The assessment and examination of physical health is an important part of multidisciplinary cooperation in a situation where violence against the child is suspected. According to the Barnahus Quality Standards, a medical examination must be conducted in a child-friendly manner and it must be carried out by specialised and competent personnel.
In addition to conducting a somatic examination in a technically high-quality manner, it is important to assess the child’s previous health history in relation to the currently suspected violence and the child’s condition. Earlier entries in the health care records may provide important information related to the currently suspected violence and investigating it, such as alternative reasons for symptoms and findings and general matters important from the point of view of the child’s well-being, health and development.
Somatic examination of the child
A physical, i.e. somatic examination related to the pre-trial investigation has several goals:
- To diagnose and document possible physical injuries
- To schedule the required diagnostic examinations (e.g., imaging examinations)
- To take the necessary samples (e.g., forensic samples)
- If necessary, to ensure the prevention, screening and treatment of communicable diseases or referral to treatment
- If necessary, to take care of emergency contraception
- To provide the necessary medical treatment and psychosocial initial support
- To assess the need for somatic and psychological health care services and their urgency, and to refer to these services
- To submit the notifications required in section 25 of the Child Welfare Act to the police, the prosecutor and the child welfare services if this has not been done yet.
- To draw up the ordered medical and other statements.
- To give appropriate and correct information, for example, about the injuries observed in the child and a prediction of recovery to the child and the family. If necessary, to check the healing of the injuries in a new examination.
Comprehensive health assessment
In addition to the somatic examination related to the pre-trial investigation, the child’s health should also be assessed comprehensively and by taking the child’s situation in to account broadly. It may sometimes be sufficient to look at the entries made in health care, for example, in connection with the somatic examination, but it is often advisable to agree a separate doctor’s appointment for it.
The child’s physical, psychological and social well-being and need for support can be assessed at this appointment. Cooperation is done with the child, the family and other professionals. Above all, the comprehensive assessment of the child’s health serves the child and the family, but it may also help the social welfare authorities, the pre-trial investigation conducted by the police and health care.
At best, the comprehensive assessment and support may prevent the recurrence of violence and long-term negative health effects, as victims of violence have been found to have an increased risk of them.