Child Maltreatment - The Important Interface Between Healthcare and Child Protection Services

Abstract

Introduction

Healthcare professionals play a central role in preventing child maltreatment. However, major uncertainties remain regarding appropriate interventions and legal frameworks. In Germany, a 24/7 telephone helpline provides counselling to medical professionals. This article examines the topics raised by callers to the helpline and characteristics of cases.

Methods

The telephone counselling service is available to healthcare professionals, child and youth welfare workers and family court professionals. The counsellors are trained physicians who offer expert guidance on medical aspects related to cases of child maltreatment. A descriptive statistical analysis of calls from 2017 onward was conducted and free text case descriptions were assessed. Where possible, the characteristics of consultations were compared to the nationwide data of child protection service assessments of a risk to a child's wellbeing.

Results

Of 9,315 calls recorded, 78.0% (6,805) were from healthcare professionals, 10.0 % (999) from child and youth welfare professionals and 0.6 % (54) from professionals involved in court cases. Affected children were predominantly either of pre-school age or young adolescents, a majority was female (55.9%). The most prevalent form of child maltreatment was physical abuse and all forms of neglect.

Discussion

Most consultations originated from healthcare professionals, often regarding uncertainties with the threshold for reporting to the authorities. Although physical abuse was the most commonly reported form, sexual abuse was over-represented compared to data from child protection service. This suggests that this form causes particular concern in healthcare professionals. Uncertainty about child protection service involvement highlights the need for training.