An emergency department intervention to protect an overlooked group of children at risk of significant harm.
Affiliation
Emergency Department, Royal United Hospital, Coombe Park, Bath, UK., philip_bath@hotmail.comIssue Date
2012-02-01T10:57:12ZMeSH
AdolescentAdult
Child
Child Abuse/*prevention & control
*Child Welfare
*Child of Impaired Parents
Emergency Service, Hospital/*organization & administration
England
Female
Hospitals, Group Practice
Humans
Male
Medical Audit
*Mental Disorders
Middle Aged
Risk Factors
Young Adult
Metadata
Show full item recordCitation
Emerg Med J. 2009 Jun;26(6):415-7.Journal
Emergency medicine journal : EMJDOI
10.1136/emj.2008.062547PubMed ID
19465610Abstract
BACKGROUND: Parental psychiatric disorder, especially depression, personality disorder and deliberate self-harm, is known to put children at greater risk of mental illness, neglect or physical, emotional and sexual abuse. Without a reliable procedure to identify children of parents presenting with these mental health problems, children at high risk of significant harm can be easily overlooked. Although deliberate self-harm constitutes a significant proportion of emergency presentations, there are no guidelines which address the emergency physician's role in identifying and assessing risk to children of these patients. METHODS: A robust system was jointly developed with the local social services child protection team to identify and risk-stratify children of parents with mental illness. This allows us to intervene when we identify children at immediate risk of harm and to ensure that social services are aware of potential risk to all children in this group. The referral process was audited repeatedly to refine the agreed protocol. RESULTS: The proportion of patients asked by the emergency department personnel about dependent children increased and the quality of information received by the social services child protection team improved. CONCLUSIONS: All emergency departments should acknowledge the inadequacy of information available to them regarding patients' children and consider a policy of referral to social services for all children of parents with mental health presentations. This process can only be developed through close liaison within the multidisciplinary child protection team.Language
engISSN
1472-0213 (Electronic)1472-0205 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1136/emj.2008.062547
Scopus Count
Collections
Related articles
- Children who harm themselves: development of a paediatric emergency department triage tool.
- Authors: Dieppe C, Stanhope B, Rakhra K
- Issue date: 2009 Jun
- Caring for adolescents with mental health problems: challenges in the emergency department.
- Authors: Stewart C, Spicer M, Babl FE
- Issue date: 2006 Nov
- Non-infant adoption from care: lessons for safeguarding children.
- Authors: Rees CA, Selwyn J
- Issue date: 2009 Jul
- Fear of harm, a possible phenotype of pediatric bipolar disorder: a dimensional approach to diagnosis for genotyping psychiatric syndromes.
- Authors: Papolos D, Mattis S, Golshan S, Molay F
- Issue date: 2009 Nov
- Establishing best practice in pediatric emergency mental health: a prospective study examining clinical characteristics.
- Authors: Kennedy A, Cloutier P, Glennie JE, Gray C
- Issue date: 2009 Jun