State programs for medical diagnosis of child abuse and neglect: case studies of five established or fledgling programs

• Published in: Child abuse & neglect 2001-04, Vol.25 (4), p.441-455
• Main Authors: Socolar, Rebecca R.S, Fredrickson, Doren D, Block, Robert, Moore, Joyce K, Tropez-Sims, Susanne, Whitworth, J.M
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Case Studies; Child; Child Abuse; Child abuse & neglect; Child Abuse - diagnosis; Child Health Services - organization & administration; Child maltreatment; Child Neglect; Child Welfare; Clinical Diagnosis; Delivery Systems; Diagnosis; Family Violence; Financial Support; Government Spending; Health Care Services; Health services; Humans; Interdisciplinary Approach; Interviews as Topic; Medical diagnosis; Medical Evaluation; Medical sciences; Medical Technology; Medicine; Mental health; Organization of mental health. Health systems; Physicians; Professional Development; Program Design; Program Implementation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regional health planning; Social psychiatry. Ethnopsychiatry; Social services; Social Workers; State; State Health Plans - organization & administration; State Programs; States; Teaching - organization & administration; Teamwork; United States; United States of America; USA
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/S0145-2134(01)00219-8

Objective: To describe the programs for medical diagnosis of child abuse and neglect in three states and efforts to establish state-wide programs in two states. To describe common themes and issues that emerged related to the establishment and maintenance of these programs. Methods: Five states were selected as case studies to represent a range of experience and type of function embodied in programs that address medical diagnosis of child abuse and neglect. Individuals knowledgeable about the programs or efforts to establish state-wide programs in their home states described these in detail. Inductive analysis was used to identify themes and issues that emerged across the states studied. Findings: Themes emerged in three general areas: funding, services, and training. Findings related to funding were: 1) State funding was vital for initiation of statewide programs; 2) Alliances with other groups with parallel interests were successfully used to garner support for child abuse programs; 3) Services needed to be adequately reimbursed to be sustained; 4) Political climate often affected funding. With regard to services we found: 1) There was no optimal way to organize services, but rather many ways that worked well; 2) It was critical to address local service needs; 3) Provision of standardized quality services was essential. With regard to training: 1) Professional training was an integral part of all statewide programs; 2) New technologies, including televideo, have been explored and implemented to assist in training in statewide programs. Conclusions: Each state has taken a unique approach to programs for the medical diagnosis of child abuse and neglect. However, there are commonalities, particularly among the states that have been successful in establishing and maintaining comprehensive services and/or training. Objectif: Décrire les programmes centrés sur le diagnostic médical de cas de mauvais traitements et de négligence dans trois Etats ainsi que les efforts qui sont faits pour établir des programmes à l’échelon de deux Etats. Décrire les thèmes et les problèmes qui émergent quant à la mise au point et au déroulement de ces programmes. Méthode: On a sélectionné 5 Etats pour faire des études de cas. Ceux-ci représentaient une variété d’expériences et de fonctionnements mis en application dans les programmes centrés sur le diagnostic de mauvais traitements et de négligence envers les enfants. Des personnes bien informées, tant au sujet de ces programmes