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It is accepted as good practice that if working with a parent with mental health problems, the safety and care of the parent's children should be assessed, writes Dorit Braun.

Monday 10 April 2000 00:00

It is accepted as good practice that if working with a parent with mental health problems, the safety and care of the parent's children should be assessed, writes Dorit Braun.

In this case, however, the mental health difficulties of Louise Jones were not properly diagnosed. The contract with NCH Action for Children, while recognising the importance of a non-statutory service for this family, tied the staff into accepting her challenging and risky behaviour without further assessment of her needs.

Looking at this case from the outside, it is noteworthy that NCH Action for Children staff saw that Louise behaved in a childlike manner. If a child or adolescent shows very angry and abusive behaviour, workers might be expected to consider whether the behaviour is a way of seeking help. In this case, the contract with social services made it difficult to step outside the boundaries of agreed work, to ask what was really going on for the parent. Moreover, as Louise had refused a full mental health assessment in the past, it would not have been easy to insist on this.

Social workers, whether working for a statutory or voluntary agency, need support and supervision to enable them to stand back from the client, to look for new explanations for their behaviours, and options for the family. Without this, there is a danger that the social worker becomes as stuck as the parent.

Social workers also need access to support and information from other disciplines to gain insights and understanding about ways of working with particular issues.

Part of the difficulty is an ambiguity about whether the child or their parent is the client. And yet, children love their parents, and need their parents' needs to be met as well as their own.

Given the ongoing potential risk to the children if Louise stops taking medication, there does seem a need for a multi-disciplinary approach to continued work with this family, which takes account of the mental health needs of Louise, and the welfare of her children.

Dorit Braun is chief executive, Parentlineplus

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