The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

Child protection: a survey of psychiatrists' knowledge and attitudes

The aim of the study was to examine psychiatrists' knowledge of the child protection process and their attitudes toward child protection training. An anonymous questionnaire survey was sent out to all psychiatric staff in a large psychiatric hospital. The response rate was 72 per cent. Fifty‐seven per cent of respondents had never attended child protection training and 16 per cent thought that it was of no relevance to their position. Significant differences in self‐rated knowledge were identified between those who had attended training and those who had not. Variations in the availability and quality of child protection training may result in psychiatrists not attaining the core knowledge required in order to work effectively as part of the child protection process. Hospital management should work towards prioritising and disseminating local child protection policies and procedures more effectively and consider routine child protection training as part of any new staff induction. The Royal College of Psychiatrists should consider inclusion of child protection in junior staff education programmes and as part of the MRCPsych examination curriculum. Likewise, consideration should be given to enhancing the status of child protection training in continuing professional development programmes for career‐grade psychiatric staff. Copyright © 2010 John Wiley & Sons, Ltd.     

Child protection training in sport‐related degrees and initial teacher training for physical education: an audit

This article reports on an online survey of child protection training for students on sport‐related and Initial Teacher Training Physical Education degrees, and on the views of recently graduated teachers of the usefulness of such training in their everyday work. The results indicate that child protection training is provided in most courses but in varying amounts. Respondents to the survey reported positively, in the main, about the effects of new requirements for teacher training (Every Child Matters: Change for Children, Department for Education and Skills, 2004). Reasons given for not including child protection in courses were: lack of time; the perceived vocational nature of the topic; lack of fit with course aims and objectives; lack of relevance; and the research rather than professional orientation of the course. Recently graduated teachers' views on their pre‐service child protection training differed from the claims made about this in the survey. In particular, they raised concerns about their lack of preparation for dealing with potential child protection situations. The article concludes that child protection training within sport‐related degrees is deficient in both consistency of delivery and in content, and that, in addition to preparing students to recognise signs and indicators of abuse, curricula should also address undergraduates' confidence and skills for responding to abuse in their everyday professional practice. Copyright © 2008 John Wiley & Sons, Ltd.     

Development of the Stay Safe programme

The development and implementation of the Stay Safe programme is described in this paper. The programme, which was developed in the Republic of Ireland, is a culturally sensitive developmentally staged child abuse prevention. It is a multisystemic programme insofar as it includes modules for teachers, parents and children. It also involves liaison with local child protection and child health professionals as an integral part of implementation. Multimedia‐based instruction is employed to facilitate multimodal leaning. The broad curriculum covers bullying and child abuse as two related forms of victimization. Disclosure training, assertiveness training and coercion management training are included in the curriculum, which also focuses on enhancing self‐esteem and the promotion of peer support. Copyright © 2000 John Wiley & Sons, Ltd.     

Prevention of child sexual abuse: implications of programme evaluation research

Thirty child abuse prevention programme evaluation studies were selected according to a set of methodological criteria following an extensive manual and computer literature search. Targets for intervention in 17 studies were children; in three parents; in four teachers; and in six studies multisystemic programmes were evaluated where some combination of children, parents and teachers was targeted for intervention. From a review of the 30 studies, it was concluded that child abuse prevention programmes can lead to significant gains in children's, parents' and teachers' safety knowledge and skills. Best practice guidelines arising from the review include the use of multisystemic programmes; child‐focused curricula which cover a wide range of safety skills and concepts; and the use of didactic instruction and discussion, video modelling and active behavioural skills training techniques in programme delivery. The curricula for parents' and teachers' programmes should cover child protection issues and local child protection procedures along with an overview of the children's programme lesson plans. Longer programmes conducted by trained staff are preferable and such staff may include teachers, parents, mental health professionals and law enforcement officers. Copyright © 2000 John Wiley & Sons, Ltd.     

Lessons from introducing a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camps in Kenya

Evidence shows that displacement, family separation and economic status are risk factors for child protection concerns and children's mental health, and that violence and economic status are risk factors for children's physical, emotional and social development. Family based care, community social support and economic strengthening have been shown to moderate such risk factors. This article explores the introduction of a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camp complex in Kenya, with the primary objective of strengthening the household economy of foster families and improving the care of the fostered children. In this article the authors reflect on the programme's work in recognising and building on existing traditional clan-based family tracing and care mechanisms for unaccompanied and separated children, as well as the importance of understanding the particular needs of specific groups of children such as those without appropriate care. They discuss issues of insecurity and lack of funding affecting programme quality and programme monitoring, and discus challenges of project design. Consideration of how such challenges can impact on existing traditional care mechanisms is shared. The authors argue for greater acknowledgement and efforts to build on traditional child protection mechanisms within wider debates on child protection systems; greater understanding and consideration of the needs of unaccompanied children in particular contexts; better monitoring of the outcomes of child protection programmes on the children they serve; and adequate and sustained funding for child protection in emergencies.     

