9 Nov 2026
The Statewide Competence Center – Bavarian Child Protection Outpatient Clinic provides highly specialized assessments of suspected child abuse and neglect throughout Bavaria. This year, the clinic is celebrating its 15th anniversary.
Over 27,000 cases of suspected child abuse and neglect were reported in Bavaria in 2025. However, most incidents of child abuse are never reported to the authorities and therefore do not appear in official statistics.
This makes the work of all institutions involved in child protection all the more important when it comes to assessing suspected cases and providing vital support. The Statewide Competence Center – Bavarian Child Protection Outpatient Clinic plays a key role in Bavaria as a steering and coordination center.
Its multidimensional and interdisciplinary team is based at the Institute of Legal Medicine at LMU Munich and consists of specialists in legal medicine, pediatric surgery, pediatric and adolescent gynecology, and social pedagogy. “We also work closely with hospital-based pediatricians who are responsible for evaluating specific cases on site at children’s clinics and establishing the corresponding structures,” explains Professor Elisabeth Mützel, director of the outpatient clinic.
The Institute of Legal Medicine has decades of experience in assessing physical violence against children and adolescents. From a very early stage, it expanded its focus to include the examination of sexualized violence.
The idea of bringing the skills and expertise within the team under one roof in the form of an outpatient clinic took shape in 2011 while the institute was helping develop guidelines on violence against children and adolescents at the initiative of the Bavarian Ministry for Family Affairs, which continues to fund the clinic today. “It had always been very important to us that our expertise should be available not just to the police and public prosecutors, but to everyone who works with children,” says Mützel.
Direct and uncomplicated access to support is essential: “Victims, parents, or legal guardians can call our hotline, which is available around the clock at +4989 2180-73011. Depending on their needs, we can connect them with children's hospitals, community-based physicians, or other organizations,” says Dr. Claudia Bormann, deputy director to Elisabeth Mützel at the Child Protection Outpatient Clinic.
It had always been very important to us that our expertise should be available not just to the police and public prosecutors, but to everyone who works with children.Prof. Dr. Elisabeth Mützel
Prof. Dr. Elisabeth Mützel | © privat
Providing support throughout Bavaria and, in particular, imparting expertise at the local level are key parts of the mission. Specialists from the competence center visit children’s hospitals and organize Interprofessional Quality Circles (multi-agency peer working groups), thus building up the necessary structures. As not all medical professionals who may encounter suspected cases of child abuse have the experience needed to recognize the warning signs, the Child Protection Outpatient Clinic offers both on-site training and e-learning courses in child protection. These courses are certified by the Bavarian State Chamber of Physicians and regularly updated to reflect the latest knowledge and standards. “There are many dedicated physicians in Bavaria,” says Mützel. “We need to pool this commitment and make sure these doctors work collaboratively rather than in isolation.”
The outpatient clinic deals with all forms of violence against children, including physical, sexual, and emotional abuse, as well as neglect.
Physical injuries, unusual behavior, or other circumstances may provide important indications that a child is at risk. “When a child presents with one or more of these warning signs at a medical practice, physicians with the appropriate training can determine whether the child should be examined by our team or referred to a hospital,” explains Claudia Bormann.
The clinic also provides RemApp, a secure telemedicine platform that protects patient data and is accessible to medical practices, youth welfare offices, and children’s hospitals. Professionals can submit anonymized case descriptions via the platform and upload photographs of injuries or X-rays from any location. A member of the outpatient clinic team then reviews the information. Depending on the type of abuse, additional specialists may be consulted.
If a child needs to be examined at our clinic, we arrange an appointment very quickly – by the following day at the latest, provided that the family is able to attend.Prof. Dr. Elisabeth Mützel
“If a child needs to be examined at our clinic, we arrange an appointment very quickly – by the following day at the latest, provided that the family is able to attend,” says Elisabeth Mützel. The guiding principle is that a child should not have to wait for help.
“First we talk to the parents or legal guardians to understand the background and circumstances. As a rule, we do not question children about the suspected incident itself.” Another fundamental principle is that no child is ever forced to undergo an examination. “If consent is given, we conduct a full-body examination and carefully document our findings,” Mützel explains. These findings can also serve as the basis for further care – in child and adolescent psychiatry, for example. “If a child is in immediate danger, we arrange hospital admission without delay.”
One question often asked by people outside the field is how specialists recognize injuries caused by abuse – and, above all, how they distinguish them from ordinary injuries that children may sustain in everyday accidents.
“For cases of suspected physical violence, we are trained to evaluate injuries based on their location, shape, pattern, or stage of development in order to determine how they may have occurred.” A single bruise, for example, is not necessarily evidence of abuse. “We ask whether the explanation is plausible: Does the account of what happened match what we see? Are there behavioral issues that are consistent with that explanation?”
This is why preliminary discussions with parents or legal guardians and careful observation of any unusual behavior are so important.
Dr. Claudia Bormann | © privat
Assessing suspected cases of child abuse and neglect is the primary field of the Bavarian Child Protection Outpatient Clinic. However, prevention is also an important part of its work.
“We were able to incorporate four video-based learning modules into our e-learning further training program for a project about mental disorders in women during the perinatal period – the time immediately before, during, and after childbirth,” explains Elisabeth Mützel. The focus was on identifying mental disorders already during pregnancy, allowing affected women to receive the earliest possible treatment. “Around 13,000 pregnant women took part in the project,” Mützel notes.
Over the past 15 years, the Statewide Competence Center – Bavarian Child Protection Outpatient Clinic has continuously expanded the range of services it offers. “When we first started, we provided telephone consultations and examined children,” Mützel recalls. “The introduction of our telemedicine platform brought us more inquiries, and eventually we expanded the supports we give to frontline colleagues in clinical child protection.”
Over the years, casework has become more complicated, observes the director of the competence center, and cases have become more complex and work-intensive. “At the same time, we have to make sure our services continue to meet actual needs. This requires extensive networking and always checking to ensure that appropriate support and services can be built up locally for children, adolescents, and their families.”
The model has been a resounding success. “There is no comparable child protection structure anywhere else in Germany,” says Mützel. It is important, she stresses, that the human and financial resources in children’s hospitals continue to be strengthened. Political support and funding are essential – and not just in Bavaria, but throughout Germany.