Child abuse and neglect are now recognised as being
‘everybody’s business’. Aspects of prevention, recognition,
assessment and treatment of child maltreatment all fall within the
province of the various branches of psychiatry. This document
reviews these responsibilities.
Following a definition of child abuse and neglect, the document
summarises key documents which have been published recently in
England and their equivalents in Scotland, Wales and Northern
Ireland. They include legislation (The Children Act 1989) and
government guidance documents accompanying this legislation:
Working Together (1999), the Assessment Framework
(2000) and Safeguarding Children in Whom Illness is Fabricated
or Induced.
Following Lord Laming’s enquiry into the death of Victoria Climbie,
the government published What To Do If You’re Worried A Child
Is Being Abused (2003). Two documents deal with evidence of
children and other vulnerable witnesses in criminal trial and
provision of therapy for child witnesses prior to a criminal trial.
The Carlile Review, published by the Welsh assembly in
2002, highlights the vulnerability of children and young people
treated and cared for in psychiatric inpatient units. Several
documents deal with domestic violence and with patients as
parents.
Several issues of practice are addressed. They include
multiagency work; culture, ethnicity and gender; confidentiality;
the storing of video recordings; and allegations against
staff.
A section on selected clinical issues highlights those which
were considered to be of particular salience in the field of child
protection: vulnerability – including learning and other
disabilities and looked-after children; transition from victim to
abuser; domestic violence; sexual abuse by adolescents; sexual
abuse by women; organised abuse; fabricated or induced illness; and
the effects on children of adult mental disorder and substance
abuse.
The section on research findings includes effects of abuse and
breaking the cycle of abuse. These were selected as being of
especial relevance to psychiatrists encountering child abuse. The
section on types of professional involvement includes general
guidance as well as guidance for specific specialties. The sections
discuss the principles of recognition of abuse, investigation and
assessment of risk to children, assessment of treatment needs and
provision; and medico-legal work. Lastly, there is a brief mention
of training needs.