Child welfare caseworkers' perspectives on the challenges of addressing mental health problems in early childhood

Although nearly half of child maltreatment victims are under the age of five and at high risk for developing serious emotional or behavioral problems, few young children involved in the child welfare system receive treatment. As the first point of service contact, child welfare caseworkers can play a key role in quickly identifying children with mental health problems and linking them to services. This study examines caseworkers' perspectives on the challenges of addressing mental health problems in early childhood. Based on five focus groups conducted with 50 caseworkers from an urban, public child welfare agency, results suggest that although workers acknowledge the importance of early intervention, difficulty identifying mental health needs in early childhood and workplace barriers impede linkage to services. Given the lasting impacts of early experiences on children's development, it is imperative that these challenges be addressed. Implications for systematic mental health screening and caseworker training are discussed.     

Inter‐professional working in child protection with families with long‐term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with 28 experienced child welfare professionals. It explores their views about families known to the child protection system with long‐term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter‐personal skills and access to specialist therapeutic services if families are to be supported to address their problems. Copyright © 2008 John Wiley & Sons, Ltd.     

A new paradigm: Bringing a historical and sociopolitical trauma lens to the training for welfare practitioners working with Aboriginal families

This article argues that child protection agencies must provide mandatory training about the Aboriginal experience within the welfare state and the resultant trauma that exists in Australian Indigenous communities. This article highlights the areas of curriculum to be included in training for welfare practitioners working with Aboriginal families in the New South Wales child protection system. The training content explores the Stolen Generations’ trauma experiences of child loss and examines the dichotomy between past child welfare laws and present child protection laws and intergenerational racism. Another key component of the training comprises information about the impacts of trauma on brain development.     

When training and prevention meet

This article explores the intended and unintended consequences of CiN/child protection training when this training is offered to parents and grandparents who live in the community. It asks whether training can fulfil a preventative function on behalf of children and child protection systems. Copyright © 2003 John Wiley & Sons, Ltd.     

Social Work Intervention in Child Abuse—An Ever-Widening Net?

This paper considers some of the issues concerning the social work response to child protection which are currently being debated by professionals involved in this field. In particular, the paper considers where there is an imbalance in the system, with too much emphasis being placed on child protection at the expense of child welfare. It describes how one authority has sought to focus its child protection investigation system. This has been achieved firstly through the use of management information to measure performance and make comparisons between different areas. This information was then used as the basis of training, encouraging staff to renew their practice and ensure that an appropriate response is made to child care referrals and that children are not drawn into the child protection net inappropriately but are dealt with within a child welfare framework. Examination of a sample of child protection investigations showed that where welfare needs were investigated, attempts were made to use available resources to meet these needs.     

The Psychological Best Interests of the Child

The "best interest of the child" is the central principle in legal disputes concerning the placement of children. Since the concept is invoked in both law and mental health, it is often viewed as meaning the same to both professions. This idea is false. Psychologically, the determination of best interest depends on the emotional life of the child, especially present and future intimate relationships. Legally, best interests include moral, financial, and multiple other factors in addition to psychological aspects. Moreover, mental health professionals tactly consider best interests as the ultimate principle in placement whereas the law considers other principles to be prior to best interest (e.g., equal protection of parents or society's needs). Opinion of mental health workers is limited to psychological considerations, which are not decisive in determining the legal best interests of the child.     

Training Graduate Social Work Students for Child Advocacy in Community Mental Health

A project aimed at training graduate social work students for child advocacy in Community Mental Health was developed and implemented through the cooperation of the School of Social Work, the Children's Treatment Center, and the Rock County Guidance Clinic. The training model was the practicum or field work experience approach. The training was concerned with providing students with knowledge and skills in child advocacy, for the treatment of severely disturbed children, and for providing services to a Black and disadvantaged population. The primary objectives were training professionals for the mental health field and to provide mental health services to children.     

Fit for Purpose? Post-Qualifying Social Work Education in Child Protection in Scotland

Recommendations for post-qualifying training and education in child protection social work consistently form part of the political response to child abuse scandals. The influence of child abuse politics upon the push towards post-qualifying training and education has been consistent across the United Kingdom. Within Scotland educators have been quick to respond to the market demand for programme provision and there is now a growing number of academic programmes being offered by higher education institutions. Yet despite post-qualifying training and education achieving the status of ‘panacea’ there is little in the way of a national dialogue about what post-qualifying training and education in social work child protection should look like. The parameters of this have not been subject to any kind of national debate and the Scottish academic community has not entered into a professional dialogue on these issues. More crucially, educators have not engaged in any level of identifiable evaluation of their provision and there is an absence of engagement with the scholarship of teaching child protection at the post-qualifying level. This paper connects with these issues to question whether the post-qualifying training and education delivered by Scotland's universities can be considered fit for purpose.     

