Self-reported mental health of children known to child protection services: an Australian population-based record linkage study

O’Hare, Kirstie; Hussain, Aniqa; Laurens, Kristin R.; Hindmarsh, Gabrielle; Carr, Vaughan J.; Tzoumakis, Stacy; Harris, Felicity; Green, Melissa

doi:10.1007/s00787-021-01841-3

Cited by 8 publications

(3 citation statements)

References 57 publications

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“…Greater involvement (i.e. a higher level of intervention severity) with child protective services has been associated with a higher prevalence of mental health disorders [29], although all levels of involvement had a higher prevalence than the general population. The general pattern aligns well with our finding of a higher risk of receiving a mental health prescription or specialist outpatient referral for children with a child protection registration in this study.…”

Section: Discussionmentioning

confidence: 99%

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

Ball,

Anderson,

Black

et al. 2023

Preprint

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PurposeChildren with experience of maltreatment, abuse or neglect are known to have a higher prevalence of poor mental health. Child Protection Services identify children most at risk of harm and in need of intervention. Mental healthcare usage in this population is not well understood as registration data is not routinely linked to health records.MethodsWe undertook data linkage to describe the population on the register, their mental healthcare usage and to calculate age- and sex-specific incidence rates of mental health outcomes. We analysed records from the Aberdeen City Council Child Protection Register and for mental health prescribing and referrals to child and adolescent mental health services (CAMHS) for the NHS Grampian region between 1stJanuary 2012 and 31stDecember 2022.ResultsWe identified 1,498 individuals with a Child Protection Register registration, of which 70% were successfully matched to health records. 20% of registrations occurred before birth and the median age of registration was 3 years. 10.1% of children with a registration ever received a mental health prescription, 5.1% for treatment of attention deficit hyperactivity disorder and 1.7% for treatment of depression. 18.9% received a referral to specialist outpatient Child and Adolescent Mental Health Services. Age- and sex- standardised incidence rates for mental health prescribing and referrals are higher for children with a child protection registration compared to the general population.ConclusionChildren identified as being at significant risk of harm and involved with child protection services are at greater risk of seeking or receiving professional mental health support than their peers. Clinical services should investigate additional ways to support this population’s mental well-being as a priority. Efforts to reduce the exposure of children to potentially harmful environments at a societal level should also be pursued.

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Section: Discussionmentioning

confidence: 99%

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

Ball,

Anderson,

Black

et al. 2023

Preprint

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“…, 2019; O’Hare et al. , 2021). Studies of maltreated children or cases where maltreatment is suspected are important, but in the UK, these represent a minority of children who have contact with social services (Rodgers and McCluney, 2021).…”

Section: Introductionmentioning

confidence: 99%

The mental health of all children in contact with social services: a population-wide record-linkage study in Northern Ireland

McKenna¹,

O’Reilly²,

Maguire³

2023

Epidemiol Psychiatr Sci

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Aims Children in contact with social services are at high risk for mental ill health, but it is not known what proportion of the child population has contact with social services or how risk varies within this group compared to unexposed peers. We aim to quantify the extent and nature of contact with social services within the child population in Northern Ireland (NI) and the association with mental ill health. We also examine which social care experiences identify those most at risk. Methods This is a population-based record-linkage study of 497,269 children (aged under 18 years) alive and resident in NI in 2015 using routinely collected health and social care data. Exposure was categorized as (1) no contact, (2) referred but assessed as not in need (NIN), (3) child in need (CIN) and (4) child in care (CIC). Multilevel logistic regression analyses estimated odds ratios (ORs) for mental ill health indicated by receipt of psychotropic medication (antidepressants, anxiolytics, antipsychotics and hypnotics), psychiatric hospital admission and hospital-presenting self-harm or ideation. Results Over one in six children (17.2%, n = 85,792) were currently or previously in contact with social services, and almost one child in every 20 (4.8%, n = 23,975) had contact in 2015. Likelihood of any mental ill health outcome increased incrementally with the level of contact with social services relative to unexposed peers: NIN (OR 5.90 [95% confidence interval (CI) 5.10–6.83]), CIN (OR 5.99 [95% CI 5.50–6.53]) and CIC (OR 12.60 [95% CI 10.63–14.95]). All tiers of contact, number of referrals, number of care episodes and placement type were strongly associated with the likelihood of mental ill health. Conclusion Children who have contact with social services account for a large and disproportionate amount of mental ill health in the child population. Likelihood of poor mental health across indicators is highest in care experienced children but also extends to the much larger population of children in contact with social services but never in care. Findings suggest a need for targeted mental health screening and enhanced support for all children in contact with social services.

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“…The long-term cognitive, mental, physical, social, and behavioral consequences of child maltreatment are well established ( Widom, 2014 ). Victims of child maltreatment experience a variety of difficulties including poor educational attainment ( Laurens et al, 2020 ; Romano et al, 2015 ), low life success/quality of life ( Najman et al, 2022 ), mental ill health ( Li et al, 2016 ; O’Hare et al, 2021 ), intergenerational maltreatment ( McKenzie et al, 2021 ), and intimate partner violence perpetration ( Li et al, 2020 ). One of the most well-documented consequences of child maltreatment is criminal offending in adolescence and adulthood ( Malvaso et al, 2018 ).…”

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confidence: 99%

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest

Tzoumakis,

Whitten,

Laurens

et al. 2024

J Interpers Violence

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The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child’s sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child’s birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.

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Self-reported mental health of children known to child protection services: an Australian population-based record linkage study

Cited by 8 publications

References 57 publications

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

The mental health of all children in contact with social services: a population-wide record-linkage study in Northern Ireland

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest

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