ObjectiveTo systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters’ (MRs) experiences with reporting.DesignAs no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs’ experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies.SettingAll healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). Participants: The studies represent the views of 1088 MRs.OutcomesFactors that influence MRs’ decision to report and MRs’ views towards and experiences with mandatory reporting of child maltreatment.ResultsForty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin.ConclusionsThe findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.

Children's exposure to intimate partner violence (IPV) is associated with significant emotional impairment and other harmful effects. It is increasingly recognized as a type of child maltreatment, with outcomes similar to other types of abuse and neglect. Children can experience harm from exposure to IPV, even when not directly involved in, or a witness to, the violence between caregivers. This review, based on a synthesis of best available evidence, addresses the epidemiology of children's exposure to IPV, including prevalence, risk and protective factors, and associated impairment, as well as strategies for identification, and interventions for prevention of exposure and impairment. Strategies for ensuring children's safety are also discussed. The article concludes with guidance specific to mental health clinicians.

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Preservation of the frenular artery at circumcision, or the use of an alternative procedure (preputial plasty), may be advisable when foreskin surgery is required, to avoid meatal stenosis after circumcision.