Child protection experts are imploring doctors to expand their duty of care to ensure patients’ hidden trauma is not overlooked by more obvious physical symptoms and illnesses.
It is a movement to reduce the rising rates of chronic illness and mental health problems in Australia, many of which are underlined by deep trauma as a result of childhood abuse and neglect.
In an editorial published in the British Medical Journal this week, Professor Leonie Segal from the University of South Australia says a comprehensive approach to healthcare is vital to addressing the poor health outcomes associated with child abuse and neglect.
“There is strong evidence that child abuse and neglect are causally linked to very poor health, including premature death,” says Professor Segal.
“Many chronic diseases, including serious mental illness, chronic pain, substance use, and physical health conditions, especially those with an inflammatory pathway such as gastrointestinal, respiratory, and autoimmune diseases, are more common in abuse victims and child neglect.
“However, too often, patients present with physical symptoms that are treated, without sufficient consideration of the possible underlying trauma.
“We know that people who have experienced childhood abuse and neglect are more likely to have chronic illnesses, so we should encourage clinicians to expand their care to consider potential underlying psychosocial causes.”
Adopting clinical approaches that incorporate a therapeutic response to address the underlying trauma, of which there are many successful models, may be more effective than a response limited to the presentation of symptoms and potentially avoid extensive investigations and surgery.
Professor Segal says it is clear Australia needs to prioritize the health and wellbeing of people who have experienced severe child abuse and neglect, pointing to their very poor health outcomes, but the responses provided are rare.
“Tackling child abuse and neglect is not just a child protection issue; It is a society-wide problem that requires an informed and proportionate response across all health, social and economic platforms. But health in particular needs to step up,” says Professor Segal.
“A change in clinical response is a solid start. If clinicians can think about a trauma-informed biopsychosocial model of health, it could help reduce the disturbing negative health (and social) impacts of exposure to severe childhood abuse and neglect and help reduce the transmission of this abuse and abandonment to the next generation.
“Additional training and skills development will be needed across the health and human services sector. But this investment will help clinicians sensitively and expertly identify and respond to people with a history of trauma, as well as address multiple aspects of chronic health, improving clinical outcomes and reducing the need for investigations and other medical interventions.” .
