Hospital-Based Healthcare Workers' Experiences of Involvement in Perinatal Child Protection Processes: A Scoping Literature Review.

As the number of infants entering Out-of-Home Care at birth internationally continues to rise, Hospital-based healthcare workers (HBHCWs) are increasingly likely to become involved in ethically, morally, and legally complex child protection processes. This scoping review aimed to identify and synthesize qualitative literature pertaining to the perspectives of HBHCWs with experiences of involvement in child protection processes occurring in the perinatal period. JBI Methodology for Scoping Reviews guided this review. Databases Ovid MEDLINE, CINAHL Plus, PsycINFO, ProQuest, Web of Science, SCOPUS, and Informit were searched between March 1 and April 30, 2023. Eighteen sources were identified as meeting the criteria for inclusion following screening by two independent reviewers. Data extracted from the included sources are presented in narrative and tabular formats. Involvement in child protection processes is an inherently conflictual experience for HBHCWs and gives rise to internal, interpersonal, and interorganizational tensions. Involvement can have an enduring impact on the HBHCWs, particularly when an infant is removed from hospital by child protection authorities. Appropriate peer, managerial, and organizational level responses are essential to ameliorate risk to HBHCWs themselves and subsequently their practice with women, infants, and families. HBHCWs can provide valuable insight into the challenges of delivering healthcare at the interface of child protection. Future research should focus on building understanding of experiences across disciplines to ensure that interventions designed to prepare and support HBHCWs are effective and evidence-based.

Overcrowded housing: One of a constellation of vulnerabilities for child sexual abuse.

BACKGROUND: Effective prevention of child abuse depends on an understanding of factors associated with the abuse. Increased risk of child sexual abuse has been associated with parental substance use and adverse socio-economic factors such as living in poverty and parental unemployment. This study investigated overcrowding as a potential socio-economic risk factor in child sexual abuse taking into account other socio-economic, child and parental factors. METHOD: This study used de-identified linked data from health and child protection data collections for the cohort of children born in Western Australia from 1990 to 2009 (n = 524,478). Cox regression was used to estimate adjusted and unadjusted hazard ratios and 95% confidence intervals for time to first sexual abuse allegation and first substantiated allegation, relative to the level of overcrowding and controlling for other risk factors. RESULTS: Higher levels of household overcrowding were associated with a 23%-46% increase in the risk of child sexual abuse allegations. Only the highest level of overcrowding was associated with a 40% increased risk of substantiated sexual abuse. CONCLUSION: The findings suggest that overcrowded living conditions are associated with an increased risk of sexual abuse for some children. This factor needs to be considered alongside other risk factors when assessing and improving child safety.

Accounting for the increase of children in care in western Australia: What can a client information system tell us?

This paper analyses a fourteen-year period of Western Australian data from the client information system of the Department for Child Protection and Family Support. Western Australia saw a large increase in the number of children in state care similar to trends across Australia as a whole. The study shows the following trends: changes in response to 'referrals' with particular increases in the number of findings of neglect and increasing proportions of these followed swiftly by entry to care; changes in patterns of entry to care with more children under one-year-old entering; increased length of stay of children in care; and, the high incidence of Aboriginal children entering and remaining in care. The data demonstrate unequivocally that increased 'referrals' are not associated with increased substantiations of harm or 'acts of commission with dangerous intent', but that neglect assessed early in the lives of children was the major precipitant for entry to care and particularly so for Aboriginal infants.

Reflections on Recovery in Mental Health: Perspectives From a Muslim Culture.

This article describes the outcomes of research into how individuals with mental health problems at the National Centre of Mental Health in Jordan perceived the causes of their mental health problems, the coping strategies they employed, how they sought help, and how they experienced what is termed the process of recovery. Semi-structured interviews were conducted with 10 male and 10 female patients diagnosed with a range of mental health problems. The research suggests that each person perceived recovery uniquely and that, for some, religion was viewed as being central to recovery. The research also suggests that social workers and other mental health professionals working with Muslim patients can better contribute to their recovery if they understand and respect the central role of these patients' religious beliefs and "faith journeys."

Responding to information about children in adversity: ten years of a differential response model in Western Australia.

This article uses a comprehensive database about children in adversity collected over the 16-year period from 1990 to 2005 in the state of Western Australia. The focus of this interrogation is the effect of major changes in responses to information about children brought to the attention of the Western Australian statutory authority in a 10-year period during this 16 years. The initiative for these changes was termed New Directions, and its associated policy and practice changes were aimed at differentiating information expressing concerns about children and families from allegations of child maltreatment. They emphasized the provision of supportive and empowering services to families experiencing difficulties - a form of differential response to children in adversity. The article covers the period leading up to the policy and practice change and the 10 years during which these changes were implemented. It examines some effects of the new policy and comments on whether the changes resulted in missed opportunities to protect children from harm, which in turn, might have led to higher rates of re-reporting. The authors present an overall picture of the nature of the information accepted by the statutory authority and how the interpretation of that information might have affected subsequent outcomes for children. In doing so, it shows that the policy and consequential practice changes associated with a differential response mechanism had long lasting positive effects that, despite dire warnings, did not compromise the protection of the small group of children identified as requiring protective interventions.

No-suicide contracts and no-suicide agreements: a controversial life.

OBJECTIVE: In this paper we describe the origins of suicide prevention contracting, identify the historical factors that led to the adoption of the intervention, and describe legal tensions that have emerged during its use. CONCLUSIONS: It would appear that one of the most frequently used clinical interventions for responding to suicidality has established a place in clinical practice without evidence attesting to its efficacy. We develop some propositions about how and why this clinical technique has been able to consolidate its place in mental health practice and, in so doing, suggest that the original technique was able to secure a clinical place without much apparent resistance because of the confluence of a number of emerging theories and community trends.