Recognizing and managing long-term sequelae of childhood maltreatment.

Childhood maltreatment is a serious public health problem and represents a significant challenge to pediatricians. Maltreated children present with a variety of emotional and behavioral problems. Pediatricians should screen for risk factors associated with maltreatment and psychiatric sequelae associated with maltreatment. Because of the complexity of psychiatric sequelae in childhood maltreatment, children who have been maltreated will likely require multidisciplinary treatment in mental health care settings. Therefore, pediatricians need to be knowledgeable about mental health services in their communities and actively assist the family in obtaining services. Although we are gaining a more sophisticated understanding of the impact that maltreatment has on the mental health of children and adolescents, much remains to be done. It is critical for pediatricians to work within their professional organizations and their individual communities to address the systemic issues that create barriers to care for patients who have suffered maltreatment. It is also critical for pediatricians to encourage their professional organizations to establish good working relationships with other organizations in areas where they share interest, need, and commitment. Such collaborative relationships at local, state, and national levels can facilitate governmental policy changes that are needed to protect and care for children and adolescents. Only through such efforts can we bring about lasting changes that will support the health and well-being of children and adolescents.