Hotline for health-care professionals who suspect child maltreatment – Germany

Paramedics, psychotherapists, dentists, doctors and nurses all have regular contact with children. This means that amidst their busy daily lives, health-care professionals play an important role in identifying cases of suspected maltreatment and in providing assistance to vulnerable children.

Yet, in the middle of a 12-hour shift, what do you do if you suspect maltreatment but are unsure of what signs to report, how to document them or where to report them?

Professor Jörg M. Fegert from the Department of Child and Adolescent Psychiatry/Psychotherapy at Ulm University in Germany notes: “Awareness of child maltreatment and the legal protocols to stop maltreatment is not as high as it should be among health professionals, particularly among professionals who should be aware as they deal with children every day.”

Failing to recognize subtle signs could mean that many children do not receive the care and treatment they need.

In order to help health-care professionals recognize and report child maltreatment, in 2017 Professor Fegert launched a national child protection hotline across Germany called Medizinische Kinderschutzhotline. It provides quick legal and practical advice on topics such as interpreting and documenting injuries, supporting victims, and contacting local services. The caller is provided with quick and accurate information and therefore the tools to deal with the suspected case.

Professor Fegert notes, “Our mission is threefold: first, to provide immediate advice on all acute questions related to cases of suspected maltreatment; second, to increase the confidence of health-care professionals for medium-term change; and third, to change attitudes and increase awareness in the long term.”

In order to achieve both their short- and long-term goals, the hotline team also developed the following tools.

• Pocket cards on abusive head trauma and the legal framework provide instant and specific advice for practitioners. These have been very successful – 15 000 have been delivered on request so far, and the programme aims to develop similar cards on the treatment of sexual abuse.
• An electronic learning course enables long-term training of practitioners on child maltreatment. One of its key features is the inclusion of difficult cases regularly discussed with the hotline team.

Initial findings are promising, and they highlight the need for such a service. A recent evaluation found that in 26% of referrals to the hotline, health-care professionals changed their course of action for the benefit of their child patient. Furthermore, 60% of those accessing the service reported that the hotline increased their ability to protect a child at risk.

Professor Fegert and his team have worked hard to fill the gap in awareness of child maltreatment among many health-care professionals. In the long term, this will create a safer world for children.

This capacity-building project is currently sponsored by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ). Due to its widespread use, funding has been extended until the end of the legislative period in 2021 with the objective of making the service permanently available.

In the WHO European Region, only 57% of countries have capacity-building programmes to help health-care providers recognize and report child maltreatment. WHO/Europe recommends that investments in such programmes be improved.