Mental health service use in children at risk of significant harm: A record linkage study of a child protection register

William P. Ball; Caroline Anderson; Corri Black; Sharon Gordon; Michael Lackenby; Martin Murchie; Bārbala Ostrovska; Katherine O'Sullivan; Helen Rowlands; Magdalena Rzewuska Díaz; Jessica E. Butler

doi:10.1016/j.socscimed.2024.117057

Mental health service use in children at risk of significant harm: A record linkage study of a child protection register

William P. Ball^*, Caroline Anderson, Corri Black, Sharon Gordon, Michael Lackenby, Martin Murchie, Bārbala Ostrovska, Katherine O'Sullivan, Helen Rowlands, Magdalena Rzewuska Díaz, Jessica E. Butler

^*Corresponding author for this work

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Abstract

Children with experience of maltreatment, abuse or neglect have higher prevalence of poor mental health. In the United Kingdom, child protection services identify children at risk of significant harm on the Child Protection Register (CPR) and intervene to reduce risk. Prevalence and incidence of mental health service use among this population of children are not well understood. We analysed records from one Scottish Local Authority's CPR, linked to electronic health records for all children in the broader health board region aged 0–17 years. We described mental health service use among children with a CPR registration using measures of mental health prescribing and referrals to child and adolescent mental health services (CAMHS). We calculated age- and sex-specific incidence rates for comparison with the general population. Between 2012 and 2022, we found 1498 children with a CPR registration, with 69% successfully linked to their health records. 20% were registered before birth and median age at registration was 3 years. Incidence rates in all measures of mental health service use were higher in children with a CPR record across all ages (at outcome) and genders compared to the general population. The largest absolute difference was for boys aged 5–9 with a CPR record, who had 31.8 additional mental health prescriptions per 1000 person-years compared to the general population (50.4 vs. 18.6 prescriptions per 1000 person-years, IRR: 2.7). Girls aged 0–4 years with a CPR registration had the largest relative difference, with a rate of CAMHS referral 5.4 times higher than the general population (12.3 vs. 2.3 per 1000 person-years). Our reproducible record linkage of the CPR to health records reveals an increased risk of mental health service use during childhood. Our findings have relevance to public mental health surveillance, service prioritisation and wider policy aiming to reduce childhood exposure to risk of harm.

Original language	English
Article number	117057
Number of pages	9
Journal	Social Science and Medicine
Volume	353
Early online date	20 Jun 2024
DOIs	https://doi.org/10.1016/j.socscimed.2024.117057
Publication status	Published - 1 Jul 2024

Data Availability Statement

Authors cannot share raw data, but it is available subject to application to Grampian DaSH. Summary data and code is available via a link in the paper.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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© 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Final published version, 2.15 MBLicence: CC BY-NC

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Ball, W. P., Anderson, C., Black, C., Gordon, S., Lackenby, M., Murchie, M., Ostrovska, B., O'Sullivan, K., Rowlands, H., Rzewuska Díaz, M., & Butler, J. E. (2024). Mental health service use in children at risk of significant harm: A record linkage study of a child protection register. Social Science and Medicine, 353, Article 117057. https://doi.org/10.1016/j.socscimed.2024.117057

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abstract = "Children with experience of maltreatment, abuse or neglect have higher prevalence of poor mental health. In the United Kingdom, child protection services identify children at risk of significant harm on the Child Protection Register (CPR) and intervene to reduce risk. Prevalence and incidence of mental health service use among this population of children are not well understood. We analysed records from one Scottish Local Authority's CPR, linked to electronic health records for all children in the broader health board region aged 0–17 years. We described mental health service use among children with a CPR registration using measures of mental health prescribing and referrals to child and adolescent mental health services (CAMHS). We calculated age- and sex-specific incidence rates for comparison with the general population. Between 2012 and 2022, we found 1498 children with a CPR registration, with 69% successfully linked to their health records. 20% were registered before birth and median age at registration was 3 years. Incidence rates in all measures of mental health service use were higher in children with a CPR record across all ages (at outcome) and genders compared to the general population. The largest absolute difference was for boys aged 5–9 with a CPR record, who had 31.8 additional mental health prescriptions per 1000 person-years compared to the general population (50.4 vs. 18.6 prescriptions per 1000 person-years, IRR: 2.7). Girls aged 0–4 years with a CPR registration had the largest relative difference, with a rate of CAMHS referral 5.4 times higher than the general population (12.3 vs. 2.3 per 1000 person-years). Our reproducible record linkage of the CPR to health records reveals an increased risk of mental health service use during childhood. Our findings have relevance to public mental health surveillance, service prioritisation and wider policy aiming to reduce childhood exposure to risk of harm.",

