Mental health services provided for physically abused children in Sweden. A 4-year follow-up of child and adolescent psychiatric charts

Abstract

As there has been a considerable increase regarding the number of police reports on physical child abuse in Sweden since the mid-1980s, there should be an increased number of children in need of trauma-focused mental health treatment. During 1986–1996, there were 126 children reported as being physically abused by a parent or equivalent and reported to the police in a police district in Sweden. Fifty-seven of these children (45%) had been the objects of interventions from Child and Adolescent Psychiatric Services (CAPS). The aim of this study was to investigate the extent and content of this. Questions addressed were: when did the children receive interventions, were these trauma-focused and could this be reflected in their charts? This group of children was referred to CAPS for different reasons and 35/122 referrals were made under the label of child physical abuse. Overall, interventions were mainly directed toward the parents. Six of 126 physically abused children received individual therapy. Abuse was not mentioned in the charts for 23 of the children, even though eight of them had been referred due to abuse. The results of this study indicate that physically abused children have often been in contact with mental health services prior to the abuse for different reasons, initially due to individual problems and later on regarding family conflict. Individual interventions for physically abused children were rare due to for instance CAPS workloads, poor motivation among parents and children, and maybe due to professionals’ lack of knowledge regarding effective treatment. The introduction of a routine checklist is recommended early on to find indications of abuse, as is the need of exploring methods working with physically abused children in Sweden.