The pediatric caseload is up dramatically from 2016, when Lake Regional nurses treated 231 cases of child abuse and neglect from January through September. And the number has increased more than 80 percent from 2015, when in the first nine months, Lake Regional nurses treated 173 cases of child abuse.

Forensic Nurses Week is Nov. 6–10, and forensic nurses at Lake Regional are using the annual observance to draw attention to a disturbing increase in cases of child abuse in mid-Missouri. From January through September 2017, Lake Regional forensic nurses treated 316 cases of child abuse and neglect. The cases came from 22 Missouri counties, and the majority — 66 percent — involved sexual abuse.
The pediatric caseload is up dramatically from 2016, when Lake Regional nurses treated 231 cases of child abuse and neglect from January through September. And the number has increased more than 80 percent from 2015, when in the first nine months, Lake Regional nurses treated 173 cases of child abuse.
What’s causing the sharp increase?
“We don’t know,” said Dee Ballard, a registered nurse in Lake Regional Emergency Department who is also a sexual assault nurse examiner. “We don’t know if more people are feeling comfortable coming forward or if the rate of abuse is increasing or if it’s some of both.”
Cara Gerdiman, executive director of the local child advocacy center Kids’ Harbor, attributes some of the increase to greater awareness of available services.
“In my opinion, we’re doing a better job of educating the public and investigators,” she said. “Staff in emergency departments recognize now when to ask more questions that might trigger an investigation and exam. The same is true with law enforcement and the Children’s Division.”
The number of cases involving adult victims has not risen so sharply. In fact, the number of adult cases, which include domestic abuse, sexual assault and elder abuse, fell from 96 in the first nine months of 2015 to 62 in the first nine months of 2016. In 2017, the first nine months saw 74 cases of adult victims. That averages to one case every three days.
“We aren’t seeing a huge increase in adult cases, but that doesn’t mean 74 cases can be shrugged off,” Ballard said. “All abuse is devastating, and we want our community to fight it in all its forms.”  
 
The Local Team
A major advance in local care of sexual assault victims came 10 years ago, when the Lake Area Sexual Assault Response Team formed. Commonly referred to as SART, this team includes members from the medical, law enforcement and social work fields. Team members work together to identify victims of sexual assault trauma, provide assessment, document injuries and use forensic techniques to collect evidence.
SART team members do their work with acute awareness of the shock and devastation that victims of assault and their loved ones experience. Team members strive to ensure that victims are not re-traumatized by the evidentiary exam. They also provide expert witness testimony and referrals and work to ensure the victim’s safety after discharge. SART services are available 24-hours-a-day, seven-days-a-week.
“Our work is always victim-centered,” Ballard said. “As forensic nurses, our first priority is meeting the patient’s needs and helping patients begin the healing process.”
SART team members provide care and services at Lake Regional Health System, as well as at both the Osage Beach and St. Robert locations of Kids’ Harbor.
Lake Regional nurses who work with SART are called sexual assault nurse examiners, or SANEs. At Lake Regional, the team of SANEs includes Ballard and fellow registered nurses Stephanie Dominique, Gia Gish, Angie Halterman, Crystal Lloyd, Wendy Pryor, Jessica Thurmond and Anne Wilson.
SANEs may specialize in providing care either for adults or for children. In all of Missouri, there are currently 13 nurses who have completed the rigorous process to become pediatric SANE-certified nurses, and five of them work at Lake Regional. Similarly, Missouri has 21 adult SANE-certified nurses, and three of them work at Lake Regional.
Lake Regional’s high concentration of SANE nurses results from the health system’s commitment 10 years ago to support Lake Area SART. Throughout Missouri, there are only two other SARTs — one in St. Louis and one in Kansas City.
“We decided 10 years ago, we were up to the task,” Ballard said.
 
How to Help
Although some of the increase in cases of child abuse and neglect might result from better services, 316 victims in nine months indicates this crisis needs more support. Gerdiman encourages caring individuals to get involved in SART’s work. She lists three ways to do that:
1) Volunteer. Kids’ Harbor needs volunteers for various roles, from entering data to helping with a new art therapy program. The organization will work around volunteers’ schedules and will help them find a role that fits their talents.
2) Give. Visit kidsharbormo.org and click on “How You Can Help” to find a wish list of supplies. The site also has a form for making a financial contribution.
3) Learn. Kids’ Harbor works with Missouri KidsFirst to educate the public about the signs of sexual abuse and what to do when it’s suspected. Classes can be provided in the community, for example, at a church or a business. “The education is for anyone,” Gerdiman said. “It takes all of us to prevent sexual abuse. We all need to be educated in recognizing the signs and creating safer spaces for kids.” Watch a two-minute preview of the “Stewards of Children” training at www.lakeregional.com/SARTnews.
 
To get involved in any of these ways, call Kids’ Harbor at 573-348-6886.