Abuse alert targets stressed parents Doctors urged to check for abuse

NURSES AND doctors are to be urged to look out for warning signs of child abuse by adults suffering from mental illness, drug or alcohol misuse, in hard-hitting government guidelines on child protection.

People who put child pornography on the Internet will also be subjected to more checks on their contacts with children, under the guidelines to be issued by the Department of Health today to NHS staff, social workers, teachers, and police.

They will also be told to watch for signs of bullying, which can cause distress and is frequently underestimated, although it can provoke cases of self-harm in children.

Under changes to guidelines last issued nearly a decade ago, professionals across the country are to be advised to check on the possible threats to children in all cases of stress in families, such as social exclusion, domestic violence, parental mental illness and drug or alcohol misuse.

The new guidelines say that, in extreme cases, a child may be at risk of severe injury, profound neglect or even death where a parent suffers from mental illness. A study of 100 examples of child deaths involving abuse or neglect showed clear evidence of parental mental illness in one- third of cases. Where police investigate reports of wife beating, they are also advised to check on children in the household.

When somebody is found to have placed child pornography on to the Internet, or to have accessed such material,the police should normally consider whether those people might also be involved in the active abuse of children, say the guidelines.

The Government may be open to allegations of encouraging "Big Brother" inspections of families, after cases where abuse was suspected among innocent parents.

The guidelines say it is important not to generalise, or to make assumptions about the impact on a child of parental drug and alcohol misuse, but it is important that the implications for the child are properly assessed.

"Some substance-misusing parents may find it difficult to give priority to the needs of their children," say the guidelines. "Some children have been killed through inadvertent access to drugs, such as methadone stored in a fridge."

All hospital and community health staff should be on the lookout for signs of child abuse."Staff - especially those in accident and emergency departments and minor injury centres - should be alert to carers who seek medical care from a number of sources to conceal the repeated nature of a child's injuries," say the guidelines.

Disabled children are at increased risk of abuse and should be safeguarded, say the guidelines. Children involved in prostitution also need special help and should be treated as the victims of crime.

Every local authority should have an area protection committee to co- ordinate action across the agencies. Some of the hardest cases to crack are those involving organised child abuse in residential homes.

In all cases where criminal offences are suspected, the police should be brought in at the earliest opportunity, the guidelines say.