Think child, think parent, think family: a guide to parental mental health and child welfare

About this guide

Why have we written this guidance?

SCIE was originally commissioned to work in this area following a 2004 Social Exclusion Unit report which identified parents with mental health problems as a group that was sometimes poorly served by health and social care.

Who is this guide for?

The guide has been written for front-line and managerial staff in mental health and children’s services from all sectors. It is also relevant for commissioners, policy makers, those delivering education and training to health and social care staff’ and others responsible for workforce development. People who use services and their carers will find useful information on what they can expect from services and where they can go for more information.

How was the guide developed?

This is an updated version of the Think Child, Think Parent, Think Family guide, which SCIE first published in 2009.  The 2009 version was based on reviews of the published literature from 1985–2005 and a practice survey - a review of existing practice in adult and children’s health and social care services - carried out in five sites in England – North Somerset, Birmingham, Liverpool, the London Borough of Southwark, and the London Borough of Lewisham between 2006–2008.  The original reports of each review and the practice survey are available on the website.

The original guide was steered by advisory groups consisting of service users bad other sector experts.

From 2009-2011, SCIE worked with the original five practice survey sites, and the five Health and Social Care Trusts in Northern Ireland, to put the recommendations of the guide into practice.  SCIE supported multi-disciplinary steering groups in each of the sites to develop an action plan, and monitor and evaluate its implementation for two years in England, and for three years in the Northern Irish trusts. This has generated a wealth of good practice examples and resource tools, which are included in the guide, as well as advice on how best to go about implementing the guide’s recommendations.

A note about terms used

We use the term ‘parent with mental health problems’ to refer to those parents with a primary diagnosis or need, identified as a mental health problem, mental illness or mental disorder. These parents may also experience other health problems or disabilities, alcohol or substance misuse, learning difficulties or domestic violence. The term includes parents who are known to children’s services but do not have a formal mental health diagnosis, and parents who have not come to the attention of secondary mental health services.

It is important to remember that adults caring for children are not always their biological parents. Step-parents, partners and others can have important caring roles in children’s lives, and their mental health needs must be taken into account just as much as those of an actual parent.  Throughout this guide, therefore, the term parent should be taken to apply to all adult carers living with the child.

The term ‘children’ is used to refer to everyone 18 years or younger, some of whom will be young carers.

The term ‘young carer’ is used to refer to someone under the age of 18 carrying out significant caring tasks and assuming a level of responsibility for another person which would normally be undertaken by an adult. Young carers undertake a variety of tasks for parents with mental health problems, including advocacy, help with correspondence and bills, liaising with professionals, administering medicines, emotional support and domestic tasks.

Different services use very different language to describe the processes they follow for assessing need and delivering support. However, essentially they all operate a basic care pathway that involves making and receiving referrals, screening clients, assessing need, putting together a care plan and reviewing existing care plans. We have therefore used these terms to describe a generic care pathway throughout this guide, based on the assumption that whatever service is providing care and whoever receives it, they will typically go through a process which includes these components.