News

Patrick Ayre reports on a comparative study of European child protection procedures where parents have mental illness.

In the UK, we face pressing problems where mental health and child protection meet. The absence of shared understandings, agendas and priorities often seems to undermine the effectiveness and coherence of the service that we offer to families where parental mental health is a problem. The Department of Health has helpfully recognised the challenges that confront us by supporting the development of an important new training pack.¹

Further insight is offered by a recent multi-national study examining co-operation between services for community mental health and child protection in 11 states across Europe. In this project, the same brief case study was considered by groups of specialist practitioners in each country, who were asked to explain what they thought would happen and what they would expect of the supportive services involved. From an examination of their responses, there emerged a set of common factors which, when they were present, made a good outcome more likely. These, the researchers suggest, provide a European model of good practice.

The first of these key factors was communication and co-operation. At all stages, the quality of communication was felt to be crucial. The presence of regular informal contact was often regarded as more important to the development of a shared understanding than was the existence of intricately wrought formal channels of communication. It was felt that "formal meetings, such as case conferences, did not provide a good opportunity for building collaboration because they were reactive, crisis-driven and case-specific".

Unsurprisingly, the availability of resources was the second key factor in successful collaboration. The most important single resource was professional time. The British participants said family support workers, the least qualified member of the children and families team, would be able to offer only very limited continuing assistance to the case described by the researchers. Elsewhere, workers in some countries, such as Germany and Sweden, said they would deploy intensive family support teams staffed by fully qualified social workers .

An appropriate response was promoted where participants shared knowledge about mental health, child welfare and the services available. The difference between the assessments made by mental health teams and by child welfare teams proved far greater in the UK than elsewhere.

A strong network of universal and targeted services available to support families represents the final element in the model of good practice. Universal services, such as schools, GPs or maternal and child health services, are often the first to become aware that a child has a mentally ill parent. Their response is often vital. Throughout Europe, these are complemented by specialist services targeted at situations where the need is more pressing.²

Reading comparative research can be a little like unexpectedly catching sight of yourself in a mirror or a CCTV monitor. You see yourself afresh and do not necessarily like what you see. As we strive to improve services for children who have a mentally ill parent, this study gives us a timely opportunity to reconsider the adequacy of what we have to offer.

- R Hetherington and K Baistow, "Supporting Families with a Mentally Ill Parent: European Perspectives on Interagency Co-operation", Child Abuse Review, 10, 2001

Patrick Ayre is senior lecturer, department of applied social studies, University of Luton.

References

¹A Falkov (ed), Crossing Bridges: Training Resources for Working with Mentally Ill Parents and their Children, Department of Health, 2001

² R Hetherington, K Baistow, I Katz, J Mesie, and J Trowell, Welfare of Children with Mentally Ill Parents: Learning from Inter-Country Comparisons, Wiley, 2001