1.4.10 Children at Risk where a Parent has a Mental Health Problem


Please also refer to Leeds Local Protocol: The Leeds Approach to Think Family, Work Family; Principles and Practice Guidance.

1. Introduction

1. The mental health of a parent or carer does not necessarily have an adverse impact on a child but it is essential to assess the implications for the child. If any agency has concerns that a child is at risk of harm because of the impact of the parent/carer's mental health they should check to see if the child is subject to a Child Protection Plan - see Recording that a Child is the subject of a Child Protection Plan Procedure.

Children are at greatest risk when:

  • The child features within parental delusions;
  • The child becomes the focus of the parent's aggression.

In these circumstances the child should be considered at immediate risk of harm and a referral made to Children's Social Care Services in accordance with the Referrals Procedure.

3. Where it is believed that a child of a parent with mental health problems may be at risk of significant harm, a Strategy Discussion/Meeting should be held and consideration should be given to undertaking a Section 47 Enquiry.
4. In circumstances whereby a parent/carer has mental health problems it is likely there are a number of professionals involved from different services. It is important that these professionals work together within enquiries and assessments to identify any links between the parent's mental health, their parenting, and the impact on the child. Any assessment should include an understanding of the needs of the family and children and an identification of the services required to meet these needs. 

2. Implications of Parent/Carer Mental Health Difficulty


To determine how a parent/carer's mental problem may impact on their parenting ability and the child's development the following questions need to be considered within an assessment:

  • Does the child take on roles and responsibilities within the home that are inappropriate?
  • Does the parent/carer neglect their own and their child's physical and emotional needs?
  • Does the mental health problem result in chaotic structures within the home with regard to meal and bedtimes, etc.?
  • Does the parent/carer's mental health have implications for the child within school, attending health appointments etc?
  • Is there a lack of the recognition of safety for the child?
  • Does the parent/carer have an appropriate understanding of their mental health problem and its impact on their parenting capacity and on their child?
  • Are there repeated incidents of hospitalisation for the parent/carer or other occasions of separation from the child?
  • Does the parent/carer misuse alcohol or other substances?
  • Does the parent/carer feel the child is responsible in some way for their mental health problem?
  • Is the child included within any delusions of the parent/carer?
  • Does the parent/carer's mental health problem result in them rejecting or being unavailable to the child?
  • Does the child witness acts of violence or is the child subject to violence?
  • Does the wider family understand the mental health problem of the parent/carer, and the impact of this on the parent/carer's ability to meet the child's needs?
  • Is the wider family able and willing to support the parent so that the child's needs are met?
  • Does culture, ethnicity, religion or any other factor relating to the family have implications on their understanding of mental health problems and the potential impact on the child?
  • How the family functions, including conflict, potential family break up etc.

3. Guidelines for Joint Working

6. It is essential that staff working in adult mental health and child care work together within the application of child protection procedures to ensure the safety of the child and management of the adult's mental health.

Joint work will include mental health workers providing all information with regard to:

  • Treatment plans;
  • Likely duration of any mental health problem;
  • Effects of any mental health problem and medication on the carer's general functioning and parenting ability.
8. Child protection workers must assess the individual needs of each child and within this incorporate information provided by mental health workers.

Mental health professionals must attend and provide information to any meeting concerning the implications of the parent/carer's mental health difficulty on the child. These will include:

  • Strategy Meetings;
  • Initial and Review Child Protection Conferences;
  • Core Groups.
10. Child care professionals must attend Care Programme Approach (CPA) and other meetings related to the management of the parent's mental health.
11. All plans for a child including Child Protection Plans will identify the roles and responsibilities of mental health and other professionals. The plan will also identify the process of communication and liaison between professionals. All professionals should work in accordance with their own agency procedures/ guidelines and seek advice and guidance from line management when necessary.

4. Contingency Planning


Child care and mental health professionals should always consider the future management of a change in circumstances for a parent/carer and the child and how concerns will be identified and communicated. This may include:

  • Relapse in the parent/carer's mental health;
  • Failure to maintain medication;
  • Change in family dynamics/relationships.
13. Professionals need to consider carefully the implications for children when closing their involvement with parents with a mental health problem. Consideration should be given to informing the appropriate Children's Social Care Services team in order that the implications for the child are assessed.