Dear colleagues
In 2007 we started a pilot in the Netherlands on the detection of child maltreatment based on parental characteristics at the Emergency Department (ED), named The Hague protocol.
This was used next to existing methods on the detecting of child maltreatment based on child characteristics. In this pilot nurses and doctors working at the adult- ED, asked patients that visited the ED after domestic violence, substance abuse or severe psychiatric problems (e.g. suicide, auto-mutilation) whether they were responsible for minors or pregnant. If they were, they would be referred to the Reporting Center for Child abuse and neglect (RCCAN), a non-jurisdictional organization. The RCCAN conducted a short investigation (within two weeks) and offered the family community based services.
Only in severe cases of maltreatment or if parents refuse to cooperate the Child protective Services (CPS) got involved.
The positive predictive value from our research on 565 families was 91%, solely based on the detecting of parental characteristics, without the children being present at the ED.
Since 2013 all Dutch professionals working with adult patients or clients are mandated to detect child maltreatment based on parental characteristics. In 2014 and 2015 this so called ‘Child-Check’ has successfully been implemented at all Dutch ED’s, ambulance services, general practitioners offices (during off-hours) and we have just started (January 2016) with the national implementation of the Child-Check at all Dutch mental health clinics and self-employed professionals.
In 2015 I was invited by the Center for Decease and Control in Atlanta to inform them about this approach. They were enthusiastic and willing to consider taking part in an advisory board if we could find US ED’s willing to take part in a pilot on the detection of child maltreatment based on parental characteristics at their ED (The Child-Check).
In 2011, 2013 and 2015 I have spoken at the San Diego Conference on child and family maltreatment, where many professionals were willing to take this message back to their hospitals to discuss the idea of a pilot.
Unfortunately we did not get any more response.
This year a pilot of the Child-Check will start in Norway and Switzerland. And last year the United Nations endorsed the Child Check in a letter to the Dutch Government.
My question to you, as you can probably guess is: Do you know anyone working at an adult ED or a hospital who would be willing to consider starting up a pilot on the detection of child maltreatment?
I have uploaded my thesis on this subject in which you can read about all the details of this research (2008-2011). I have also uploaded an implementation plan, which describes the possibilities for US ED’s and hospitals who do not have an RCCAN to their disposal.
Hope to hear from you,
best regards
Hester Diderich
