title: Barriers and Challenges in Seeking Psychiatric Intervention in a General Hospital, by the Collaborative Child Response Unit, (A Multidisciplinary Team Approach to Handling Child Abuse) A Qualitative Analysis.
abstract: Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services.
  
  
  METHODS
  Members of the team were recruited from different disciplines and trained by experts. A mission statement, protocol to assess the victims and provide treatment was formulated as an algorithm. The barriers to psychiatric treatment among the stakeholders were analyzed using framework method of qualitative analysis. Results (After 20 months) the unit received 27 referrals in 20 months, 24 females, and 3 males. Age of the victims was between 8 months and 17 years. Two cases found to be physically abused. Penetrative sexual abuse was found in 23 cases, pregnant victims were 4. Most referrals were by police, trafficking found in 6 cases.
  
  
  CONCLUSIONS
  It was possible to provide multidisciplinary care to the victims and families. Recurrent themes of barriers to psychiatric treatment were stigma, victim blaming; focus on termination of pregnancy, minimization of abuse in males by stakeholders. Conclusion is collaboration needs more effort to integrate psychiatric services but can minimize the reduplication of services.
authors.affiliation: Department of Psychiatry, MSR Medical College, Bengaluru, Karnataka, India.
authors.forename: Vyjayanthi Kanugodu Srinivasa
authors.initials: VK
authors.lastname: Subramaniyan
authors.affiliation: Department of Psychiatry, Rajiv Gandhi Medical College, Thane, Maharashtra, India.
authors.forename: Anukant
authors.initials: A
authors.lastname: Mital
authors.affiliation: Department of Paediatrics, MSR Medical College, Bengaluru, Karnataka, India.
authors.forename: Chandrika
authors.initials: C
authors.lastname: Rao
authors.affiliation: Department of Forensic Medicine, MSR Medical College, Bengaluru, Karnataka, India.
authors.forename: Girish
authors.initials: G
authors.lastname: Chandra
keywords: Barriers to psychiatric treatment; child abuse; multidisciplinary team; protection of children from sexual offenses act; qualitative analysis