Care proceedings and mental health
Francesca Massarella calls for a change in the way poor mental health is perceived and approached, particularly before the point of care proceedings being issued.
A large proportion of parents or carers involved in family law proceedings of any description suffer from poor mental health.
This may either be the catalyst for the issue of proceedings, a contributing factor to the same or a consequence of the proceedings themselves. In any scenario, there needs to be acknowledgement by all those working in the sphere of children’s safeguarding that poor mental health is an issue that needs to be handled sensitively and effectively.
The Numbers
According to the Ministry of Justice’s Family Court Statistics in the quarter of July to September 2024, there were 4,073 public law cases issued which was a 3% increase compared to the equivalent quarter in 2023. [1]
According to the mental health charity, ‘Mind’, 1 in 4 people in England will experience some sort of mental health problem each year and 1 in 6 will experience a common mental health problem such as anxiety or depression, in any given week. It must follow then that a proportion of these people will be parents, and a further proportion will be parents who have social care involvement with their family. [2]
A study was completed in September 2024 by University College London and Great Ormond Street Institute of Child Health of social and health characteristics of mothers involved in family court care proceedings in England. Part of this involved studying mothers involved in care proceedings and other women using mental health services in four local authorities in south London. [3] The aims were to:
- Create a research database that linked records of mothers involved in care proceedings in south London to mental health service data and assess linkage accuracy.
- Compare the characteristics of mental health service use among mothers involved in care proceedings and other women using mental health services.
- Compare the risk of death among mothers involved in care proceedings with other women using mental health services.
- Evaluate patterns of mental health service use before and after start of care proceedings.
The key findings of this part of the study were as follows:
- Out of the 3,226 mothers involved in care proceedings that were studied, 66.2% of these mothers were linked to a mental health service record, meaning they had been referred to or attended a mental health service.
- 2% of mothers involved in care proceedings studied had a diagnosis of mental illness requiring secondary or tertiary mental health services.
- 34% of mothers involved in care proceedings studied had two or more diagnoses.
- 1% of mothers involved in care proceedings had substance use problems.
- Despite the high prevalence of serious mental illness, mothers involved in care proceedings studied were more likely than other users to have referrals rejected and to be discharged for failure to engage.
- Service contacts increased before care proceedings for 34.1% of mothers involved in care proceedings studied but declined steeply after proceedings started in 25.6% of those studied.
Two of the key conclusions of this study were that there needs to be a) improved access and continuity of mental health services for vulnerable mothers and b) joint working between social care, family courts and mental health services for mothers before, during and after care proceedings.
Many parents who are subject to care proceedings or other levels of local authority involvement in their lives have experienced adverse childhood experiences (‘ACES’) of their own. This contributes to their own ability to parent and/or can cause parents to be vulnerable to addiction and involvement in problematic adult relationships. All of this can be compounded when involvement of social care begins, especially when this escalates to care proceedings, which can be incredibly stressful for anyone involved.
A parent who struggles with addiction to substances or alcohol may be using such substances as a crutch or form of self-medication for their mental health struggles. Conversely, the longstanding use of alcohol or substances may have given rise to mental health issues themselves. For example, some individuals who misuse cannabis or cannabinoids to excess over time can experience drug-induced psychosis. Alternatively, the use of such substances could have exposed the individual to becoming involved in criminality or unhealthy relationships which centre around mutual substance misuse.
A parent who struggles with forming healthy relationships and is the victim of or perpetrates domestic abuse, may do so because of an undiagnosed mental health condition. Again, contrarily, those who perpetrate or are the victims of domestic abuse, may develop mental health issues because of the trauma they have suffered or inflicted.
According to the UK Adult Substance Misuse Treatment Statistics 2022/2023 of the 137,749 adults who were admitted to a drug and alcohol rehabilitation facility to overcome substance addiction, 71% required mental health treatment in addition to their substance addiction treatment. [4] According to the National Centre for Domestic Violence, it is estimated that every day almost 30 women attempt suicide because of experiencing domestic abuse and every week 3 women take their own lives. [5]
This is the lens through which all social care involvement and/or care proceedings needs to be viewed. Poor mental health is the epidemic which courses through the veins of the issues which cause children to require state intervention. Whilst this is at various degrees, there is more likely than not always going to be a need for parents and/or carers to have some kind of mental health support at some stage of this intervention.
Francesca Massarella is a family and public law barrister at Spire Barristers.
[1] Ministry of Justice, December 2024
[2] https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-facts-and-statistics/#References
[3] Georgina Ireland et al, September 2024
[4] Office for Health Improvement & Disparities, December 2023
