Childhood Abuse
According to the World Health Organization (2001), approximately 40 million children below the age of fifteen who are subjected to child abuse each year. Childhood abuse affects children mentally and psychologically. It brings children psychiatric problems like anxiety, depression posttraumatic stress disorder and eating disorders.  Maltreatment can cause victims to feel isolation, fear, and distrust, which can translate into lifelong psychological consequences that can manifest as educational difficulties, low self-esteem, depression, and trouble forming and maintaining relationships (Nichter et al., 2020). Children who are victims of child abuse suffer from emotional traumas for years. It is the responsibility of everybody working in the medical field to report any suspected child abuse to authorities.
According to Marwaha et al. (2020), hundreds of thousands of children in the United States experience abuse or neglect each year. A greater understanding of the risk factors and strategies for screening can help professionals working with children and families identify different maltreatment types and high-risk situations.  Assessing child abuse requires a careful evaluation of the suspected childhood abuse condition. Detecting child abuse is an essential aspect of efforts to protect children from harm and determine which children need interventions to reduce associated abuse impairment, like mental health problems (Gu et al., 2020). Strategies used to determine childhood abuse include a thorough assessment and interview of the child—careful observation is needed during an interview to notice any unusual behavior the client may exhibit. The provider should have a conducive environment whereby the child can explain his or her abuse without fear or pressure. The child should feel safe and protected to give out the information needed. The provider should also know the life stressors and how to minimize them on the child. A good relationship should be established between the child and the counsellor. Early detection of abuse can save further child trauma in life.
According to National Child Traumatic Stress Network (2019), trauma Screening refers to a tool or process that is a brief, focused inquiry to determine whether an individual has experienced one or more traumatic events, has reactions to such events, has specific mental or behavioral health needs, and needs a referral for a comprehensive trauma-informed mental health. Utilizing trauma assessments into practice can assist in identifying the severity and consequences of traumatic events. An additional strategy to decrease child abuse is to change social customs and encourage constructive parenting.  Education about abuse should be given to parents to reduce the harms of abuse and neglect exposure.
Media Exposure
While social media can provide education and entertainment, they can also damage children. The influence of the media on the psychosocial development of children is profound. Thus, physicians need to discuss their child’s exposure to media with parents and provide guidance on age-appropriate use of all media, including television, radio, music, video games, and the Internet. Not all television programs are harmful, but data showing the detrimental effects of exposure to violence, inappropriate sexuality and offensive language are convincing (Sadock, 2014). One of the benefits of media is that it can be a teaching tool to the child about the dangers of abuse and how to avoid or report it. Social media and the Internet also allow children who are victims of abuse to find support to assist in coping.  Their emotional wellbeing can benefit from the support they receive. The disadvantage of media platforms can also be used as gateways for perpetrating child abuse.  It gives the perpetrator easy access to children, which can result in cyberbullying and sexual abuse.
Mandatory Reporting
It is the responsibility of any PMHNP and providers to report any form of abuse. Even if it’s just a suspect, it needs to be registered. Child protection Services requires to notify of any form of abuse to be involved and act.  Failure to comply is considered a felony in many states. It is essential to discuss with the client and the parents their thoughts regarding pursuing legal action against the abuser.  The child identity needs to be anonymous to the abuser to avoid more abusive acts.
Gu, H., Ma, P., & Xia, T. (2020). Childhood emotional abuse and adolescent nonsuicidal self-injury: The mediating role of identity confusion and moderating role of rumination. Child Abuse & Neglect106. https://doi-org.ezp.waldenulibrary.org/10.1016/j.chiabu.2020.104474
Nichter, B., Hill, M., Norman, S., Haller, M., & Pietrzak, R. H. (2020). Associations of childhood abuse and combat exposure with suicidal ideation and suicide attempt in U.S. military veterans: A nationally representative study. Journal of Affective Disorders276, 1102–1108. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2020.07.120
Marwaha, S., Briley, P. M., Perry, A., Rankin, P., DiFlorio, A., Craddock, N., Jones, I., Broome, M., Gordon-Smith, K., & Jones, L. (2020). Explaining why childhood abuse is a risk factor for poorer clinical course in bipolar disorder: A path analysis of 923 people with bipolar I disorder. Psychological Medicine50(14), 2346–2354. https://doi-org.ezp.waldenulibrary.org/10.1017/S0033291719002411
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
The National Child Traumatic Stress Network.  Screening and Assessment. Retrieved from
World Health Organization. (2001). Prevention of Child Abuse and Neglect: Making the links
between human rights and public health. Geneva: World Health Organization.