● 中文摘要：

　　本研究運用深度訪談、焦點團體、問卷調查及檔案檢閱等方式，蒐集並分析2006年~2007年台灣兒虐致死與攜子自殺事件的實證資料。研究結果歸納兒虐致死危險因子如下：在個人因子方面─一、與父母親或主要照顧者有關的危險因子，包括與個人基本屬性、托育、暴力、經濟、情緒管控或障礙、個人特殊習性、犯罪行為等有關之議題。二、與兒童本身有關的危險因子：主要指兒童某些特質增加父母或主要照顧者之照顧難度，並非指兒童必須為其受虐負責，包括不被期待生下的兒童或未能滿足父母之期待或願望等。在關係因子方面─兒童受虐的危險因子與家人間、朋友間、親密伴侶間及同輩團體間的關係有關，包括與親子依附或情感連結、婚姻或情感、案父母之原生家庭、社區環境關係及支持系統有關的危險因子。在社區或社會因子方面─如社區缺乏相關服務以支持家庭。 研究結果歸納攜子自殺的危險因子如下：在父攜子自殺個案方面─一、離婚確定後的一年內是男士攜子自殺的「高危險期」；二、在離婚後，對於離婚的妻子或其娘家親人多有騷擾、糾纏與恐嚇的行為；三、加害人情緒穩定度不足；四、強的親子依附關係；五、「權力控制型」加害人以孩子為籌碼；六、家有身心障礙兒少，支持系統不足。母攜子自殺個案方面─一、憂鬱症病史，或健康狀況不佳；二、嚴重的財務困境，超過當事人能力負荷；三、親子依附關係強；四、外部支持系統薄弱；五、符合高風險家庭的指標。在舉家自殺的個案方面─一、嚴重的財務困境，超過當事人能力負荷；二、討債公司施壓暴行，感受到威脅與絕望；三、親子依附關係強；四、外部支持系統薄弱；五、符合高風險家庭的指標。這三類的攜子自殺案例共同的危險因子是：一、曾透露輕生意念，或有自殺未遂記錄；二、多未向專業機構或政府部門求助。 在兒虐致死防治方面本研究建議立即可行事項如下：一、針對施虐者或主要照顧者應強化親職教育，協助新手爸爸媽媽，提供喘息服務或安置照顧服務，增加學齡前幼兒托育服務的可及性。二、針對兒童保護網絡，社政單位應加強兒童少年保護工作人員之專業敏感；檢視評估兒童少年保護工作人員之工作負荷量與服務性質，並適時調整。三、針對童年受虐與曾安置協助之個案應提供必要之支持協助，避免落入暴力代間循環；提供可及性之托育服務資源；建立跨縣市個案之追蹤輔導機制；結合鄰里工作者，提供社區支持協助或轉介相關資源；加強成人兒童保護工作之宣導。對各防治網絡部門的建議分別是：教育單位應著力於親職教育向下紮根；協助新手爸爸媽媽或養育不同階段兒童少年之父母的親職諮詢需求；加強托育服務或學前教育之可及性。衛生醫療單位應加強新生嬰兒之預防注射與追蹤；培養衛生醫療單位之兒童保護敏感度與覺察；協助藥酒癮患者之戒治工作，增加案家使用資源之可及性；協助需求者之情緒管控與壓力調適；加強兒童少年保護工作之宣導與通報。司法單位應確保入獄服刑個案之未成年子女獲得適當照顧或安置；針對受託照顧入獄服刑個案之未成年子女者，提供該受託照顧者的犯罪紀錄；提供社政單位施虐者相關訊息，特別是出獄資訊，以建立後續防止家中其他未成年子女受虐之保護機制。職訓、就業輔導單位應積極提供國中或高中/職背景，年齡主要集中在25-35歲間之失業者，相關之職業訓練與輔導。民政單位應將鄰里工作者納入兒童少年之保護防治體系。針對兒虐致死成因部分，建議調整現行重大兒虐個案評估檢討機制、列管追蹤防治策略之執行。本研究之中長期建議為建立兒虐致死個案之長期資料庫。 在攜子自殺防治方面本研究建議立即可行事項如下：社政體系應補強高風險家庭方案；增訂校方通報「高風險家庭評估表」專用版本、務實並正確評估個案需求；調整人力與資源之配置，增加追蹤高風險及高度危機家庭的家訪密度；檢討評估現有高風險家庭等預防性措施，找出目前無法及早介入案家，提供實質協助的主因，並投入必要資源改善之。此外還應利用低收入戶清查評估家庭其他問題；開發及重點補助男士專業服務；建立有效的「強制性親職教育輔導」；透過建立結案標準與程序、建立個案危險分級制度、地方後送資源盤點與補強及成立「重案組」等策略，以有效降低個案量；提高保護性業務督導的質與量；提高幼托機構的敏感度；關懷身障家庭照顧者的身心照顧。在強化兒童保護網絡方面，本研究認為基本上攜子自殺是成人自殺事件的延伸，衛政應擔起更多的責任。建議衛生醫療單位應研議將自殺列為法定通報項目，訂定「自殺獲救者後續處遇之標準作業流程」，加強自殺防治初級預防工作，強化社區精神衛生資源網絡，持續宣導「兒童生命自主權」的概念，以「殺子後自殺」用詞取代「攜子自殺」，以降低其「文化正當性」。建議教育單位應與社政部分共同研商通報高風險的準則與兩部門分工的界限，以減少學校「卸責式的過度通報」；學童有轉學次數頻繁、多次或不正常請假時應進行家庭訪視；強化教師的「高風險」認知與危機應變能力；教導學童求救與自救方式。建議戶政與民政單位應提供初離婚者諮商輔導資訊；強化村里長的角色與責任。建議警政單位應在必要時勻派警力陪同社工執行任務；對傳媒謹守保密原則；更具敏感度地評估兒少的危險性，並在通報單上加以註明。建議司法單位審慎衡酌加害人的交保；修訂民法第1055條，家暴案件協議離婚之子女監護權歸屬，應經社工員訪視評估以兒童最佳利益考量並送法院裁判。本研究中長程建議方面包括：保護性業務的人力資源策略規劃與管理；普遍建立「學校社工制度」；建立攜子自殺個案檔案庫；建立「兒童非預期死亡檢討機制」；建立兒虐與疏忽致死案例監控系統。 關鍵字：兒虐致死、攜子自殺、兒童保護、兒童虐待及疏忽、家庭暴力 

