Objectives: To examine associations between being the subject of child protection reports in early childhood and diagnoses of mental disorders during middle childhood, by level of service response.

Design, Setting, Participants: Retrospective analysis of linked New South Wales administrative data, 2001-2016, for a population cohort of children (mean age in 2016, 13.2 years; SD, 0.37 years) enrolled in the longitudinal NSW Child Development Study (NSW-CDS), wave 2 linkage.

Main Outcome Measures: Associations between being the subject of a child protection report (any, and by level of child protection response) during early childhood (birth to 6 years of age) and diagnoses of mental disorders during middle childhood (6-14 years).

Results: 13 796 of 74 462 children in the NSW-CDS (18.5%) had been the subjects of reports to child protection services during early childhood: 1148 children had been placed in out-of-home care at least once, and 1680 had been the subjects of substantiated risk-of-significant-harm reports but were not placed in care, while 9161 had non-substantiated reports, and 1807 had reports of facts that did not reach the threshold for significant harm. After adjusting for sex, socio-economic disadvantage, perinatal complications, and parental mental illness, early childhood contact with protection services was associated with increased frequency of being diagnosed with a mental disorder during middle childhood (adjusted odds ratio [aOR], 2.72; 95% CI, 2.51-2.95). The frequency was highest for children who had been placed in out-of-home care (aOR, 5.25; 95% CI, 4.46-6.18).

Conclusion: Childhood-onset mental disorders are more frequently diagnosed in children who come to the attention of child protection services during early childhood, particularly in children placed in out-of-home care.

Item Type:	Refereed Article
Keywords:	childhood adversity, mental disorders, out-of-home care, child psychiatry, mental health policy, population health, social determinants of health, stress, trauma and stressor related disorders
Research Division:	Health Sciences
Research Group:	Epidemiology
Research Field:	Epidemiology not elsewhere classified
Objective Division:	Health
Objective Group:	Specific population health (excl. Indigenous health)
Objective Field:	Neonatal and child health
UTAS Author:	Neil, AL (Associate Professor Amanda Neil)
ID Code:	135597
Year Published:	2019
Funding Support:	National Health and Medical Research Council (1133833)
Web of Science® Times Cited:	15
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2019-11-05
Last Modified:	2019-12-06
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