Melissa J Green1,2, Gabrielle Hindmarsh1, Maina Kariuki1, Kristin R Laurens1,3, Amanda L Neil4, Ilan Katz5, Marilyn Chilvers6, Felicity Harris1, Vaughan J Carr1,2. 1. University of New South Wales, Sydney, NSW. 2. Neuroscience Research Australia, Sydney, NSW. 3. Queensland University of Technology, Brisbane, QLD. 4. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS. 5. Social Policy Research Centre, University of New South Wales, Sydney, NSW. 6. NSW Department of Family and Community Services, Sydney, NSW.
Abstract
OBJECTIVES: To examine associations between being the subject of child protection reports in early childhood and diagnoses of mental disorders during middle childhood, by level of service response. DESIGN, SETTING, PARTICIPANTS: Retrospective analysis of linked New South Wales administrative data, 2001-2016, for a population cohort of children (mean age in 2016, 13.2 years; SD, 0.37 years) enrolled in the longitudinal NSW Child Development Study (NSW-CDS), wave 2 linkage. MAIN OUTCOME MEASURES: Associations between being the subject of a child protection report (any, and by level of child protection response) during early childhood (birth to 6 years of age) and diagnoses of mental disorders during middle childhood (6-14 years). RESULTS: 13 796 of 74 462 children in the NSW-CDS (18.5%) had been the subjects of reports to child protection services during early childhood: 1148 children had been placed in out-of-home care at least once, and 1680 had been the subjects of substantiated risk-of-significant-harm reports but were not placed in care, while 9161 had non-substantiated reports, and 1807 had reports of facts that did not reach the threshold for significant harm. After adjusting for sex, socio-economic disadvantage, perinatal complications, and parental mental illness, early childhood contact with protection services was associated with increased frequency of being diagnosed with a mental disorder during middle childhood (adjusted odds ratio [aOR], 2.72; 95% CI, 2.51-2.95). The frequency was highest for children who had been placed in out-of-home care (aOR, 5.25; 95% CI, 4.46-6.18). CONCLUSION: Childhood-onset mental disorders are more frequently diagnosed in children who come to the attention of child protection services during early childhood, particularly in children placed in out-of-home care.
OBJECTIVES: To examine associations between being the subject of child protection reports in early childhood and diagnoses of mental disorders during middle childhood, by level of service response. DESIGN, SETTING, PARTICIPANTS: Retrospective analysis of linked New South Wales administrative data, 2001-2016, for a population cohort of children (mean age in 2016, 13.2 years; SD, 0.37 years) enrolled in the longitudinal NSWChild Development Study (NSW-CDS), wave 2 linkage. MAIN OUTCOME MEASURES: Associations between being the subject of a child protection report (any, and by level of child protection response) during early childhood (birth to 6 years of age) and diagnoses of mental disorders during middle childhood (6-14 years). RESULTS: 13 796 of 74 462 children in the NSW-CDS (18.5%) had been the subjects of reports to child protection services during early childhood: 1148 children had been placed in out-of-home care at least once, and 1680 had been the subjects of substantiated risk-of-significant-harm reports but were not placed in care, while 9161 had non-substantiated reports, and 1807 had reports of facts that did not reach the threshold for significant harm. After adjusting for sex, socio-economic disadvantage, perinatal complications, and parental mental illness, early childhood contact with protection services was associated with increased frequency of being diagnosed with a mental disorder during middle childhood (adjusted odds ratio [aOR], 2.72; 95% CI, 2.51-2.95). The frequency was highest for children who had been placed in out-of-home care (aOR, 5.25; 95% CI, 4.46-6.18). CONCLUSION: Childhood-onset mental disorders are more frequently diagnosed in children who come to the attention of child protection services during early childhood, particularly in children placed in out-of-home care.