We all see Vulnerable Children

Vulnerable children do not always present as patients requiring immediate medical treatment.

Children may accompany their parents who are seeking medical treatment or may be siblings of a child seeking treatment.

If you are working in an adult focussed health service you should be mindful of factors such as:

• family violence
• alcohol and Substance abuse
• mental illness
• cognitive impairment.

These factors can affect a parent's capacity to provide safe and appropriate care for children.

We have a duty of care to children who are dependent on any adult that is being treated in a health service.

For further information, please consult: Vulnerable babies, children and young people at risk of harm: Best practice framework for acute health services DHS 2006

The following factors can comprise Parenting

Illness

A debilitating or chronic illness which requires hospitalisation or requires substantial support to remain at home may impact on the ability of the parent or carer to meet the needs of any dependent children.

Mental illness

Mental illness can jeopardise a parent's capacity to function adequately and drug or alcohol use often compounds the problem. Depression, substance dependence and personality disorders are the most frequently reported psychiatric conditions affecting parents who abuse their children. Parents with mental illness might experience difficulty relating to their child, display impulsive physical discipline or fail to meet the child's emotional and developmental needs. Parents with psychotic illnesses comprise a significant proportion of parents who kill their children.

All professionals working with parents with a mental illness are encouraged to enquire about the children and take action to ensure the children's safety and wellbeing.

Family violence

Exposure to family violence can constitute a form of child abuse. A baby, child or young person may be harmed directly or indirectly by physical violence when they are attempting to protect another person. The psychological trauma for children who experience family violence also has profound effects on their development and behaviour.

Child abuse frequently co-exists with family violence. One in five Victorian women are directly affected by family violence over the course of their lifetime, and it is the leading contributor to preventable death, disability and illness in Victorian women aged 15 to 44 years.

Family violence is a factor in more than half of all substantiated child protection cases and children are present at more than half of police attendances for family violence.

Substance abuse

Many studies have reported the co-occurrence of parental substance abuse and child abuse. Factors which lead to child abuse may include:

• women using illicit drugs avoid seeking help for prenatal, postnatal, and parent-child problems for fear that their drug use will be exposed
• alcohol misuse
• the perception that nothing is wrong
• the lack of interest in parenting
• isolation or marginalisation from traditional health services
• the of lack access to relevant treatment services
  

Cognitive impairment

Many people with a significant cognitive impairment have a limited capacity to understand the complexities of pregnancy and parental responsibilities. The capacity to meet the growing child's physical and developmental needs may also be compromised as a result of the cognitive impairment.

Socio economic disadvantage

Families that are experiencing financial hardship, families who may have limited education and families who may be socially isolated. These factors can create greater stresses on the family unit and may lead to a reduced capacity by the parent to care for their children.