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case the goal must be permanent removal of the child with a view to a long-term
placement in foster care or, better, in adoption.
The psychiatrist has an important role on the team in giving support and making
recommendations as to future management of cases. The psychiatrist can help
supervise the social worker who should never work exclusively in doing intensive
casework with abusing families. The psychiatrist can spell out the long-term effects of
. a hostile environment on an abused child who will develop similar patterns of
. interaction with his children. The psychiatrist must help the team decide whether or
not there is hope of return of the child. He must help decide whether removal is to
be permanent, in which case adoption should be considered as it has a far higher
chance of success than foster care or institutionalization according to Richards (1977).
Foster care often precipitates the child into a series of removals more damaging to the
child than the actual abuse. lones (1977) recommends a quick decision on the fate of
abused children and feels the psychiatrist has a vital role to play in making a diagnosis
so that the future of these abused children may be determined.
(5) The role of the health visitor in the treatment of child abuse
Hallett and Stevenson (1980) describe health visits as :
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being the prevention of mental, physical and emotional ill-health;
the early detection ofill-health and the surveillance ofhigh-risk groups;
the identification ofneed and the mobilisation ofappropriate resources;
health teaching and the provision of care through support;
advice and guidance.