Head To Head

Has child protection become a form of madness? No

BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d3063 (Published 18 May 2011) Cite this as: BMJ 2011;342:d3063
  1. Margaret Spinelli, associate professor of clinical psychiatry1,
  2. Louise M Howard, professor in women’s mental health2
  1. 1Columbia University College of Physicians and Surgeons, New York , USA
  2. 2King’s College London, London, UK
  1. Correspondence to: M Spinelli Mgs8@columbia.edu

Alain Gregoire and Simonetta Hornby (doi:10.1136/bmj.d3040) argue that child protection fails to detect many children in need of help while becoming ever more bureaucratic and unhelpful, while Margaret Spinelli and Louise Howard believe that child protection interventions are essential to prevent abuse

Abuse of children is a global problem. In the United States over three million reports of child abuse are made every year and almost five children die every day as a result of child abuse.1 In the UK, currently around 46 000 children are the subject of a child protection plan.2 But research indicates that abuse and neglect are both under-reported and under-recorded, so such figures underestimate the prevalence of child abuse. A recent survey found that 18.6% of secondary school children in the UK have been severely abused or neglected during childhood—equivalent to 973 000 children across the UK.2

Most abused and neglected children are not getting the help they need, and the consequences are potentially devastating. Physical abuse of children may result in death or serious physical injuries. Sexual abuse can …

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