Avoidable mortality among parents whose children were placed in care in Sweden: a population-based study

Wall‐Wieler, Elizabeth; Vinnerljung, Bo; Liu, Can; Roos, Leslie L.; Hjern, Anders

doi:10.1136/jech-2018-210672

Cited by 12 publications

(10 citation statements)

References 27 publications

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“…In this study, we did not attempt adjustment for other risk factors for premature death as we were limited to answering how mortality rates differed between our study cohort and matched controls rather than why they differed. Previous research into deaths among women whose children entered care in Manitoba, Canada and Sweden found that the association between entry into care and death remains after adjusting for other mortality risk factors [17,42,43]. These studies also used several control group methods including biological sisters and women whose children died.…”

Section: Findings In Contextmentioning

confidence: 99%

“…Population-based characterisation of maternal mental health need and service use among birth mothers is needed, yet suitable data are lacking [16]. In several settings, researchers have overcome this barrier by linking administrative child protection and health datasets [17][18][19][20][21]. Within the SAIL Databank, Griffiths et al used new linkages between Welsh family court data and health data on antenatal care, hospitalisations and general practitioner (GP) contacts, and found high prevalence of maternal mental health difficulties in the 2 years prior to childbirth [22].…”

Section: Introductionmentioning

confidence: 99%

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

Pearson

Grant²,

Wijlaars

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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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.

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Section: Findings In Contextmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Pearson

Grant²,

Wijlaars

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

View full text Add to dashboard Cite

show abstract

“…we matched on few variables and adjusted only for age), previous research into deaths among women whose children entered care in Manitoba, Canada and Sweden has shown that higher rates of death remain after adjusting for other mortality risk-factor and different control groups such as biological sisters or women whose children died. [14,47,48] Strengths and limitations This is one of the first UK studies to describe maternal mental health service use among women involved in care proceedings, focused on England. Though the SLaM population may vary in terms of population demographics and service availability from other parts of the UK -potentially affecting the generalisability of these findings -we found similarly high rates of mental health need among women in proceedings as were found in Wales.…”

Section: Findings In Contextmentioning

confidence: 99%

“…To provide evidence on parental health in the context of child protection, many high-income countries and regions have successfully established linkages between data collected by child protection systems and administrative health data sets. [14][15][16][17][18] In South Australia, for example, the state government has worked together with researchers and local Aboriginal and Torres Strait Islander communities to establish a state-wide linkage project -the South Australia Early Childhood Data Project. [19] As well as being used for research, this linkage has directly informed redesign of the South Australian Child and Family Health Service in response to calls to improve and widen its support for families to reduce the need for child protection intervention.…”

Section: Introductionmentioning

confidence: 99%

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

Pearson¹,

Grant²,

Wijlaars³

et al. 2021

Preprint

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Background Research in England suggests a high burden of mental health problems and substance misuse among women whose children enter care. Family courts therefore need to consider timely support for parental mental health and likely time to recovery within public family law proceedings concerning placement of a child into care (‘care proceedings’). We report population-based evidence from linked, routinely collected, de-identified records on the type and severity of maternal mental health problems in relation to care proceedings. Methods We linked family court data and mental health service records for 2137 (66%) of women involved in care proceedings between 2007-2019 in the South London and Maudsley NHS Mental Health Trust (SLaM) catchment area. We compared their 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 old. Results Most women (79%) were known to SLaM before care proceedings began. Compared to the matched controls, 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 be admitted to a SLaM inpatient unit (27% vs 14%) or to be sectioned under the Mental Health Act (19% vs 8%). Finally, women had a 2.15 (95% CI: 1.68 to 2.74) times greater hazard of dying, compared with the matched controls, adjusted for age. Conclusions Given the high prevalence and severity of mental health problems among women involved in care proceedings, family law and social care policy is needed to ensure adequate and timely treatment for parent mental health problems. The increased risk of dying among those accessing mental health services highlights the critical need for post-proceeding services to ensure parents whose children enter care continue to receive support after care proceedings conclude.

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“…6 In Canada and Sweden, national mortality data report that birth parents who have children removed are over three times more likely to die of a preventable cause compared to their biological siblings 16 or to other parents. 17 …”

Section: Introductionmentioning

confidence: 99%

‘On paper, you’re normal’: narratives of unseen health needs among women who have had children removed from their care

Grant

Powell

Philip

et al. 2023

Journal of Public Health

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Background Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare. Methods We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges. Results Three narrative subplots were developed to consolidate experiences of unmet health need: (i) ‘on paper you’re normal’: narratives of complex need, (ii) ‘in my family, everyone had issues’: narratives of whole family need and (iii) ‘I’m still mummy, no matter where they are’: narratives of maternal identity and health. Conclusions Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women’s narratives illustrate opportunities for health intervention, especially immediately following child removal.

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Avoidable mortality among parents whose children were placed in care in Sweden: a population-based study

Cited by 12 publications

References 27 publications

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

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

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

‘On paper, you’re normal’: narratives of unseen health needs among women who have had children removed from their care

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