Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

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IntroductionMaternal mental health problems and substance misuse are key risk factors for child neglect or abuse and court-mandated placement into care. Linkage between mental health records and family court data could raise awareness about parent mental health needs and inform approaches to address them. ObjectivesTo evaluate data linkage between administrative family court data and electronic mental health records for a population-based mental health service for 1.3 million people in South London. MethodsWe deterministically linked administrative family court data for women (n=5463) involved in care proceedings in South London with service user records from the South London and Maudsley NHS Mental Health Trust (SLaM). We restricted the cohort to women involved in proceedings between 2007 and 2019, in local authorities where SLaM solely provides secondary/tertiary mental health services and the Improving Access to Psychological Therapies (IAPT) (n=3226). We analysed the associations between match status and sociodemographic/case characteristics using multivariable logistic regression. ResultsTwo-thirds (2317/3226; 66%) of women linked to a SLaM service user record at some point; most (91%) who linked accessed secondary/tertiary mental health services, indicating serious mental illness. Accounting for possible missed matches, we estimated that 70-83% of women accessed SLaM services at some point. Older women at index proceedings (>35yrs OR: 0.69, 95%CI: 0.54-0.88vs<25yrs) and Black women or women from other ethnic groups (Black ethnic groups 0.65, 0.50-0.83; other ethnicity 0.59, 0.43-0.81 vs White ethnic groups) had lower odds of linking. Odds of linking were higher for women with an infant in proceedings (1.42, 1.18-1.71), or with curtailed/terminated parental responsibility (1.44, 1.20-1.73). ConclusionsOur linkage supports growing evidence of a high burden of mental health problems and substance misuse among women whose children enter care in England, compared to the general population. Research using this linkage should inform strategies to address the considerable mental health needs of vulnerable women and their children.

BackgroundIn conflict-affected settings, women and girls are vulnerable to gender-based violence (GBV). GBV is associated with poor long-term mental health such as anxiety, depression and post-traumatic stress disorder (PTSD). Understanding the interaction between current violence and past conflict-related violence with ongoing mental health is essential for improving mental health service provision in refugee camps.MethodsUsing data collected from 209 women attending GBV case management centres in the Dadaab refugee camps, Kenya, we grouped women by recent experience of GBV using latent class analysis and modelled the relationship between the groups and symptomatic scores for anxiety, depression and PTSD using linear regression.ResultsWomen with past-year experience of intimate partner violence alone may have a higher risk of depression than women with past-year experience of non-partner violence alone (Coef. 1.68, 95% CI 0.25 to 3.11). Conflict-related violence was an important risk factor for poor mental health among women who accessed GBV services, despite time since occurrence (average time in camp was 11.5 years) and even for those with a past-year experience of GBV (Anxiety: 3.48, 1.85–5.10; Depression: 2.26, 0.51–4.02; PTSD: 6.83, 4.21–9.44).ConclusionRefugee women who experienced past-year intimate partner violence or conflict-related violence may be at increased risk of depression, anxiety or PTSD. Service providers should be aware that compared to the general refugee population, women who have experienced violence may require additional psychological support and recognise the enduring impact of violence that occurred before, during and after periods of conflict and tailor outreach and treatment services accordingly.

Introduction In England, in cases of child maltreatment or neglect, the state can intervene through the family court to remove them from their family home and place them in out-of-home care. The Children and Family Court Advisory and Support Service (Cafcass) collect and maintain administrative records of all public family law cases in England. While these records are primarily used to monitor and manage the case load of Cafcass teams across England, researchers have re-purposed this data for analysis to understand the drivers and outcomes of public family law intervention. Data contents The administrative dataset is a reflection of the cases Cafcass get involved with and the extent of their involvement. There are three main types of unit within the data: applicants (English local authorities), subjects (children) and parties (those with parental responsibility, typically biological mothers and fathers). As such, the data collected comprises information at the person-level (e.g. demographics of the children and adults), and information at the case-level (e.g. types of applications made, hearing dates and final legal outputs). Between 1 April 2007 and 31 March 2019, Cafcass have captured information on approximately172,100 public family law cases, involving 282,300 children, and 249,500 adults (of which 289,300 are recorded as biological parents). They record relations between adults and children making it possible to identify families. Additionally, Cafcass recording practices have improved over time, this has increased the availability of demographic information of all those involved, as well as child’s final legal outcome. Data access Researchers can apply to the Secure Anonymised Information Linkage Databank (SAIL) for access to the Cafcass pseudonymised administrative data extract, where it is refreshed bi-annually.