National Framework for Universal Child and Family Health Services

3.8.3 Early identification of family need and risk

Page last updated: 20 May 2013

There is widespread agreement on the role of universal child and family health services in identifying health needs within the family in order to provide families with support as early as possible. This reflects the evidence about the complex interaction of risk and protective factors that influence a child’s health, wellbeing and development and an acknowledgement of the social determinants of health. All universal child and family health services should have a system in place for early identification to:

  • identify the factors known to increase the likelihood of a child experiencing poorer health, development and wellbeing outcomes in later childhood and adult life or factors which protect a child from poor outcomes;
  • work with parents, families and communities to address health and development needs and minimise the impact of parent, child, family and community risk factors;
  • identify the factors indicative of child abuse and neglect and refer or report appropriately; and
  • facilitate support for children and families across multiple services (for example, health, education, housing).
Under the auspices of the COAG, a recommended Common Approach to Assessment, Referral and Support (CAARS) in Australia was developed in 2009 [43]. In addition, there are a number of psychosocial or family assessment tools used in pregnancy and in the early postpartum period to identify family need early. Few of these tools have been validated. As noted above, most protocols include the EPDS and this is recommended in the current draft Clinical Guidelines for perinatal mental health [92]. Austin et al [101] reported that the Pregnancy Risk Questionnaire (PRQ) was more reliable than previously reported tools in the antenatal prediction of postnatal depression, allowing identification of high and low risk groups. However, further work is needed to test the positive predictive value of a risk assessment tools.