Parental mental ill health in a parent or carer does not always have a harmful impact on a child's development. Just as there is a range in severity of illness, there is a range of potential impact on families. All services working with a family must work together to make sure that the voice of the child is heard and they are properly safeguarded.
Examples where parental mental ill health may impact a child’s development or safety
- Specific symptoms which involve the child directly, such as delusions or the child being part of the parent’s suicide plan.
- Mental ill health impacts on the parent’s day-to-day activities.
- The parent is emotionally unable to respond to the child.
- Interactions between the child and parent triggers or worsens mental ill health.
- Lack of consistency in the child’s care, for example changes in carers due to hospital admissions.
- Loss of concentration preventing the parent from keeping the child safe.
- Medication not being stored securely.
- The child taking on the role of carer for the parent.
Complicating risk factors
It is important to recognise that other issues can worsen the risk presented by mental ill health. For example, drug or alcohol misuse, domestic abuse, conflict, or limited support networks, could all show an increased likelihood of the child suffering significant harm.
Other complicating risk factors can include:
- History of mental health problems with an impact on the person’s functioning.
- Misuse of drugs, alcohol, or medication.
- Severe eating disorders.
- Self-harming behaviour and/or suicidal thoughts.
- Lack of insight about the problems and the impact on the child or insight not applied.
- Not following suggested treatment.
- Poor engagement with services.
- Previous or current compulsory admissions to mental health hospital.
- Mental ill health combined with domestic abuse and/or relationship difficulties.
- Mental ill health combined with isolation and/or poor support networks.
- Mental ill health combined with criminal offending (forensic).
Protective factors, positives, and strengths to consider
- The mental ill health is mild or short-lived.
- The parent is engaged and compliant with services.
- There is another parent or family member who can help.
- There is no other family conflict.
- The child has a good understanding of the parent’s condition.
- The child has wider support from extended family, friends, teachers, or other adults.
- The child has a secure base, a sense of belonging and security, good self-esteem, and an internal sense of worth and competence.
- The child has positive nursery, school and/or community experiences.
Working Together
The most effective response to children and families affected by mental ill health comes from all agencies adopting a whole-family approach. This is based on good communication and coordinating the support provided by adult and children's services to a whole family. The aim is to secure better outcomes for the children and adults through the use of targeted, specialised and whole-family approaches to address family needs.
Central to this approach is good collaborative working by using:
- Routine enquiry.
- Robust inter-agency communication and information sharing.
- Joint assessment of need.
- Joint planning.
- Action in partnership with the family.
Action
- Encourage the parent to seek support from their GP. The GP can help them access primary and secondary mental health services.
- Provide information about Talking Therapies who can help with stress, anxiety and depression and have online self-help resources about bereavement, low mood and sleeping problems.
Parents, Carers or Family Members with Mental Ill Health in the SCSP Child Protection and Safeguarding Procedure Manual
For further information relating to safeguarding children please consult Section 3.3.6 of the Sheffield Children Safeguarding Partnership Child Protection and Safeguarding Procedures Manual 3.3.6 Parents, Carers or Family Members with Mental Ill Health
Further Information
SHSC mental health services – further information and referral criteria for each Sheffield Health and Social Care (SHSC) service
The Think Child, Think Parent, Think Family guidance and toolkit developed by SCIE is particularly useful when working with parents and carers with mental health issues.
The Sheffield Mental Health Guide can help you identify services to support families where there are mental health issues. It provides information about mental health in Sheffield, from services to activities, and from conditions to support.
The Parents with a mental health problem: learning from case reviews summary by NSPCC has key issues and learning for improved practice around parental mental health and child welfare.