Understanding families with multiple, complex, and unmet service needs in the child protection system through the lens of linked administrative data in New South Wales, Australia

Background: Co-occurrence of domestic and family violence (DFV), substance misuse (SM), and mental health (MH) issues is widely discussed in child protection cases, as they reflect multiple, complex, and unmet service needs of families. Objective: Using population-level, high-volume linked administrative data from the NSW Human Services Data Set, this study aimed to quantify the prevalence of children reported to child protection services who live in families with co-occurring DFV, SM, and MH. Participants and setting: The sample comprised a retrospective cohort of 584,365 unique children with a first child
protection Helpline record between 2004 and 2018. Methods: Binary indicators for presence of DFV, SM, and MH (individually and combined) are derived from child protection Helpline reports within 12 months of first contact and their parents’ prior records in police, court, and healthcare systems. Findings: Out of 584,365 children, 33 % had at least one Helpline concern of DFV. Of these, 81 % recorded only DFV, 16.6 % had DFV in combination with either SM or MH, and 2.4 % recorded all three. For a large share of these children, there was evidence in other systems that their parents had those issues prior: up to 47 % had a police report for DFV, 34 % (37 %) were treated in ambulatory care for (diagnosed with) MH, and 27 % had a diagnosis of SM. Conclusion: Information linked together from other service systems can help identify and create avenues for interventions to support the large share of families with multiple and complex service needs prior to child protection involvement.