Objectives Technology-facilitated abuse refers to the misuse of digital systems to inflict harm, such as the use of device-surveillance software in interpersonal abuse, the exploitation of GPS trackers for stalking, and the manipulation of smart home lights to induce epileptic seizures.^{1 2}Child health practitioners play an essential role in safeguarding young people from harm, yet these technology-related threats are rarely accounted for in traditional safeguarding guidelines. We seek to address this gap. Our initial research demonstrated the lack of safeguarding guidelines available to clinicians who encounter patients experiencing technology-facilitated abuse.¹ Our ongoing research project with safeguarding professionals seeks to (i) identify the emerging trends of technology-facilitated abuse affecting young people, (ii) uncover gaps in current safeguarding guidance, and (iii) form comprehensive recommendations for ensuring best practice when caring for patients harmed by technology.

Methods Safeguarding practitioners supporting patients in hospital and community settings were engaged in an initial focus group, which was then followed up with one-to-one interviews. Notes were taken throughout and all one-to-one interviews were recorded and transcribed. The documentation was retrospectively evaluated by two researchers, who identified key themes and learning points within the data. Ethics approval was obtained from University College London, and informed written consent was obtained from all participants.

Results Technology played a role in initiating and intensifying harm in a number of safeguarding cases, for example (1) Tik-Tok challenges leading to an exacerbation of gender-based abuse, (2) the use of GPS tracking systems to enact physical assaults and (3) the creation of deepfakes (synthetic images) to manipulate individuals. Specific demographic groups appeared to be more at risk, including young women and girls, LGBTQ youth, religious and ethnic minorities and children with long hospital stays. Participants consistently reported that digital harms were not captured by safeguarding tools and there was a lack of guidance for practitoners on how to address these risks.

Conclusion Technology-facilitated forms of abuse are on the rise, with perpetrators adapting digital technologies such as smartphones, trackers such as AirTags and spyware tools to cause harm. Hospital guidance and safeguarding training needs a digital update to ensure clinicians can effectively care for vulnerable patient groups.

References

1. Straw, Isabel, Leonie Tanczer. Safeguarding patients from technology-facilitated abuse in clinical settings: a narrative review. PLOS Digital Health Jan 2023;2(no. 1).

2. Alshehri, Ahmed, et al. Are Smart Home Devices Abandoning IPV Victims?’ 2020 IEEE 19th International Conference on Trust, Security and Privacy in Computing and Communications (TrustCom), 2020, pp. 1368–75.