6.10 Mental Ill Health of a Parent of Carer

RELEVANT GUIDANCE

Mental Ill health Crisis Care Concordat: Improving outcomes for people experiencing mental health crisis

AMENDMENT

This chapter was revised throughout in December 2023.

1.	Mental illness in a parent or carer does not necessarily have an adverse impact on a child, such judgements would be discriminatory. It is however essential always to assess the presentation and behaviours of the adult and potential or actual implications for any children involved in the family;
2.	Parental mental illness can have an impact on children in a number of ways including: Restriction of social and recreational activities for children; Children taking caring responsibilities for adults or other children inappropriate to their age; Neglect of a child's physical or emotional needs; Forms of mental illness may blunt parents' emotions and feelings or cause them to behave towards their children in bizarre or unpredictable violent ways; in extreme circumstances this may place a child at risk of severe injury, profound neglect, or even death; Post natal depression can be linked to behavioural and physiological problems in the infants of such mothers; Where the parent has to be hospitalised, children can find this difficult to understand why it has happened, have difficulty coping with separation and older children may feel the stigma of their parent being a patient on an acute Mental Health ward. Statistics: Parental/Carer mental ill health is a factor in a third of child safeguarding practice reviews/serious case reviews (LPR’s); Children whose parents/carers suffer from mental illness are considered as a key vulnerable group (Children Act 2004), but they are also a group most likely to be excluded from health and social care provision; (The children act, 2004); Approximately two-thirds of children whose parent/carers have mental health problems will experience mental health difficulties themselves; Nearly a third of young carers are estimated to be caring for a parent with a mental health problem and are the group least likely to be offered a carers’ assessment; Parental mental ill health that is not managed can lead to an inability to look after the child’s physical and emotional needs (NSPCC 2021). Parental mental ill health can occur alongside or be directly impacted by other adverse life experiences: Financial difficulties; Disability; Trauma; Domestic abuse; Substance and alcohol misuse.
3.	The adverse effects on children of parental mental illness are less likely when the illness is mild, lasts only a short time, is not associated with family disharmony, and does not result in the family breaking up;
4.	Children may also be protected when the other parent or another family member can respond to the child's needs;
5.	Children most at risk of abuse or neglect where mental illness of a parent or carer is a feature of family life are those who feature within parental delusions, those who become targets for parental aggression or rejection, and those who are neglected as result of parental mental illness;
6.	Although there are no specific procedures for working with children who are suffering or are likely to suffer Significant Harm where the mental ill health of a parent or carer is a feature of family life, it is important that all professionals and agencies involved co-operate as closely as possible with communication between agencies paramount in ensuring the safety of both children and parents alike. Identifying and communicating at an early stage any concerns any professionals have regarding the impact on the child of the parent's Mental Health will ensure appropriate support is provided at a very early stage thus minimising the impact, if any, on the child;
7.	Some professionals involved with such families will be working primarily with an adult member of the family. However, they should not lose sight of their joint responsibility to safeguard the interests of any child in the family, and any such professional should be invited to and take part in discussions, meetings and conferences concerning the welfare or protection of the child, as arranged. Attendance at safeguarding training for such staff above should be made available;
8.	Those professionals involved in treating or providing therapeutic services to adults with mental ill health, who are also parents or carers, should seek support and supervision from the Trust’s Safeguarding Duty Hub who can advise around referring the child to Children's Social Care if there are any concerns about the care or welfare of the child - see Knowsley MASH (Multi-Agency Referral Form). This may include a child who is a Child in Need, a child who is vulnerable or a child who is at risk of suffering Significant Harm.