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Hospitalisation rates higher among children in care


South Australians placed in child protection are up to 52 per cent more likely to be hospitalised by their mid-teens than their counterparts, according to new research.

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The University of South Australia study examined the impact of child abuse and neglect from data of 608,540 children born in SA between 1986 and 2017.

It found the most frequent reasons for hospitalisations among those who had been through the child protection system during this period were for mental illness, substance abuse and physical injuries.

Lead author Emmanuel Gnanamanickam said of the total number of children, approximately 121,000 or one in five had been in contact with the child protection system.

“You can have a range of contact from just having someone notified of suspected maltreatment, all the way up to having been placed in out of home care,” Gnanamanickam said.

“We’ve looked at all of the child protection system contact up to the time … that we finished analysis, which was the 30th of June 2017.”

Data from the South Australian Department of Child Protection shows as of May 31 the total number of children aged under 18 in care was 4312.

The research found by 16.5 years, people who had been placed in out of home had an average of 7.7 hospital admissions, which was about four times more than children who had no contact with the system.

Gnanamanickam said hospitalisations for those who had been in the system increased once they became teenagers, with people aged between 15 and 32 years hospitalised two to four times more than those with no contact.

“If you look at the one to 12 years-olds, it’s quite similar between child protection children who had any contact and those who no contact. But from 13 years onwards you start to see some differences,” Gnanamanickam said.

“The main difference is … hospitalisation for mental illness related stuff and injury and poisoning or toxic effects of drugs are more frequent.

“It’s not to say that children who haven’t had child protection system haven’t had those hospitalisations, it’s just when we look at the most frequent.

“When we look at the children who did not have child protection contact, we have hospitalisations for digestive conditions, for ear, nose and throat and for musculoskeletal stuff as the most frequent.”

He said because the study examined “the extreme outcomes” it was unclear how much health support children in protection required.

“Obviously not all health conditions are serious enough to be treated in a hospital, most of them are treated in a primary care setting or in a GP,” Gnanamanickam said.

“So even though the SA child protection system is identifying children who are at risk, the health outcomes for these children remain poor – including those whom the suspected maltreatment is not substantiated.

“So definitely more needs to be done to support families and this is a task for both the child protection system, the wider human services system and Health.

“It’s an effective cross-agency based strategies need to be available to individuals, families and children and it should be for early in life. Because we’ve seen that these differences are showing up early in life.”

Department for Child Protection CEO Cathy Taylor said the department worked closely with the departments of health, education and human services to ensure children’s needs were met.

“Exposure to trauma through experiences of abuse and neglect in childhood can negatively affect a child’s health and development, which can flow into adulthood if not addressed as early as possible,” Taylor said.

“This is why the state government has a strong focus on the early provision and coordination of services for children, young people and their families, to ensure children and young people get the best possible start in life and reduce the need for other services in the longer term such as mental health and health treatment.

“In addition, DCP has mechanisms such as care team meetings and complex case reviews for children and young people with highly complex needs who require extra support when in care.”

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