scholarly journals Linking data on women in public family law court proceedings concerning their children to mental health service records in South London

Author(s):  
Rachel Pearson ◽  
Amelia Jewell ◽  
Linda Wijlaars ◽  
Stuart Bedston ◽  
Emily Finch ◽  
...  

IntroductionMaternal mental health problems and substance misuse are key risk factors for child neglect or abuse and court-mandated placement into care. Linkage between mental health records and family court data could raise awareness about parent mental health needs and inform approaches to address them. ObjectivesTo evaluate data linkage between administrative family court data and electronic mental health records for a population-based mental health service for 1.3 million people in South London. MethodsWe deterministically linked administrative family court data for women (n=5463) involved in care proceedings in South London with service user records from the South London and Maudsley NHS Mental Health Trust (SLaM). We restricted the cohort to women involved in proceedings between 2007 and 2019, in local authorities where SLaM solely provides secondary/tertiary mental health services and the Improving Access to Psychological Therapies (IAPT) (n=3226). We analysed the associations between match status and sociodemographic/case characteristics using multivariable logistic regression. ResultsTwo-thirds (2317/3226; 66%) of women linked to a SLaM service user record at some point; most (91%) who linked accessed secondary/tertiary mental health services, indicating serious mental illness. Accounting for possible missed matches, we estimated that 70-83% of women accessed SLaM services at some point. Older women at index proceedings (>35yrs OR: 0.69, 95%CI: 0.54-0.88vs<25yrs) and Black women or women from other ethnic groups (Black ethnic groups 0.65, 0.50-0.83; other ethnicity 0.59, 0.43-0.81 vs White ethnic groups) had lower odds of linking. Odds of linking were higher for women with an infant in proceedings (1.42, 1.18-1.71), or with curtailed/terminated parental responsibility (1.44, 1.20-1.73). ConclusionsOur linkage supports growing evidence of a high burden of mental health problems and substance misuse among women whose children enter care in England, compared to the general population. Research using this linkage should inform strategies to address the considerable mental health needs of vulnerable women and their children.

2015 ◽  
Vol 28 (5) ◽  
pp. 415-436 ◽  
Author(s):  
Jillian J. Turanovic ◽  
Nancy Rodriguez

This study identifies the factors related to mental health service use among children of incarcerated mothers. Data on 700 children collected from a diverse sample of mothers in Arizona are used, and a two-stage probit model with sample selection is estimated to assess the various child, mother, and caregiver characteristics associated with children’s use of mental health services. Results indicate that children involved in child protective services (CPS) and children cared for by grandparents are more likely to receive mental health services, whereas children of Native American mothers and children who have been exposed to violence are less likely to receive services for their mental health needs. These findings have important implications for correctional policy regarding the intake screening of female inmates and suggest that criminal justice agencies communicate more closely with CPS and community-based services to ensure children’s mental health needs are addressed while their mothers are in prison.


Recognition and assessment of mental health problems 984 Anxiety and depression 986 General principles of treatment for anxiety and depression 988 Other common mental health disorders 990 Alcohol and substance misuse 992 Nursing alcohol and substance misuse problems 994 Suicide and deliberate self-harm 995 Mental Health Act ...


Author(s):  
Rachel J Pearson ◽  
Amelia Jewell ◽  
Linda Wijlaars ◽  
Ruth Gilbert

IntroductionAn estimated 23% of children in England are exposed to maternal mental health problems, with growing concern around how maternal mental health affects parenting capacity and entries into public care for their children. There is limited evidence on the prevalence of mental health service need among women whose children enter care and on whether these needs are sufficiently met. With England’s family justice system and children’s social care sector increasingly overstretched, there is a need to identify opportunities for an improved response to maternal mental health. Objectives and ApproachWe linked administrative family court data for women (n = 5463) involved in public family court proceedings (care proceedings) across eight London boroughs between 2007 and 2019, with patient records from South London and Maudsley NHS mental health trust (SLaM). Work is ongoing to (1) describe the frequency, type and timing of mental health service use among women who link and (2) compare these findings to general population trends. Results2843 (52%) women linked to a SLaM patient record via deterministic linkage. Matches had better recording of identifiers and were more likely to have returned to court than non-matches (36% vs 26%). The majority of women (75.0%) were referred for treatment before the start of their (first) care proceeding, while 34.8% had a diagnosis recorded in a structured field. To appraise linkage quality, we manually reviewed de-identified clinician notes for 100 randomly selected women who linked; we confirmed ‘true’ match status for 95 women and found no evidence contradicting match status for the remainder. Conclusion / ImplicationsThis novel linkage between mental health and family court data supports growing evidence that women whose children enter care in England have high prevalence of mental health problems. Research using this linkage will help to inform strategies to improve maternal mental health and outcomes for vulnerable women and their children.


