Examining the Need for Psychosocial Services in Pediatric Non-Accidental Trauma
Abstract
Child abuse is a significant issue within our society. In 2014, there were a
reported 702,208 cases of child abuse and neglect across the country, with nearly 120,000
suffering from physical abuse. Research has shown the adverse physical and
psychological consequences of child maltreatment. Despite what we know about the
benefits of early intervention for this population, the degree of implementation of
psychosocial interventions, specifically in a hospital setting, remains unclear. In an initial
study that utilized archival data from the Loma Linda University Children’s Hospital
(LLUCH) Trauma Registry Database, researchers found that the majority of children
admitted to the hospital for non-accidental trauma (NAT) received minimal inpatient
psychosocial services and psychosocial referrals at discharge. Given the gravity of these
statistics, this doctoral project sought to verify the initial findings of the archival data
through an in-depth chart review. A random sample of 20% (n=151) of the original 746
archival charts were selected. Subjects were previous pediatric patients at LLUCH who
sustained a traumatic injury and whose case was identified as NAT. The results of the
current study were consistent with previous findings and demonstrated that Pediatric
Psychology saw 5.3% of children while inpatient and only 4.6% were referred for an
inpatient consultation by a separate psychological service. Furthermore, a mere 3.3% of the sample received a psychosocial referral upon discharge. While the majority of the
sample (87.4%) received a social work referral, only 52% of those children were actually
seen. Finally, while the current study found higher rates of referrals to Child Protective
Services (CPS; 82.8%) compared to the previous findings (67.6%), it highlighted that
17.2% of the sample was not referred to CPS despite the mandated referral. This study
demonstrated that psychosocial services needed to address the impact of trauma are often
not being provided at LLUCH. In an attempt to evaluate if this was a more pervasive
problem, researchers reviewed the National Trauma Database and determined that the
important search fields for psychosocial supports are not available. This data underscores
the importance of improving the coordination of care between pediatric psychology,
psychosocial services, and the medical field.
Description
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Article
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Keywords
mental health services, child abuse, neglect, long term adverse effects, research
Citation
O'Bannon, S. N. (2019). Examining the Need for Psychosocial Services in Pediatric Non-Accidental Trauma. Loma Linda University Electronic Theses, Dissertations & Projects.