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 that 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.
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