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A descriptive study of mental health services provided for physically abused children in Sweden: A four-year follow-up of child and adolescent psychiatric charts
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Since there has been a considerable increase in 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. The aim of this study was to investigate the extent and content of this. Questions addressed were: What interventions were provided prior to, at the acute situation, and during the 4 years after the physical abuse incident? This group of children was referred to (CAPS) for different reasons, but few for physical abuse. Only 35 out of 122 referrals were made under the label of child physical abuse. Overall, interventions were almost exclusively directed toward the parents. Six out of 126 physically abused children received individual therapy. Abuse was not mentioned in the charts for 23 of the children, even though 8 of them had been referred due to  abuse. The results of this study indicate that physically abused children often have been in contact with mental health services prior to the abuse for different reasons. 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.

Keyword [en]
Child physical abuse, mental health services, intervention, therapy, follow-up
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-63719OAI: diva2:382429
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2010-12-30
In thesis
1. Child physical abuse: Reports and interventions
Open this publication in new window or tab >>Child physical abuse: Reports and interventions
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis was begun in 1998 at a time when increased numbers of police reports regarding child physical abuse was presented. The increase had been overshadowed by the research on the sexual abuse of children and showed that child physical abuse in Sweden had only been scarcely investigated since the institution of the Swedish anti spanking law in 1979.

The aim of this thesis was to investigate child physical abuse from a judicial, social, child- and adolescent psychiatric and a user perspective where a parent or equivalent was the perpetrator. One police district was investigated between 1986 and 1996 and all reports regarding child physical abuse were included. The abused children (n=126) were also followed through social services’ files and child and adolescent psychiatric service charts from birth to a 4-year follow up from the abuse incident studied. Finally, mothers of the physically abused children were interviewed.

The greatest increase in police reports during the years investigated, turned out to be concerned with violence between children. The incidence where a carer was the abuser proved to be comparable to the incidence in other Nordic countries, with the adjustment that first generation immigrants were found to abuse their children 8 times as often as native Swedish citizens and second generation immigrants. There were a wide variety of injuries inflicted on the children, where bruises were the most common. Only a few cases where injuries could be verified ended up in court. Social services contact was common among the abused children and their families prior to the abuse incident studied, as were previous reports on child abuse and neglect. Injuries from the abuse as well as familial and context characteristics had an impact on referred social services interventions. The two most important factors for a child still to be receiving social services interventions 4 years after the abuse incident were whether the mother was mentally ill and whether there had been reports on child abuse or neglect prior to the studied abuse incident. About half of the children had been receiving interventions from the mental health services at some point in time, but mainly due to other reasons than physical abuse. Mental health treatment for the physically abused children was rare even though many of the children had contact with the child and adolescent psychiatric services repeatedly before, at and after the abuse incident. The interviewed mothers conveyed a picture of satisfaction with the police’s work but were mainly critical towards the social services. The mental health service was considered to be doing a good job, but needed to do even better.

The results indicate that despite an environment that supports public values, attitudes and laws confirming a standpoint against violence towards children, there is still a gap between intentions and reality in Sweden. The thesis provides one way of looking at child physical abuse, but puts forward the urgent need of further studies.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2005. 82 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 879
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-28708 (URN)13875 (Local ID)91-7373-858-1 (ISBN)13875 (Archive number)13875 (OAI)
Public defence
2005-07-21, Aulan, Hälsans hus, Campus Norrköpng, Linköpings universitet, Norrköping, 13:00 (Swedish)
2005Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2010-12-30

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Lindell, CharlottaSvedin, Carl Göran
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Child and Adolescent Psychiatry Faculty of Health SciencesDepartment of Clinical and Experimental Medicine
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