Parental mental health and child welfare: A guide for adult and children's health and social care services


Problems with current practice

Many staff lack confidence in making an assessment of the impact of mental health problems on a family. Staff from children's services may have only a limited knowledge of mental health problems, particularly their impact on parenting. They may not consider that parenting also has an impact on a person's mental health. Adult mental health staff can provide valuable information in support of these assessments, but it is not their responsibility to make a final judgement.

Families facing multiple adversity (e.g. depression, drug and alcohol misuse, and homelessness) need careful multi-disciplinary and multi-agency assessment and support. People who use services have commented that assessments are only 'partial' because they are too fragmented and 'only the service user holds the whole picture'.

Assessments rarely explore a family's strengths in the same amount of detail as any areas of concern. The concept of resilience is not generally well understood. At the same time, some practitioners can be overly optimistic, and fail to recognise the need to protect children from harm.This has been a serious problem in some cases where children have died.

Assessments can be based on limited information if not shared appropriately across agencies:

Criteria to access services currently act as a barrier to providing services to these families because:

In a successful service:

Recommendations for change

Staff need to:

Safeguarding children in families with a parent with mental health problems

The responsibility for safeguarding children does not only lie with children's services. It is a requirement of safeguarding children policy that adult services, including mental health services, know whether their service users have children or are in contact with children. This again highlights the importance of routinely identifying and recording which people who use mental health services are parents and which children have parents with mental health problems.

This is not to imply that adult mental health problems are the only serious risk factor for children's safety. The research evidence suggests that other factors (e.g. parental drug and alcohol misuse, domestic violence, and/or learning disability) are often present in serious child abuse or neglect situations. It is therefore important to be able to recognise and understand what contribution adult mental health problems make to an assessment of overall risk of harm to children.

The lessons from cases where children have been killed by their parents, or suffered significant harm, suggest it is also important to train and support for staff so that they are:

  • constantly vigilant
  • open and inquisitive, regardless of any assumptions based on previous assessments
  • aware of the need to reassess following new or increasing numbers of incidents and following changes in circumstances
  • able to challenge colleagues within partner agencies if required
  • aware of their responsibility to pass on concerns about the welfare of a child to Children's Social Care.

Organisations need to:

Managers need to: