Children of Patients Undergoing Psychiatric Treatment: An Investigation of Statutory Support Services After Referrals to Child Protection Services

Abstract

Aims: Preventive interventions for children of parents with mental illness are widely recommended. Mental health services entrust concern for patients' children by referrals to child protection services. We investigated service coverage for children following referrals. Methods: Data from referrals regarding 376 children of adult psychiatry patients over 2008-2012 was linked to information from municipal records and Danish national registers. We conducted Cox regression and used Kaplan-Meier curves to show time to intervention and cumulative incidence of any child and family support services with oneyear follow-up from referral date. Results: At follow-up, 32% of children were provided with a child and family support service on average 73.4 days after referral. The most common services were family treatment (18%) and family counseling (11%). A statutory child assessment was conducted for 21% of children. Contents of the referrals suggested that 60% of children experienced adverse home environments and/or acute situations due to parents' psychiatric illness. Predictors of initiation of support services included a child living alone with the patient, hazard ratio 2.09 (1.41-3.08), the patient being the mother, hazard ratio 1.72 (1.11-2.65), and an adverse home environment presenting an acute situation specified in referral, hazard ratio 1.89 (1.01-3.51). Conclusion: Our finding that only one third of children receive support after referrals from psychiatry within an average of three months suggests an underserved population of atrisk children. These findings warrant reconsideration of resource allocation and creation of more efficient intervention strategies to protect at-risk children and prevent development of mental illness and adversity.

Haitalliset lapsuudenkokemukset ja lapsuusperheen sosioekonominen asema nuorten itsensä vahingoittamista ennustavina tekijöinä

“…Tulosten perus teella monet itseään vahingoittavat nuoret olisi mahdollista tavoittaa jo lapsuudessa, kun heidän vanhempansa hakeutuvat hoitoon esimerkiksi mielenterveyden häiriöiden tai päihteiden käytön vuoksi. Lasten hyvinvoinnin huomioiminen näis sä hoitokontakteissa voisi mahdollisesti ehkäis tä nuoruusiän itsensä vahingoittamista ja toisaal ta myös monia muita hyvinvointivajeita (55,56). Tutkimuksen tulosten perusteella myös vanhem pien hyvinvoinnin huomioiminen heidän lastensa vahingoitettua itseään on tarpeen, sillä vanhem mat kaipaavat usein lisätukea tällaisessa tilan teessa (57).…”

A study protocol for the randomized clinical trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness.

“…Intrinsic factors in the child may also predispose them to be more or less affected by parental mental illness, including temperament, gender, and cognitive and social skills (Reupert et al, 2013). They are less likely to graduate from primary school or achieve high grades (Ranning et al, 2018), have a higher cumulative morbidity and mortality rate (Ranning et al, 2019), and are to some extent overlooked by both the mental health services and social services of the municipality (Ranning et al, 2020).…”

A study protocol for the randomized controlled trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness

“…Intrinsic factors in the child may also predispose them to be more or less affected by parental mental illness, including temperament, gender and cognitive and social skills [ 13 ]. They are less likely to graduate from primary school or achieve high grades [ 14 ], have a higher cumulative morbidity and mortality rate [ 15 ] and are to some extent overlooked by both the mental health services and social services of the municipality [ 16 ].…”