Workload, class bias cited in failure to protect girl who died without insulin

Elizabeth Struhs was eight years old when she died on January 7, 2022, from diabetic ketoacidosis—a preventable medical emergency triggered by the absence of insulin. Her father, Jason Struhs, had stopped treating her type 1 diabetes after joining a religious sect that rejected modern medicine. A Queensland coroner's inquest is now examining why child protection services failed to keep her safe, and the answer emerging from the witness stand involves overwork, bias, and a system that moved too quickly to close her case.

Elizabeth first came to the attention of child safety authorities in 2019 after arriving at a hospital in a coma, a crisis that should have signaled serious danger. The department initiated what was supposed to be an intensive intervention—a structured program designed to monitor high-risk families closely. But after just seventeen weeks, child safety ended its involvement and returned Elizabeth to her father's sole care. This decision contradicted the objections of specialist doctors in Brisbane who had treated her. The only condition was a voluntary agreement with her parents to continue her medical care.

The single child safety officer assigned to Elizabeth's case testified in court on Friday that she was not able to work as intensively as the situation demanded. According to departmental guidelines, she should have conducted weekly home visits. She did not. She carried a caseload of approximately 25 to 28 children spread across 15 families, all supposedly receiving the same level of intensive oversight. The Toowoomba region where Elizabeth lived was among the busiest in Queensland for child protection work. Most of her other cases involved families dealing with domestic violence, drug use, and sexual abuse. The officer was often out of the office visiting other families, and on at least one occasion, a student worker conducted a home visit to the Struhs house instead of a qualified professional.

During cross-examination, counsel assisting the coroner raised a question that cut to the heart of the failure: had the officer been influenced by the appearance of the Struhs home? The family lived in what was described as an upper-class house. The officer agreed she may have been "overly influenced" by this presentation. She acknowledged that she and her colleagues likely prioritized other cases—those involving children at what seemed like more immediate risk. She also revealed a personal complication: her own child had nearly died of type 1 diabetes at age six, and she had asked not to be assigned to Elizabeth's case at all. Yet she was assigned anyway.

The case worker told the court she had not fully grasped the danger posed by Elizabeth's mother's church group, which she had viewed as a source of family support rather than a threat. She said she had faith that Jason would continue to treat his daughter despite his wife's beliefs, and that he would leave his wife if she tried to prevent the medical care. That faith was misplaced. All fourteen adult members of the sect, including both of Elizabeth's parents and the group leader Brendan Stevens, were later convicted of her manslaughter.

When the coroner asked another child safety witness whether there had been organizational pressure to close cases quickly, the answer was direct: "Absolutely." The witness explained that intensive interventions could be intrusive and potentially harmful to children if prolonged, creating an incentive to wrap them up within three months. Yet this same pressure may have pushed Elizabeth's case toward closure before the real danger—her parents' religious rejection of insulin—had been adequately addressed or monitored.

On November 13, 2019, a more senior child safety officer assessed Elizabeth as "safe" and ended the intervention. The inquest is still ongoing, examining how a system designed to protect children instead allowed one to return to a home where she would be denied the medicine keeping her alive.