A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment

Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt

“…A recent study of Child Abuse Counseling and Reporting Centre records of the Hague protocol (in which children were identified in the same manner as in our study) found low numbers of children needing support as well (Diderich et al 2015a). However, compared with previous studies, in which high levels of maltreatment and psychosocial impairment were found in children whose parents had similar problems (Diderich et al 2013;Hoytema van Konijnenburg et al 2013;Evans et al 2008;Wood & Sommers 2011;Ammerman et al 2010;Hser et al 2014;Torvik et al 2011), our findings are unexpected. We think that several explanations are possible.…”

“…To improve in‐hospital identification of child maltreatment, a new policy based on the ‘Hague protocol’ (Diderich et al ) was developed and implemented in hospitals in Amsterdam, the Netherlands, in 2010. This policy states that all adults visiting the emergency department due to intimate partner violence, substance abuse or a suicide attempt that are considered important risk factors for child maltreatment should be asked whether they have any children in their care (Hoytema van Konijnenburg et al ).…”

“…Earlier retrospective evaluation of these policies showed high rates (79–91%) of child maltreatment in the identified families (Diderich et al ) (Hoytema van Konijnenburg et al ), most frequently being a witness of intimate partner violence. However, it is unclear if, and to what extent, these children experience psychosocial problems.…”

Vulnerable Family Meetings: A Way of Promoting Team Working in GPs’ Everyday Responses to Child Maltreatment?

“…This might be achieved, for example, by identifying children from codes in their electronic primary care records and cross referencing concerns with children and parents known to be vulnerable by other professionals (as in practice B, Table 1) or by selecting families where parental risk factors are known to the GP practice, such as domestic violence, drug and alcohol abuse and suicide attempts. This latter approach is already used throughout all Dutch ED departments [36][37][38] and in some English EDs [39] to identify at risk children. Any protocolised selection of children for discussion might also require a filter of professional concern about the child, to make the meeting directly useful to practice [35] and to make numbers manageable.…”

Evaluation of Child Maltreatment in the Emergency Department Setting

“…1 The Netherlands has recently instituted a protocol that screens adult ED patients with high-risk complaints for possible abuse of their children. 16 Adults presenting to the ED for substance abuse, suicide attempt, self-mutilation, or issues related to domestic violence were asked if they were responsible for the care of minors. Positive responses yielded a visit by a representative of the local child abuse center who screened the child for signs of abuse.…”