This study will be controversial as it highlights the continuing link of violent deaths of children and psychiatric disorder and the forgotten/ hidden psychiatric-criminological child protection interface.

We challenge the Child Protection assumption that there is a continuum of neglect into abuse that, at the extremes, leads to the death of a child. The avoidance of such tragedies has become the benchmark of the effectiveness of child protection, reflected in the high profile situations in every Western country.

This has led to a practice culture of fearing the ‘worst case scenario’ with inevitable defensive bureaucratisation, hence the importance of answering the question’who kill children’?

Based upon an analysis of the latest WHO mortality statistics in the 20 Western Countries, we juxtapose All forms of children’s (0–14) mortality against indices of relative poverty i.e. Income Inequalities, and answer the core question from a decade cohort of people who actually killed children,

We show that whilst child neglect is related to poverty, statistically poverty is Not related to child-abuse-related-deaths (CARD).

It will be shown that men with previous convictions for violence pose physical risk to children, followed by psychotic parents. Consequently, assailants’ problems are essentially ‘psychological/ criminological’, rather than socio-economic though poverty always compounds vulnerable situations.

A more accurate risk assessment would enable psychiatric and child protection practitioners to differentiate the neglect and poverty interface from CARD, enabling each discipline to offer an optimal practice intervention earlier and more effectively.