1.4.10 Children at Risk where a Parent has Mental Ill Health


Calderdale - Assessing Impact of Parental Mental Health on Children and Young People


This chapter was reviewed and updated throughout in December 2023. It should be re-read.

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 first assess the risk and then take appropriate steps in accordance with the identified risks such as interagency information sharing, consideration of an Early Help assessment or referral to Children’s Social Care. Agencies should also check to see if the child is subject to any multi-agency safeguarding or support plan e.g., Child Protection, Child in Need or Early Help - see Recording that a Child is the subject of a Child Protection Plan Procedure.

Children are at risk when:

  • Mothers have a severe mental illness or personality disorder;
  • Parents are expressing thoughts around harming their child;
  • There is a pregnancy, and the mother has a history of significant mental health problems;
  • There is mental ill health combined with domestic abuse;
  • History of substance misuse;
  • History of alcohol misuse;
  • A history of non-compliance and poor engagement with services;
  • Parents are unable to meet the day to day needs of their child.

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.

2. Implications of Parent/Carer Mental Health Difficulty


To determine how a parent/carer's mental ill health ay 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?
  • Is a young carers assessment required?
  • Does the parent/carer neglect their own and / or their child's physical and emotional needs?
  • Does the parental mental ill health result in chaotic structures within the home with regard to meals and bedtimes, etc.?
  • Does the parent/carer's mental ill health have implications for the child for example within school, or being taken to 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 needs and the 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 ill health?
  • Is the child included within any delusions of the parent/carer?
  • Does the parent/carer's mental ill health result in them rejecting or being unavailable to the child?
  • Does the child witness acts of violence or is the child subject to violence? Is the child exposed to domestic abuse within the home environment?
  • Does the wider family/support network understand the mental ill health 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/support network 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 ill health and the potential impact on the child?
  • How the family functions, including conflict, potential family break up etc.
  • Does the child have disabilities that would increase their vulnerability?
  • Does the child have care and support needs of their own that need to be addressed?
  • What support would enable a parent with enduring and complex mental health concerns fulfil their parenting role and the needs of the wider family?

3. Guidelines for Joint Working

4. It is essential that staff working in adult mental health and those providing services to children childcare work together within the application of safeguarding/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 to inform risk assessment with regard to:

  • Treatment plans;
  • Likely duration of any mental ill health;
  • Effects of any mental ill health and medication on the carer's general functioning and parenting ability.
6. 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;
  • Multi-Agency safeguarding and/or Support Plan meetings;
  • Child in Need Meetings;
  • Early Help Meetings.
8. Mental Health services convene Care Programme Approach (CPA) and other meetings related to the management of the parent's mental health. Childcare professionals should be invited to and attend these meetings.
9. All plans for a child including Child Protection Plans and other multi-agency plans will identify the roles and responsibilities of mental health professionals 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


Childcare 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.
11. Professionals need to carefully consider the implications for children when closing their involvement with parents with a mental ill, health Consideration should be given to informing the appropriate Children's Social Care Services team in order that the implications for the child are assessed.