Audit: Identifying child safeguarding concerns in adults presenting to the emergency department with mental health issues

By:

Pocknell, S

Contributor(s):

Publication details: 2017Uniform titles:

Archives of Disease in Childhood

Online resources:

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Summary: Aims To assess awareness of childsafeguarding issues among Emergency Department (ED) staff when assessing adultpatients presenting with the 'toxic trio' of mental health issues +/-domesticviolence and substance misuse. Methods 98 adults who attended the ED, between7th-20th March 2016, with mental health issues were included. ED medicalrecords were analysed for the following information: * Was the patient seen byan ED doctor or nurse, or mental health team member, and asked about: * socialhistoryresponsibilities for children * known to social services * substancemisuse * self harm * domestic violence * Was the patient discussed with A and Esenior/paediatrician/safeguarding team * Was a referral made to social services* 'Proformalyse' and 'Rio' databases were checked, to see if the abovequestions were asked by the mental health team, and whether the patient wasknown to mental health services. The safeguarding team reviewed referralsreceived during this period to determine if any corresponded to this data set.Results All of the patients in this data set present with one of the 'toxictrio': mental health issues. 25% also had substance misuse or domestic violenceissues. 19% of patients were asked a social history by an ED doctor, comparedwith 40% of the patients seen by the mental health team. Only 11% of patientswere directly asked by ED staff if they had children, compared with 44% ofpatients asked by the mental health team. 2% of patients were asked aboutsocial services. Five ED records noted a referral to social services was to bemade. Only one of these five referrals was found by the safeguarding team ontheir database. Conclusion Few adults in ED presenting with one or more of the'toxic trio' are asked about responsibilities for children, despite a writtenpolicy. We are currently missing a large number of potential child safeguardingissues in adult ED. We plan to amend the ED mental health triage proforma toinclude questions relevant to child safeguarding. [Conference abstract]

Holdings
Item type	Home library	Collection	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves	Staff publications for NMDX		Available

NMUH Staff Publications

102

Aims To assess awareness of childsafeguarding issues among Emergency Department (ED) staff when assessing adultpatients presenting with the 'toxic trio' of mental health issues +/-domesticviolence and substance misuse. Methods 98 adults who attended the ED, between7th-20th March 2016, with mental health issues were included. ED medicalrecords were analysed for the following information: * Was the patient seen byan ED doctor or nurse, or mental health team member, and asked about: * socialhistoryresponsibilities for children * known to social services * substancemisuse * self harm * domestic violence * Was the patient discussed with A and Esenior/paediatrician/safeguarding team * Was a referral made to social services* 'Proformalyse' and 'Rio' databases were checked, to see if the abovequestions were asked by the mental health team, and whether the patient wasknown to mental health services. The safeguarding team reviewed referralsreceived during this period to determine if any corresponded to this data set.Results All of the patients in this data set present with one of the 'toxictrio': mental health issues. 25% also had substance misuse or domestic violenceissues. 19% of patients were asked a social history by an ED doctor, comparedwith 40% of the patients seen by the mental health team. Only 11% of patientswere directly asked by ED staff if they had children, compared with 44% ofpatients asked by the mental health team. 2% of patients were asked aboutsocial services. Five ED records noted a referral to social services was to bemade. Only one of these five referrals was found by the safeguarding team ontheir database. Conclusion Few adults in ED presenting with one or more of the'toxic trio' are asked about responsibilities for children, despite a writtenpolicy. We are currently missing a large number of potential child safeguardingissues in adult ED. We plan to amend the ED mental health triage proforma toinclude questions relevant to child safeguarding. [Conference abstract]

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