Editorial: Reaching all children BMJ Volume 323, pp 176-177
Children whose mothers are victims of domestic violence are at high risk of physical and psychological ill health, yet these children are being failed by the health system, finds a study in this week's BMJ. New strategies are urgently needed to meet the needs of these largely "invisible" children.
Researchers in Cardiff assessed 148 children living in refuges for women victims of domestic violence. Records from the child health system were incorrect or unavailable for over half the children and uptake of routine health assessments and immunisations was low.
Nineteen per cent of children aged 3-4 years had developmental problems and almost half the children aged 3-15 years displayed probable mental health difficulties. Concerns about physical, emotional and behavioural wellbeing was expressed by mothers of 113 (76%) children.
Child health surveillance should be accessible to all children yet, in effect, these children form a largely invisible population, outside the health system and poorly served by it. We are concerned that, without dedicated services to which these families can be referred, many fall through the system.
The authors argue that time spent in a refuge provides a window of opportunity to review the health and developmental status of these children. Specialist health visitors could provide support and advocacy and facilitate access to mainstream services, they conclude.
Judith Shankleman, Sure Start Health Visitor, Splott Clinic, Cardiff, Wales