Child Welfare Investigations of Exposure to Intimate Partner Violence Referred by Medical Professionals in Ontario: A Uniquely Vulnerable Population?

Abstract

Victims of intimate partner violence (IPV) and their children may be at an increased risk for negative health outcomes and may present to healthcare settings. The objective of the current study is to examine the profile of medical-referred child welfare investigations of exposure to IPV in Ontario, Canada. Data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 were used. We compared medical-referred investigations with all other investigations of exposure to IPV. Descriptive and bivariate analyses as well as a logistic regression predicting transfers to ongoing services were conducted. Six percent of investigations of exposure to IPV conducted in Ontario in 2018 were referred by a medical source. Compared to other investigations of exposure to IPV, these investigations were more likely to involve younger children (p = 0.005), caregivers with mental health issues (p < 0.001) and few social supports (p = 0.004), and households noted to be overcrowded (p = 0.001). After controlling for clinical case characteristics, investigations of exposure to IPV referred by healthcare sources were 3.452 times as likely to be kept open for ongoing child welfare services compared to those referred by other sources (95% CI [2.024, 5.886]; p < 0.001). Children and their families who are identified in healthcare settings for concerns of exposure to IPV tend to receive extended child welfare intervention compared to those identified elsewhere. There is a clear difference in service provision in healthcare-originating investigations of exposure to IPV versus investigations originating from other sources. Further research into the services provided to victims of IPV and their children is needed.