Volume 201 - Issue 3
Role of the medical community in detecting and managing child abuse
Author: Klaus Martin Beckmann
Med J Aust 2014; 201 (3): 143. || doi: 10.5694/mja14.00154
Published online: 4 August 2014
Published online: 4 August 2014
Children in out-of-home placements have complex health needs
To the Editor: I thank Oates,1 and Gwee and colleagues2 for writing on the role of the medical community in detecting and managing child abuse. I would like to add to the points they make. Doctors have a crucial role in medical follow-up for children in out-of-home care. Many children in out-of-home placements have complex needs, with physical and mental health disorders.3 Placement breakdowns mean that some children lack consistency in medical follow-up, which can lead to complete treatment drop-out. This is a significant risk factor for children in care.4
Keeping the child health passport up to date can help with handover of medical conditions for children changing placements. General practitioners can assist with handover by keeping a log of prescriptions issued, with photocopies of private scripts.5 A doctor should highlight in the medical record when a patient is a child in care, making note of the name of the person who attends with the child, which organisation he or she works for, and details of the responsible government department and case worker. Such details can be useful to track a new abode for the child, particularly in the context of a missed appointment. Details of the guardian are also valuable when seeking consent for treatment.
Medication safety can be promoted through: carers leaving prescriptions at a designated pharmacy; weekly or fortnightly dispensing; use of Webster-paks; and the safe storage of medications by carers. The medical community can, with documentation and attention to prescribing, assist with the medical management of children in care.
Competing interests
No relevant disclosures.
References
- Oates RK. Role of the medical community in detecting and managing child abuse [editorial]. Med J Aust 2014; 200: 7-8. 1
- Gwee A, Coghlan B, Rayner C, et al. Fortnightly emergency department case-file audit for timely detection of missed cases of suspicious injury [letter]. Med J Aust 2014; 200: 23. 2
- Tarren-Sweeney M, Hazell P. Mental health of children in foster and kinship care in New South Wales, Australia. J Paediatr Child Health 2006; 42: 89-97. 3
- Golding K. Helping foster carers, helping children: using attachment theory to guide practice. Adoption & Fostering 2003; 27: 64-73. doi: 10.1177/030857590302700209. 4
- Hollingworth S, Duhig M, Hall W, Scott J. National trends in the community prescribing of second-generation antipsychotic medications in Australian children and youth: the incomplete story. Australas Psychiatry 2013; 21: 442-445. lefthere