● English Abstract:

     No single factor on its own can explain why some individuals behave violently towards children or cause child victims to death. Ecological model are used to analyze the complex interaction of a number of risk factors at different levels. The first level of the model, the individual, deals with risk factors in parents and caregivers and risk factors in children. Included in this grouping are the parents or caregivers, having been maltreated in childhood, used physical punishment to discipline children in their care. Risk factors for children in this group do not imply that the children are responsible for the maltreatments they received. It may mean an unwanted baby or an infant with perceived excessive needs, etc. The second level of the model, the relationships, examines an individual’s close social relationships with family members, friends, intimate partner, and peer groups. These types of relationship may influence an individual’s risk of committing or suffering maltreatment. Examples of the risk factors include family violence, lack of support system to handle stressful conditions, etc. The third level, the community, refers to possible situations within a community that may affect children negatively. Lack of community-based family support services is one of the critical elements. Strategies for preventing child deaths caused by maltreatments should aim to reduce the possible risk factors and to strengthen the protective measures. This research concludes that the risk factors for paternal filicide-suicide may include divorce, harassment and threatening behavior after divorce, emotional instability, strong attachment to parent-child relationship, power-control type personality traits, lack of support to caregivers of disabled children. The first year after confirmed divorce appears to be a period of “highest risk” for this category. The risk factors of maternal filicide-suicide appear to include depression or illness, serious financial problems, strong attachment of parent-child relationship, weak support system, and high-risk family. The risk factors of familial filicide-suicide include serious financial problems, commercial debt collectors’ violence, and strong attachment of parent-child relationship, weak support system, and high-risk family. The common risk factors of these three types of filicide-suicide cases are suicidal attempts and lacking of helping behavior. Recommended preventive strategies include enhancing early childhood education and care, providing training in parenting, increasing access to day care services, strengthening the awareness of child protection, and building an integrated network of child protection. This study considered various interventions from social, health, educational, legal, and employment perspectives. A team of investigators with special training and expertise can provide proper responses to situations that may potentially cause deaths in children. Development of a comprehensive database tracking case histories would be useful in providing evidence-based information for prevention purposes. Other recommendations include strengthening the existing “high-risk families” program, increasing the frequencies of home-visiting by social service agencies, reconfirming family needs through periodical reviews of low-income families, providing effective mandatory parenthood training, reducing caseload of social workers. Funding and development of social programs for men, particularly, newly divorced men, should be considered. As filicide-suicide may be considered as an extension of adult suicide, it is reasonable to recommend that Department of Health develop effective services to address needs and treatments for patients following suicide attempts. Concerning the long-term planning, this study finds a great need for a comprehensive strategic planning in child protection focusing on such topics as human resources, systematic case reviews of filicide-suicide, dedicated database, and surveillance mechanism. 

● 文章連結：

https://goo.gl/dkrqa5

● 資料來源：

政府研究資訊系統