Now! (United States).[9]

Primary prevention campaigns

In the United States

The United States has very few programs related to the primary prevention of child sexual abuse.[3][1]

In 2019, the Moore Center for the Prevention of Child Sexual Abuse, along with 25 youth-focused organizations, urged the United States Congress to invest $10 million into primary prevention measures. That would represent 0.001% of the money that the U.S. had spent into incarcerating child sex offenders before.[1][3] Later, the The House Labor HHS Appropriations Committee decided to include $2 million directed to child sexual abuse prevention research in the 2020 budget.[1]

A research from the Johns Hopkins University states that the Unites States government has spent $5.4 billion to incarcerate people for child sex offenses each year. That meant that, for each dollar invested into primary prevention of CSA, 2,700$ was allocated to incarceration.[1]

In Germany

Germany has made itself notable for its early investments into primary prevention measues, its first project being founded in 2005.[2]

Since 2008, the German Government has backed the Prevention Project Dunkelfeld, which includes a hospital-based clinic and an anonymous online hotline for people who are attracted to minors.[10] As of 2018 and until 2021, the German health ministry had invested $6 million a year into Dunkelfeld.[2]

According to its chairman, Dunkelfeld has treated thousands of people who are attracted to minors. Many of these people are from outside Germany.[2][10]

In India
KEM Hospital's entrance

In 2018, 1,700 Indians with attraction to minors had taken an online test from the Programme for Primary Prevention of sexual violence (PPPSV) to evaluate their propensity to commit child sexual crimes. Those who had the highest risk were invited to a voluntary therapeutic treatment at the KEM Hospital research center.[8]

This campaign was accomplished with the help from the Berlin Institute of Sexology.[6]

According to Klaus Michael Beier, the goal of PPSV is to accomplish primary prevention measures in India by means of medical science and technology.[8]

References
  1. "America Has Been Going About Stopping Child Sex Abuse The Wrong Way". Time. 2023-02-15. Retrieved 2023-03-31.
  2. Magazine, Undark (2021-06-07). "Can a Radical Treatment for Pedophilia Work Outside of Germany?". Undark Magazine. Retrieved 2023-03-31.
  3. J. Letourneau, Elizabeth (2019-09-11). "We spend billions after child sexual abuse happens and nothing to prevent it". The Hill. Retrieved 2023-03-31.
  4. Finkelhor, David (2009). "The prevention of childhood sexual abuse". The Future of Children. 19 (2): 169–194. doi:10.1353/foc.0.0035. ISSN 1054-8289. PMID 19719027.
  5. Knack, Natasha; Winder, Belinda; Murphy, Lisa; Fedoroff, J. Paul (March 2019). "Primary and secondary prevention of child sexual abuse". International Review of Psychiatry (Abingdon, England). 31 (2): 181–194. doi:10.1080/09540261.2018.1541872. ISSN 1369-1627. PMID 30917709.
  6. "Transformation of a Paedophile". The New Indian Express. Retrieved 2023-03-31.
  7. Harriet L. MacMillan and others, “Primary Prevention of Child Sexual Abuse: A Critical Review. Part II,” Journal of Child Psychology and Psychiatry 35, no. 5 (1994): 857–76; Sandy K. Wurtele, Cindy L. Miller-Perrin, and Gary B. Melton, Preventing Child Sexual Abuse: Sharing the Responsibility (University of Nebraska Press, 1993).
  8. "Pune: 1,750 Indians took online paedophilia test in 10 months". The Indian Express. 2018-10-15. Retrieved 2023-03-31.
  9. "Calls double in London from potential online child sex abusers". BBC News. 2023-03-10. Retrieved 2023-03-31.
  10. "Model project for pedophiles saved". DW. Retrieved 2023-03-31.
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