Undetected abuse among intensive case management clients.

A study of the first 89 clients referred to an intensive case management program revealed substantial previously undetected physical and sexual abuse, yet none of the clients had ever been asked about their abuse experiences. Fifty percent of the clients were adult children of alcoholics, and 34 percent were childhood sexual abuse victims. The adult children of alcoholics experienced significantly more of every kind of abuse, including incest and childhood physical and sexual abuse, than clients whose parents were not alcoholic. Substance abuse problems were reported by more than half of the clients and by 75 percent of the adult children of alcoholics. Self-mutilation and heavy use of mental health services were also correlated with having an alcoholic parent. The authors suggest that mental health providers make routine inquiry about clients' family history of alcoholism and history of physical and sexual abuse.