Maltreated children are vulnerable to adverse mental health outcomes. Information about how children’s mental health needs vary according to different levels of child protection contact (potentially culminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10 years and self-reported mental health difficulties at age 11 years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placed in OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placement and 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment.

受虐待的儿童容易受到不良心理健康结果的影响。关于儿童的心理健康需求如何根据不同级别的儿童保护接触（可能最终导致家庭外护理 [OOHC]）而变化的信息对于有效提供服务很有价值。本研究旨在检验 10 岁之前与儿童保护服务的不同接触程度与 11 岁时自我报告的心理健康困难之间的关联。参加者（n = 26,960）来自新南威尔士儿童发展研究，这是一项多机构、多代、纵向记录关联研究，将行政记录与横断面调查数据相结合。我们检查了四个级别的儿童保护反应（非阈值报告、未经证实的报告、经证实的报告、OOHC；每个都与没有报告有关）和自我报告的心理健康困难的六个领域（包括内化和外化症状，以及精神病-喜欢的经历）。与儿童保护服务的所有级别接触都与所有领域心理健康困难的几率增加有关。被安置在 OOHC 的儿童和报告经证实的儿童报告精神健康困难临床水平的几率最高；48. 1% 的 OOHC 安置儿童和 45.6% 的儿童保护报告得到证实的儿童在至少一个领域表现出临床水平的心理健康困难。儿童保护报告未经证实或确定未达到重大伤害风险阈值的儿童在童年中期出现心理健康困难的风险也增加。这些发现强调了对所有面临虐待风险的儿童进行早期发现和干预的重要性。在童年中期出现心理健康问题的风险也增加了。这些发现强调了对所有面临虐待风险的儿童进行早期发现和干预的重要性。在童年中期出现心理健康问题的风险也增加了。这些发现强调了对所有面临虐待风险的儿童进行早期发现和干预的重要性。