'Our mission is to break the cycle of despair," says Chanya Suebpetch, one of the members of a team of social workers at Siriraj Hospital in Bangkok. The 37-year-old works in the Division of Child and Adolescent Psychiatry, Department of Pediatrics. Chanya's work is therefore focused strongly on supporting vulnerable children.
When Chanya walks into the interview room where much of her work is done, particularly speaking to suspected victims of abuse, the efforts to protect children are immediately visible. The room is set up with cameras to record interviews. This is crucial to avoid children having to repeat interviews, which can be traumatic experiences.
"These measures are essential for any child brought in for consultation," says Chanya, while pointing to a room behind a one-way mirror. Although this room means that a child can speak without feeling scrutinised by large numbers of strangers, Chanya does make sure that "children understand they may be observed and listened to by designated personnel". These designated personnel may include law enforcement, justice officials or psychiatrists ready to provide additional support in the most sensitive of cases. Chanya's commitment to ensuring children are comfortable during difficult times is obvious. It is also the culmination of years of work.
A doll used to help children describe their abuse.
Chanya's journey into social work began when she started volunteering at the Centre for the Protection of Children's Rights in 11th grade. It was here that she learned invaluable skills from experienced social workers, including how to calmly handle difficult clients. Witnessing the impact that social workers could have on the lives of vulnerable children inspired her to pursue social work as her full-time career.
Chanya then studied and graduated from the Faculty of Social Administration at Thammasat University and is now a dedicated social worker at Siriraj Hospital. She is one of 33 licensed social workers at the hospital and part of a larger community of approximately 3,000 licensed social workers in Thailand who work to support individuals across the nation, including more than 13 million children. Her main focus is on providing support to patients registered at the hospital, as well as managing complex cases referred from other hospitals.
Every week, Chanya juggles new cases while managing follow-ups on existing ones. During quieter weeks, there might be three cases, but during peak periods, this number can escalate to as many as 10. This demanding workload includes thorough interviews and assessments for new cases, home visits to families for further assessment, and maintaining communication to monitor progress with existing patients.
Toys used to alleviate children's anxiety during interviews or serve as icebreakers.
Once a registered patient at the hospital undergoes examination, those suspected of experiencing abuse or maltreatment are referred for a consultation with a social worker. The team conducts interviews to assess risks and determine the urgency of the situation. In cases involving a family member as a perpetrator, the team assesses whether immediate separation from the family is necessary for the child's safety.
Chanya's role in the hospital multidisciplinary team involves translating medical knowledge into actionable guidance for parents or guardians. For instance, if a child is neglected and not attending school, thus hindering their ability to learn and thrive, a doctor might advise enrolling the child in education.
"I work to persuade parents to prioritise their child's schooling, assisting them in finding solutions. This may involve adjusting their daily routine, such as arranging to drop the child at kindergarten before work."
Among the issues Chanya highlighted as most affecting children, sexual abuse was the most prevalent. This was followed by neglect, often stemming from parents having limited understanding of education and childcare. The families Chanya works with include those from low-income households, where parents often have a limited educational background and struggle to make ends meet. Consequently, many children remain unenrolled in school or drop out prematurely, significantly impacting their quality of life. Each year, Siriraj Hospital deals with around 200 cases of sexual abuse and neglect.
Chanya sadly observes that physical or emotional abuse is not uncommon, and is often overlooked by societal norms. Children who face criticism or feel unwelcome in their own home can suffer from trauma or develop long-term stigma.
Toys used to alleviate children's anxiety during interviews or serve as icebreakers.
These challenges are just a fraction of a social worker's responsibilities. While physicians address and treat patients' mental or physical illnesses, social workers tackle the broader context of their lives, including relationships and environment.
Social workers' ideal outcome is to reintegrate each child into their families and a caring environment. But, in many cases, this is not possible due to an unsafe physical or emotional environment. It then becomes the social worker's responsibility to identify the most appropriate placement for the child.
Chanya was once deeply moved when a parent, who had caused suffering to their own child due to their own history of childhood abuse, asked: "Why didn't I meet a social worker like you when I was abused by my parent?"
"I only wish these children didn't have to endure these bleak environments," Chanya says. She emphasises that with a greater number of quality social workers, fewer children will have to endure such harsh circumstances.
Over her nine years at the hospital, Chanya has facilitated numerous children in returning to their families or being placed in more nurturing environments. However, she doesn't see herself as an angel. "Some cases yield no success. Nonetheless, many lives have improved, even if they haven't reached the best possible standard. Progress, no matter how slow, is still progress."
Muhammad Rafiq Khan, chief of Child Protection, Unicef Thailand, emphasised the shortage of social workers in the country despite the alarming surge in mental health issues among children and young people. According to a 2022 Unicef study, 1-in-7 adolescents aged 10-19 and 1-in-14 children aged five to nine in Thailand have mental health disorders.
However, each social worker is tasked with overseeing a disproportionate number of individuals, a far cry from the recommended ratio of 1 social worker for every 2,000 children. This stark contrast poses a significant challenge in addressing the needs of those they serve.
"Thailand must prioritise the development of high-quality public services and a nurturing environment for children, to ensure that they can reach their fullest potential and cultivate brighter futures," Khan concluded.
