Authors
Rachel Jane Beck Pearson
Publication date
2021/12/28
Pages
1-293
Institution
UCL (University College London)
Description
Background Maternal mental health problems and substance misuse are key risk factors for child maltreatment and are common among children entering care in England. Better evidence about the health needs of women whose children enter care is needed to inform prevention and service responses across the family courts, children’s social care and healthcare. Methods I used area-level and person-level linked administrative data from health, children’s social care and family justice in England. First, I performed an ecological analysis of the association between maternal health before birth and infant entry into care using national data. Next, I used linked mental health and substance use service use and family court data for 3226 women in court proceedings concerning their child(ren)s entry into care in the South London and Maudsley NHS Foundation Trust catchment. I generated evidence on the type, severity and timing of health problems and identified predictors for returning to court with a new child. Results Parts of England with higher prevalence of maternal history of mental health, substance misuse or violence-related hospital admission among births had higher rates of infant entry into care, adjusting for potential confounders. Among women in proceedings in the SLaM catchment, 66% (of 3226) linked to a SLaM patient record and 54% were known to SLaM before their first recorded set of proceedings. Women who linked had high rates of schizophrenia spectrum disorders, personality disorders and substance misuse, compared to other female SLaM patients. They also had two-fold higher expected mortality rates, adjusted for age, and …
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