Working together to support disabled parents

Case 6: Mother with HIV who is hospitalised with depression

Without an inter-agency protocol in place

A mother who is HIV positive has to spend a few weeks in hospital as a result of a physical health crisis. Her two children are taken into temporary foster care organised by social services. The mother becomes depressed, in part because of her anxiety for her children's future, and is moved to a psychiatric ward. The children's visits are cut down from three or four a week to one a fortnight because the psychiatric ward is not considered a suitable environment for children. Because there are no indications that the mother's mental health situation will improve and the children are finding the situation difficult, the possibility of long-term foster care is being discussed within children's social services.

With an inter-agency protocol in place

When the woman is first admitted to hospital, routine inquiries establish that she has children and is anxious about their future. A meeting is immediately called involving the health service, a health visitor with whom she has a good relationship, the HIV specialist service and children's services. Because the mother is not well enough to attend, an advocate employed by a local advocacy service represents her expressed wishes and intentions at the meeting. The children are also allocated a specialist advocate so that their views can be represented.

It is agreed that the children will be looked after by a relative, supported by a foster carers’ allowance. It is agreed with the mother that the health visitor will take on a key worker role. When the mother subsequently develops depression a further meeting is called to discuss the children's future. A series of appointments with specialist counsellors is arranged as a priority for the mother and the children because of the impact of the separation. The mother and children make it clear that they wish to remain in contact. Consequently, the mother is treated in a ward which has a room specially prepared for family visits and so she is able to maintain frequent contact with the children.