Meeting the training needs of GP registrars in child abuse and neglect

A questionnaire survey undertaken among general practitioner registrars in North Thames in 1998 revealed significant deficiencies in their child protection training. A minority expressed confidence at the prospect of dealing with child protection cases in the future. A new, interactive training package was subsequently developed and delivered to a sample of GP registrars in Northeast Thames in 1999. Preliminary evaluation confirmed that the new training material was sensitive to the needs of recipients and levels of perceived confidence with participation in child protection work were increased. Further work is needed to develop the package and to oversee its successful incorporation into general practitioner vocational training. Copyright © 2001 John Wiley & Sons, Ltd.     

Specialist assessment in child protection proceedings: problems and possible solutions

Specialist assessment is a crucial part of child protection intervention. This review considers problems surrounding the process of obtaining a specialist assessment in the child protection process, focusing especially on mental health assessment. Difficulties identified concern different professional frames of reference and agency functions, individual influences and power differentials, communication and decision-making at child protection conferences, court proceedings, ‘sensitive costs’ and resources. Particular attention is paid to difficulties associated with the multi-agency nature of the child protection process. Possible solutions are discussed under the following headings: structures and procedures, communication and role clarity, interpersonal relationships, the role of the keyworker, consultation and the responsiveness of specialists to referrer needs. A comprehensive strategy is advocated in improving the input of specialist services to child protection proceedings. This strategy should employ a combination of structural, procedural and interpersonal approaches and its effects should be thoroughly evaluated. © 1998 John Wiley & Sons, Ltd.     

Improving mental health assessments in child protection through audit

Existing agency records, together with questionnaires completed by social services referrers and mental health providers, were used to identify problems in current arrangements for obtaining specialist mental health assessments in child protection cases. Standards were set and implemented through a multi‐agency steering group. The practice of referrers and providers was then reaudited. Sixty‐nine social workers, six mental health specialists and 27 child protection initial case conferences (involving 31 children) were involved in the reaudit over a 4‐month period. Initially, main problems concerned communications, unclear referral and access arrangements, waiting times and disagreements over prioritization. Standards concerned consultation and decision‐making arrangements within the child mental health service, the format of referral and reply letters, the sharing of information and the attendance of mental health professionals at child protection case conferences. There appeared to be improvements in all these areas at reaudit. In conclusion, some shared views of problems, additional support funding and the audit process appear to have helped to improve inter‐agency collaboration and develop more efficient referral and care arrangements. There is a need to maintain and further develop this work, and audit would again be a useful means. Copyright © 1999 John Wiley & Sons, Ltd.     

Child Psychiatry in the Chinese Setting

This article introduces the history and social background and describes the present situation of child psychiatry in China. Certain Chinese social, political and cultural issues are explored, as the one-child policy and the Chinese family structure. Numerous currents of thought coexist in Chinese child psychiatry. Four examples of mental health disorders in child and adolescent psychiatry and their treatments in the Chinese public health care system are described (attention deficit hyperactivity disorder, anorexia nervosa, posttraumatic stress disorder and internet addiction).     

School counsellors' perceptions of mandatory reporter training and mandatory reporting experiences

The purpose of this study was to examine child abuse reporting by a national sample of school counsellors in the United States. The qualitative results from a large mixed methods study incorporating both quantitative and qualitative strands are presented. Participants were asked to comment on past child abuse training, noting the areas of training they found most beneficial and areas where they desired additional training. Participants were also afforded the opportunity to make any general comments regarding their perceptions of the current mandatory reporting legislation and their experiences of reporting child abuse. Results showed that while many school counsellors felt past training on mandatory reporting legislation and identifying types of abuse was helpful, they identified a need for additional training in identifying emotional and sexual abuse, and supervisory neglect (i.e. lack of supervision by a parent or caretaker producing potential injury or harm to the child). They also desired more training regarding working with children and families affected by child abuse. Four themes emerged from the open question. The first theme illuminated concerns regarding the effectiveness of the mandatory reporting process while the second theme was equally negative, with counsellors sharing many frustrations about their working relationship with child protection services. Additional themes related to their reporting experiences and specific challenges embedded in the school context, such as dealing with parents following a report, difficulty getting adolescent reports investigated and working with school personnel to ensure that reporting responsibilities were understood and followed. Copyright. © 2009 John Wiley & Sons, Ltd.