Mental health service use among mothers involved in public family law proceedings:linked data cohort study in South London 2007–2019

Pearson, R.J. and Grant, C. and Wijlaars, L. and Finch, E. and Bedston, S. and Broadhurst, K. and Gilbert, R. (2022) Mental health service use among mothers involved in public family law proceedings:linked data cohort study in South London 2007–2019. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954

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Abstract

Purpose: Mental health problems and substance misuse are common among the mothers of children who experience court-mandated placement into care in England, yet there is limited research characterising these health needs to inform evidence-based policy. In this descriptive study, we aimed to generate evidence about the type, severity, and timing of mental health and substance misuse needs among women involved in public family law proceedings concerning child placement into care (‘care proceedings’). Methods: This is a retrospective, matched cohort study using linked family court and mental health service records for 2137 (66%) of the 3226 women involved in care proceedings between 2007 and 2019 in the South London and Maudsley NHS Mental Health Trust (SLaM) catchment area. We compared mental health service use and risk of dying with 17,096 female-matched controls who accessed SLaM between 2007 and 2019, aged 16–55 years, and were not involved in care proceedings. Results: Most women (79%) were known to SLaM before care proceedings began. Women had higher rates of schizophrenia spectrum disorders (19% vs 11% matched controls), personality disorders (21% vs 11%), and substance misuse (33% vs 12%). They were more likely to have a SLaM inpatient admission (27% vs 14%) or to be sectioned (19% vs 8%). Women had a 2.15 (95% CI 1.68–2.74) times greater hazard of dying, compared to matched controls, adjusted for age. Conclusion: Women involved in care proceedings experience a particularly high burden of severe and complex mental health and substance misuse need. Women’s increased risk of mortality following proceedings highlights that interventions responding to maternal mental health and substance misuse within family courts should offer continued, long-term support.

Item Type:
Journal Article
Journal or Publication Title:
Social Psychiatry and Psychiatric Epidemiology
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2738
Subjects:
ID Code:
167885
Deposited By:
Deposited On:
24 Mar 2022 12:50
Refereed?:
Yes
Published?:
Published
Last Modified:
04 May 2022 02:51