author = "Ball, {William P.} and Caroline Anderson and Corri Black and Sharon Gordon and Michael Lackenby and Martin Murchie and Bārbala Ostrovska and Katherine O'Sullivan and Helen Rowlands and {Rzewuska D{\'i}az}, Magdalena and Butler, {Jessica E.}",

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T2 - A record linkage study of a child protection register

AU - Ball, William P.

AU - Anderson, Caroline

AU - Black, Corri

AU - Gordon, Sharon

AU - Lackenby, Michael

AU - Murchie, Martin

AU - Ostrovska, Bārbala

AU - O'Sullivan, Katherine

AU - Rowlands, Helen

AU - Rzewuska Díaz, Magdalena

AU - Butler, Jessica E.

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N2 - Children with experience of maltreatment, abuse or neglect have higher prevalence of poor mental health. In the United Kingdom, child protection services identify children at risk of significant harm on the Child Protection Register (CPR) and intervene to reduce risk. Prevalence and incidence of mental health service use among this population of children are not well understood. We analysed records from one Scottish Local Authority's CPR, linked to electronic health records for all children in the broader health board region aged 0–17 years. We described mental health service use among children with a CPR registration using measures of mental health prescribing and referrals to child and adolescent mental health services (CAMHS). We calculated age- and sex-specific incidence rates for comparison with the general population. Between 2012 and 2022, we found 1498 children with a CPR registration, with 69% successfully linked to their health records. 20% were registered before birth and median age at registration was 3 years. Incidence rates in all measures of mental health service use were higher in children with a CPR record across all ages (at outcome) and genders compared to the general population. The largest absolute difference was for boys aged 5–9 with a CPR record, who had 31.8 additional mental health prescriptions per 1000 person-years compared to the general population (50.4 vs. 18.6 prescriptions per 1000 person-years, IRR: 2.7). Girls aged 0–4 years with a CPR registration had the largest relative difference, with a rate of CAMHS referral 5.4 times higher than the general population (12.3 vs. 2.3 per 1000 person-years). Our reproducible record linkage of the CPR to health records reveals an increased risk of mental health service use during childhood. Our findings have relevance to public mental health surveillance, service prioritisation and wider policy aiming to reduce childhood exposure to risk of harm.

AB - Children with experience of maltreatment, abuse or neglect have higher prevalence of poor mental health. In the United Kingdom, child protection services identify children at risk of significant harm on the Child Protection Register (CPR) and intervene to reduce risk. Prevalence and incidence of mental health service use among this population of children are not well understood. We analysed records from one Scottish Local Authority's CPR, linked to electronic health records for all children in the broader health board region aged 0–17 years. We described mental health service use among children with a CPR registration using measures of mental health prescribing and referrals to child and adolescent mental health services (CAMHS). We calculated age- and sex-specific incidence rates for comparison with the general population. Between 2012 and 2022, we found 1498 children with a CPR registration, with 69% successfully linked to their health records. 20% were registered before birth and median age at registration was 3 years. Incidence rates in all measures of mental health service use were higher in children with a CPR record across all ages (at outcome) and genders compared to the general population. The largest absolute difference was for boys aged 5–9 with a CPR record, who had 31.8 additional mental health prescriptions per 1000 person-years compared to the general population (50.4 vs. 18.6 prescriptions per 1000 person-years, IRR: 2.7). Girls aged 0–4 years with a CPR registration had the largest relative difference, with a rate of CAMHS referral 5.4 times higher than the general population (12.3 vs. 2.3 per 1000 person-years). Our reproducible record linkage of the CPR to health records reveals an increased risk of mental health service use during childhood. Our findings have relevance to public mental health surveillance, service prioritisation and wider policy aiming to reduce childhood exposure to risk of harm.

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SN - 0277-9536

VL - 353

JO - Social Science and Medicine

JF - Social Science and Medicine

M1 - 117057

ER -

Mental health service use in children at risk of significant harm: A record linkage study of a child protection register

Abstract

Data Availability Statement

UN SDGs

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