Conference paper
ASSESSING PARENTING CAPACITY IN PSYCHIATRIC MOTHER AND BABY UNITS: A CASE REPORT AND REVIEW OF LITERATURE
Julie Hammond
; King’s College London, School of Medicine, London, UK
Maurice Lipsedge
; South London and Maudsley NHS Foundation Trust, London, UK
Abstract
Aims and hypothesis: This review aimed to improve infant risk assessments in the context of maternal mental illness by
identifying key predictors of poor parenting outcomes.
Background: Inadequate parenting as a result of severe and persistent mental illness is a common reason for courts terminating
parental rights. However, the current practice of parenting capacity assessments in the setting of perinatal psychiatry is fraught with
risks and uncertainty. A well-recognised flaw in the assessment process is the lack of valid and reliable tools that have been
specifically validated for assessing parenting capacity in mothers with a history of mental illness and the potential risk of harm to
their infant. To date, there is only one instrument available.
Methods: A systematic search of Medline, PsycInfo and Embase via the Ovid interface was conducted between September and
December 2014. Citation snowball sampling was also used to identify further relevant studies. An additional search was performed
in Google to access grey literature.
Results: A total of 38 citations were identified, of which 8 publications focusing on the populations of England, France and
Belgium met the eligibility criteria of this review. Evidence from existing research suggests that poor parenting outcomes in maternal
psychiatric illness are strongly associated with correlates of socio-economic inequalities. However, evidence regarding the longterm
implications of such factors is weak as only one follow up study and no longitudinal studies were identified in this review.
Conclusion: Our review suggests that the use of standardised empirically validated risk assessment tools would benefit the
current practice of parenting assessments by improving the process by which collected information is analysed. This would enhance
the accuracy of decision-making, and improve the safeguarding of the infant. Further research is needed on medium to long-term
parenting outcomes, particularly regarding its relations to: the type of maternal psychiatric disorder; the quality of maternal
relationships; previous attachment experience; psychiatric illness or behavioural disorder in the partner and neonatal/infant medical
complications. This would more accurately reflect the dynamic nature of parenting and would help to determine the effectiveness of
specific interventions addressing risk factors associated with poor parenting outcomes.
Keywords
parenting capacity assessment; mother baby unit; mental illness; psychiatric diagnosis; psychotic disorder; parenting outcome; social service intervention; separation at discharge
Hrčak ID:
264457
URI
Publication date:
8.9.2015.
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