5.23 Enduring and/or Severe Parental Mental Illness |
The majority of parents who suffer significant mental ill-health are able to care for and safeguard their child/ren and / or unborn child.
In some cases, enduring and/or severe parental mental ill health will seriously affect the safety, health and development of children. Where professionals believe that this may be the case a referral must be made to Children's Social Care Services.
The following parental risk factors justify a referral to Children's Social Care Services for an assessment of whether a child has suffered or is at risk of suffering significant harm (including, for example impairment suffered from seeing or hearing the ill-treatment of another):
- Previous history of mental health problems
- Predisposition to or severe post natal illness
- Delusional thinking involving the child
- Self-harming behaviour and suicide attempts
- Altered states of consciousness e.g. splitting / dissociation, misuse of drugs, alcohol or medication
- Obsessional compulsive behaviours involving the child
- Non-compliance with treatment, reluctance or difficulty in engaging with necessary services, lack of insight into illness or impact on the child
- Disorder designated 'untreatable' either totally or within time scales compatible with the child's best interests
- Domestic violence and/or relationship difficulties
- Unsupported and/or isolated parents
The following factors may also lead to the conclusion that a child may have suffered or is at risk of suffering significant harm:
- A child acting as a young carer for a parent or a sibling
- Impact on child's growth, development, behaviour and/or mental/physical health, including alcohol/substance misuse and self- harming behaviour
- The parent/carer needs or illnesses taking precedence over the child's needs
- Insufficient alternative care for the child within extended family
If a child has suffered or is at risk of suffering significant harm as the result of commission or omission on the part of the parent/ carer, then the welfare of the child must be paramount.
Importance of Working in Partnership
Adult and child mental health professionals, child care social workers, health visitors and midwives, school nurses and education services must share information in order to be able to assess risks.
Care programme meetings about parents who have mental health difficulties must include consideration of any needs or risk factors for the children concerned. Relevant Children's Social Care Services teams along with other relevant agencies should be involved in planning discharge arrangements.
Strategy Meetings and Child Protection Conferences must include any psychiatrist, community psychiatric nurse, psychologist and adult mental health social worker involved with the parent / carer.
Children's Social Care Services may be requested to assess whether it is in the best interests of a child to visit a parent or family member in a psychiatric hospital or. r high security hospitals (Broadmoor, Ashworth and Rampton) - see Visits by Children to High Security Hospitals and Prisons Procedure.
In summary, psychiatric hospitals should have written policies drawn up in consultation with Children's Social Care Services regarding visiting of patients by children, which should only take place following a decision (regularly reviewed) that such a visit would be in the child's best interests.
Where there are child welfare concerns regarding visits to patients detained under the Mental Health Act, the trust should ask the Children's Social Care Services Assessment Team to assess whether it is in the child's best interests.
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