Prevalence of Child Abuse and Neglect by Health Professionals Abstract. Background: Child abuse and neglect pose a permanent developmental risk for children and adolescents. After the family environment, the second most frequent context in which abuse occurs is institutions. However, institutions in the medical and psychotherapeutic fields have rarely been the subject of epidemiological studies, despite the existing institutional and individual risk factors, like stressful working conditions or patients' previous experiences of child maltreatment. Besides physical, emotional, and sexual abuse as well as neglect, in the medical and therapeutical context, there is also the risk that children experience coercive measures that may be perceived as traumatizing and victimizing even if they're medically justified or necessary. Objective: This article gives an overview of the research on the prevalence rates of child abuse, neglect, and coercive measures perpetrated by health professionals, focusing especially on the field of child and adolescent psychiatry and psychotherapy. Method: Using a keyword-based literature search, we identified studies reporting prevalences of child maltreatment perpetrated by health professionals in medical-therapeutic institutions, general and pediatric hospitals, departments of child and adolescent psychiatry and psychotherapy, in addition to epidemiological studies on adult patients. Results: Apart from analyses concerning the frequency of coercive measures, which were experienced by 10 - 25 % of child and adolescent psychiatric inpatients, there exist two representative retrospective surveys on the German population, one of which differentiates between distinct types of medical-therapeutic institutions. In the latter, between one-fifth and one-third of the participants reported having experienced at least one type of abuse or maltreatment during hospitalization in their childhood, whereby the prevalences in departments for child and adolescent psychiatry/psychotherapy were always higher than in general and pediatric hospitals. Physical abuse (10 - 31 %), emotional abuse (10 - 23 %), and neglect (12 - 22 %) were the most frequent forms experienced by the respondents. Child sexual abuse by health professionals was less frequent, with 0.8 % of the participants reporting incidents in medical-therapeutic institutions in general, whereas there was a much higher prevalence of 7.3 % in child and adolescent psychiatry. Discussion and Conclusion: This article gives an overview of the prevalence of child maltreatment in the medical and therapeutic fields. Because of the lack of epidemiological studies, we included inquiries on different samples and of varying methodological quality. Therefore, the article does not represent a systematic overview but rather provides a first estimation of the problem. Besides indicating alarmingly high prevalence rates, it also shows the need for further research on the issue.
