Abstract
General practitioners (GPs) are crucial in detecting and reporting child abuse and neglect. However, GPs tend to underreport their suspicions of child abuse. This qualitative study aimed to examine how GPs detect potential child abuse, how they act upon their suspicions, which barriers they encounter and how the detection and reporting of child abuse can be improved. Semi-structured interviews were conducted with 15 GPs, which were transcribed, coded and thematically analyzed. GPs are aware of various signs and a gut feeling plays an important role in detecting child abuse. GPs believe they miss child abuse signs and need education about the most important signs of child abuse, how to talk to parents about potential child abuse and the steps of the Dutch reporting code. As for risk assessment, GPs barely use structured instruments even though these are regarded as helpful in the decision-making process. Finally, GPs experience deficits in the cooperation with organizations, including schools, youth care organizations and the Child Protective Services (CPS). Directions for improvement to overcome barriers in child abuse detection and reporting are to develop appropriate instruments, lowering the threshold for GPs to follow child abuse courses, and improving cooperation between GPs and other organizations, especially CPS.
Authors:Jeanne Gubbels, Erik Stolper, Claudia van der Put and Mark Assink.