Parental Mental Illness
Parental mental illness does not necessarily have an adverse impact on a child’s developmental needs, but it is essential to always assess its implications for each child in the family.
Where a parent has enduring and / or severe mental ill-health, children in the household are more likely to be at risk of, or experiencing, significant harm.
Risk Factors +
A child at risk of significant harm or whose well-being is affected by parental mental illness, could be a child:
- Who features within parental delusions
- Who is involved in his / her parent’s obsessional compulsive behaviours
- Who becomes a target for parental aggression or rejection
- Who has caring responsibilities inappropriate to his / her age (see Young Carers)
- Who may witness disturbing behaviour arising from the mental illness
- Who is neglected physically and / or emotionally by an unwell parent
- Who does not live with the unwell parent, but has contact (e.g. formal unsupervised contact sessions or the parent sees the child in visits to the home or on overnight stays)
- Who is at risk of severe injury, profound neglect or death
- Who is an unborn child of a pregnant woman with any previous major mental illness
Some of the key findings of the 47 Serious Case Reviews (SCRs) studied in detail from the last Biennial Review of SCRs (PDF, 504Kb) are:
- Domestic violence was present in 66% of cases
- Substance misuse was present in 57% of cases
- Mental ill health was present in 55% of cases
- All three issues were present in 34% of cases
"Nearly three quarters of children had lived with current or past domestic violence and/or parental mental ill health and/or substance misuse. The combination of these three problems can produce a toxic caregiving environment for the child." Biennial Review of SCRs (PDF, 504Kb)
Parenting Capacity +
The following factors may impact upon parenting capacity and increase concerns that a child may have suffered or is at risk of suffering significant harm:
- History of mental health problems with an impact on the sufferer’s functioning
- Unmanaged mental health problems with an impact on the sufferer’s functioning
- Misuse of drugs, alcohol, or medication
- Severe eating disorders
- Self-harming and suicidal behaviour
- Lack of insight into illness and impact on child, or insight not applied
- Non-compliance with treatment
- Poor engagement with services
- Previous or current compulsory admissions to mental health hospital
- Disorder deemed long term ‘untreatable’, or untreatable within time scales compatible with child’s best interests
- Mental health problems combined with domestic abuse and / or relationship difficulties
- Mental health problems combined with isolation and / or poor support networks
- Mental health problems combined with criminal offending (forensic)
- Non-identification of the illness by professionals (e.g. untreated post-natal depression can lead to significant attachment problems)
- Previous referrals to LA children’s social care for other children
Working in Partnership with Adults' Services +
Adult mental health professionals must identify those service users who are pregnant and those who are parents or who have regular access to children, whether they reside with children or not. Professionals should consider the needs of all children as part of their Care Programme Approach (CPA) assessments.
When adult mental health services and LA children’s social care are both involved with a family, joint assessments should be carried out to assess the support parents need and the risk of harm to the child/ren.
Where appropriate, children should be given an opportunity to contribute to assessments as they often have good insight into the patterns and manifestations of their parent’s mental ill-health.
CPA assessments and meetings for any adult who is a parent must include ongoing monitoring of the needs and risk factors for the children concerned. LA children’s social care should be invited to contribute if they are involved with a family or where risks and needs have been identified that justify their involvement.
Mental health professionals must be included in strategy meetings, child protection conferences or associated meetings if a mental health service user is involved.
Mental health inpatient services should have written policies regarding the welfare of children and particularly the visiting of inpatients by children.
Safeguarding Adults (external link) Referral & Advice Line: 020 8489 1400 (office hours) or 020 8489 0000 (out of hours).
Parents with Learning Disabilities +
Learning disabled parents may need support to develop the understanding, resources, skills and experience to meet the needs of their children. Such support is particularly necessary where the parent/s experience the additional stressors of:
In most cases it is these additional stressors, when combined with a parent’s learning disability, that are most likely to lead to concerns about the care their child/ren may receive. If a parent with learning difficulties appears to have difficulty meeting their child/ren’s needs, a referral should be made to LA children’s social care, who have a responsibility to assess the child’s needs and offer supportive and protective services as appropriate.
Where a parent has enduring and / or severe learning disabilities, children in the household are more likely to be at risk of, or experiencing, significant harm.
- Children of parents with learning disabilities are at increased risk from inherited learning disability and more vulnerable to psychiatric disorders and behavioural problems, including alcohol / substance misuse and self-harming behaviour
- Children having caring responsibilities inappropriate to their years placed upon them, including looking after siblings
- Neglect leading to impaired growth and development, physical ill health or problems in terms of being out of parental control
- Mothers with learning disabilities may be targets for men who wish to gain access to children for the purpose of sexually abusing them.
Safeguarding Children where there are concerns of Parental Mental Health Protocol +
The Parental Mental Health Protocol (PDF 823KB) aims to facilitate information sharing and clarify the role of all practitioners working with families where there may be concerns regarding parental mental health. This includes children and young people whose care may be affected because of their parent’s mental health.
Safeguarding Children where there are concerns of Parental Mental Health Protocol (PDF 823KB)