2021 ◽  
Author(s):  
Rachel Jane Pearson ◽  
Claire Grant ◽  
Linda Wijlaars ◽  
Emily Finch ◽  
Stuart Bedston ◽  
...  

Background Research in England suggests a high burden of mental health problems and substance misuse among women whose children enter care. Family courts therefore need to consider timely support for parental mental health and likely time to recovery within public family law proceedings concerning placement of a child into care (‘care proceedings’). We report population-based evidence from linked, routinely collected, de-identified records on the type and severity of maternal mental health problems in relation to care proceedings. Methods We linked family court data and mental health service records for 2137 (66%) of women involved in care proceedings between 2007-2019 in the South London and Maudsley NHS Mental Health Trust (SLaM) catchment area. We compared their mental health service use and risk of dying with 17,096 female matched controls who accessed SLaM between 2007 and 2019, aged 16-55 years old. Results Most women (79%) were known to SLaM before care proceedings began. Compared to the matched controls, women had higher rates of schizophrenia spectrum disorders (19% vs 11% matched controls), personality disorders (21% vs 11%), and substance misuse (33% vs 12%). They were more likely to be admitted to a SLaM inpatient unit (27% vs 14%) or to be sectioned under the Mental Health Act (19% vs 8%). Finally, women had a 2.15 (95% CI: 1.68 to 2.74) times greater hazard of dying, compared with the matched controls, adjusted for age. Conclusions Given the high prevalence and severity of mental health problems among women involved in care proceedings, family law and social care policy is needed to ensure adequate and timely treatment for parent mental health problems. The increased risk of dying among those accessing mental health services highlights the critical need for post-proceeding services to ensure parents whose children enter care continue to receive support after care proceedings conclude.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033317
Author(s):  
Rachel M Hiller ◽  
Sarah L Halligan ◽  
Richard Meiser-Stedman ◽  
Elizabeth Elliott ◽  
Emily Rutter-Eley

ObjectivesYoung people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer–child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.Design and participantsParticipants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42–65 years old and ranged from those who were relatively new to the profession (<12 months’ experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children’s emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.ResultsOnly half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.ConclusionsFindings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.


2010 ◽  
Vol 34 (5) ◽  
pp. 195-199
Author(s):  
Barry Wright ◽  
Chris Williams ◽  
Marcella Sykes

SummaryThis paper reports on the last 8 years in the development of a child mental health learning disability service. The growth, challenges and pitfalls faced by the service are charted here. The paper also shows how a service can cope with rising demand without the development of waiting lists and how a specialist service can be embedded within a generic child and adolescent mental health service (CAMHS) as a tier 3 team, thus creating synergies and commonalities of purpose, while avoiding service gaps that inevitably arise from separate services with specific referral criteria. This is a healthy service model that meets the needs of local children with moderate to severe intellectual disabilities and concomitant child mental health problems.


2018 ◽  
Vol 65 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Ka-Fai Chung ◽  
Samson Tse ◽  
Chit-Tat Lee ◽  
Michael Ming-Cheuk Wong ◽  
Wing-Man Chan

Background: Public expenditure on mental health education has grown exponentially in the past two decades. Does the experience of stigma among people with mental health problems improve over time? Our study aims to compare the levels of perceived stigmatization, rejection experiences and stigma–coping among mental health service users in Hong Kong between 2001 and 2017 using longitudinal and repeated cross-sectional study design. Method: The baseline survey was completed by 193 psychiatric outpatients in 2001. They were traced for re-assessment in 2017. Another sample of 193 outpatients matched in age, gender and psychiatric diagnosis was recruited in 2017 for cross-sectional comparison. Participants completed a 39-item questionnaire on stigma experiences, Beck Depression Inventory and Disability Assessment Schedule at both time points. Results: In total, 109 of 193 participants (56.5%) of the 2001 survey were re-assessed. No significant change in perceived stigmatization, rejection experiences and stigma–coping was found among the 109 participants interviewed in 2001 and 2017. For cross-sectional comparison, significant differences in two perceived stigma items were observed upon Bonferroni correction (chi-square test, p < .005) and remained significant after controlling for confounding factors by regression analysis. Improvements in perceived stigmatization were on marriage and friendship, while viewpoints on trustworthiness, dangerousness, devaluation, avoidance and personal failure remained unchanged, and there was no improvement in rejection experiences and stigma–coping. Conclusion: Positive attitude changes over time are unlikely to occur if there is no targeted intervention on stigma. Our findings highlight that evidence-based antistigma interventions are urgently needed.


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