Child protection specialists advocate for a complete healthcare approach, urging clinicians to consider potential underlying trauma from child abuse or neglect when treating physical symptoms, in order to enhance health outcomes and potentially reduce rates of chronic illnesses and mental health problems in Australia.
Specialists in child protection are urging healthcare providers to widen their scope of responsibility of care, in order to prevent patients from being missed due to more obvious physical symptoms and illnesses.
This program aims to reduce the growing number of chronic illnesses and mental health problems in Australia, many of which are linked to childhood abuse and neglect.
Professor Leonie Segal of the University of South Australia says a whole-of-person approach to medical treatment is critical to address the problems associated with child neglect and abuse.
Prof Segal claims that child mistreatment and neglect is linked to severe illness, including early death.
"Many chronic illnesses, including severe mental illness, chronic pain, substance abuse, and physical health difficulties, are more common among children who have been maltreated or neglected. Such as those with an inflammatory pathway such as gastrointestinal, respiratory, and autoimmune illness."
“Too often, patients present with physical disturbances that are treated, without taking into account any possible underlying trauma.
"We know that people who have been neglected are more likely to have a chronic illness," says the FDA. We need to encourage physicians to investigate possible psychosocial causes further in their treatment.
Adopting clinical approaches that involve a therapeutic response to address the root cause of trauma — of which there are many successful ones — might be more effective than a limited response to the present symptoms and potentially save time and expense.
Prof Segal believes it's clear that Australia must prioritize the health and well-being of those who have experienced severe child neglect and neglect, noting their very poor health outcomes, but proportionate responses are rare.
"Child abuse and neglect is not just a child protection issue; it's a whole-of-society issue that requires a deliberate and balanced approach across health, social, and economic channels," says Prof Segal.
"A change in the clinical response is a good start." If clinicians can develop a trauma-informed biopsychosocial model of health, it might help mitigate the damaging health (and social) consequences of exposure to severe child abuse and neglect and to prevent the transmission of this abuse and neglect to the next generation.
"Extra training and skill development across the health and human services industries will be required." However, this investment will help clinicians identify and respond sensitively and expertly to persons with histories of trauma, as well as target multiple aspects of chronic health, reducing the need for investigations and other medical interventions.
Leonie Segal and Jackie Amos, the BMJ, refer to "the serious health consequences of abuse and neglect in early life." DOI: 10.1136/bmj.p930
