Identification of abuse histories in a community mental health centre: The need for policies and training

In the context of studies finding low levels of enquiry about abuse by clinicians in the U.S.A. and the U.K., the medical records of 200 consecutive adult clients of a New Zealand Community Mental Health Centre were reviewed. All information regarding clients' abuse histories contained within the files was noted. The results suggest that enquiry about abuse is not routinely taking place. Assessments conducted using a form with an abuse section identified significantly greater prevalence rates of abuse than assessments conducted without the form. When notes in the current chart from previous contacts with mental health services were included, a prevalence rate of 46% for childhood and/or adulthood abuse was calculated. Only approximately half of this abuse, however, was identified in the notes of the current admission. Recommendations are proposed regarding the need for unit policies ensuring routine enquiry about abuse in standardised admission procedures, and for providing clinicians with training in how and when to enquire about abuse, and how to respond.