News

Maltreatment – not out-of-home care – poses mental health risks among children with comparable abuse experiences

Abused children taken into out-of-home care do not have a higher risk of poor mental health outcomes compared with those with similar maltreatment experiences who remain at home, new Australian Catholic University (ACU) research shows.

The research, led by ACU Institute of Child Protection Studies (ICPS) Research Fellow Lottie Harris, analysed outcomes of depression, anxiety, post-traumatic stress, and substance use disorders among adults with comparable childhood maltreatment histories.

It found that for those who had been placed in out-of-home care (OOHC), the experience did not have a direct influence on poor mental health outcomes compared with those who remained at home once maltreatment intensity was considered.

Ms Harris said the research, published in Child Abuse & Neglect, was based on data from the landmark Australian Child Maltreatment Study (ACMS), which surveyed more than 8500 Australians about their experiences of child abuse and neglect.

She said the new research compared the mental health outcomes of 395 participants who were placed in OOHC with those who experienced comparable child maltreatment – such as similar age of onset, frequency and duration, perpetrator type and range of maltreatment experiences – but were not placed into care.

“The analysis showed that those who experienced out-of-home care were no more likely to experience any mental health disorder than non-care-experienced people once they were matched on the intensity of their childhood maltreatment experience,” she said.

“These results suggest that the key risk factor for mental health disorders is the prior experience of child maltreatment and the intensity and characteristics of child maltreatment rather than the experience of out-of-home care itself.”

Ms Harris said the new research findings highlighted the importance of assessing the child maltreatment intensity already experienced as a risk factor for poor mental health outcomes among those moved into OOHC.

“Out-of-home care is often used as an intervention in the most intense child maltreatment cases, but this alone is insufficient to support healing from child maltreatment or to mitigate the psychological damage already caused,” she said.

“Similarly, those who are not removed from their homes but have experienced comparably intense childhood maltreatment also require holistic mental health supports.

“The bottom line is we need to be addressing the impact of the maltreatment itself – regardless of care status.”

Ms Harris said more needed to be done to reduce the incidence and intensity of childhood maltreatment.

“Early primary prevention and trauma-informed systems targeting families whose children are at risk of physical abuse, sexual abuse, emotional abuse, neglect and/or exposure to domestic violence are crucial,” she said.

“Proactive mental health support at an early stage is also likely to considerably reduce the burden of future mental health disease stemming from maltreatment experienced during childhood.”

The research team also included ICPS Director Professor Daryl Higgins, Associate Professor Megan Willis, of ACU, Professor David Lawrence, of Curtin University, Professor Ben Matthews, of Queensland University of Technology, Dr Eva Malacova, of the QIMR Berghofer Medical Research Institute, Associate Professor Holly Erskine, of the Queensland Centre for Mental Health Research, Associate Professor Franziska Meinck, of the University of Edinburgh, and Associate Professor Divna Haslam, of the University of Queensland.