Identifying signs of child neglect and abuse in general practice

INTRODUCTION: Children who live with neglect and abuse are often identified late in the process. At the front line of Danish healthcare, where most children are seen regularly, general practice is well placed to raise concerns about child health and wellbeing. Little is known about the role general practitioners (GPs) play in suspecting and reporting child neglect and abuse. We explored challenges GPs are facing in identifying such children and illustrated some of the barriers preventing GPs from reporting on these cases. METHODS: This was an explorative pilot study, preceding a larger multidisciplinary project. We conducted eight semi-structured interviews with selected Danish GPs. The interviews were transcribed verbatim and coded using thematic analysis. RESULTS: GPs rarely experienced concrete signs of child neglect and abuse, and reporting to the social services was often a way of helping families to get the support they needed. When GPs suspected that “something was wrong”, this was based on a gut feeling, triggered by non-measurable and intangible signs such as changes in health-seeking behaviour or in the relationship between caregivers and children. CONCLUSIONS: The intangibility of signs provoking suspicion of neglect and abuse made acting or reporting difficult and GPs felt that they lacked opportunities to take action. More knowledge is needed on how to approach matters of child protection and wellbeing across health professions and specialities.