Children of parents who have been hospitalised with psychiatric disorders are at risk of poor school readiness

Bell, Megan F.; Bayliss, Donna M.; Glauert, Rebecca; Harrison, Amanda; Ohan, Jeneva L.

doi:10.1017/s2045796018000148

Cited by 22 publications

(24 citation statements)

References 74 publications

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“…Our results also support previous evidence showing that having a history of admissions for mental health or behavioural conditions or adversity is an important potential risk indicator for poor infant outcomes that should be considered when supporting individual women in clinical practice. 18 A UK study using primary care records showed that a majority of mothers registered with a general practice had received mental health treatment or diagnosis between the birth of their child and the child's 16th birthday. 37 Parental mental health is strongly linked to child and adolescent mental health and mortality in early adulthood.…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 10 , 11 , 12 , 13 , 14 , 15 , 16 Routine hospital records can be used to identify psychosocial risk factors and their influence on child outcomes. 11 , 17 , 18 , 19 However, most previous studies focused on single risk factors, and there is a gap in the evidence on which of these risk factors—when considered together—are associated with the highest risk. There is an absence of studies using routine records to explore multiple psychosocial risk factors across maternal age groups, before and during early pregnancy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between pre-pregnancy psychosocial risk factors and infant outcomes: a population-based cohort study in England

Harron

Gilbert

Fagg

et al. 2021

The Lancet Public Health

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Summary Background Existing studies evaluating the association between maternal risk factors and specific infant outcomes such as birthweight, injury admissions, and mortality have mostly focused on single risk factors. We aimed to identify routinely recorded psychosocial characteristics of pregnant women most at risk of adverse infant outcomes to inform targeting of early intervention. Methods We created a cohort using administrative hospital data (Hospital Episode Statistics) for all births to mothers aged 15–44 years in England, UK, who gave birth on or after April 1, 2010, and who were discharged before or on March 31, 2015. We used generalised linear models to evaluate associations between psychosocial risk factors recorded in hospital records in the 2 years before the 20th week of pregnancy (ie, teenage motherhood, deprivation, pre-pregnancy hospital admissions for mental health or behavioural conditions, and pre-pregnancy hospital admissions for adversity, including drug or alcohol abuse, violence, and self-harm) and infant outcomes (ie, birthweight, unplanned admission for injury, or death from any cause, within 12 months from postnatal discharge). Findings Of 2 520 501 births initially assessed, 2 137 103 were eligible and were included in the birth outcome analysis. Among the eligible births, 93 279 (4·4%) were births to teenage mothers (age <20 years), 168 186 (7·9%) were births to previous teenage mothers, 51 312 (2·4%) were births to mothers who had a history of hospital admissions for mental health or behavioural conditions, 58 107 (2·7%) were births to mothers who had a history of hospital admissions for adversity, and 580 631 (27·2%) were births to mothers living in areas of high deprivation. 1 377 706 (64·5%) of births were to mothers with none of the above risk factors. Infants born to mothers with any of these risk factors had poorer outcomes than those born to mothers without these risk factors. Those born to mothers with a history of mental health or behavioural conditions were 124 g lighter (95% CI 114–134 g) than those born to mothers without these conditions. For teenage mothers compared with older mothers, 3·6% (95% CI 3·3–3·9%) more infants had an unplanned admission for injury, and there were 10·2 (95% CI 7·5–12·9) more deaths per 10 000 infants. Interpretation Health-care services should respond proactively to pre-pregnancy psychosocial risk factors. Our study demonstrates a need for effective interventions before, during, and after pregnancy to reduce the downstream burden on health services and prevent long-term adverse effects for children. Funding Wellcome Trust.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between pre-pregnancy psychosocial risk factors and infant outcomes: a population-based cohort study in England

Harron

Gilbert

Fagg

et al. 2021

The Lancet Public Health

View full text Add to dashboard Cite

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“…Compared to other children, those growing up with a parent with a mental illness are at risk of a range of adverse behavioural, developmental and emotional outcomes (1–3). Bell et al (4) found that children of parents who had been hospitalized for a mental illness were much less likely to be school ready. Difficulties with schooling have also been shown in Sweden where Hjern et al highlighted that twice as many children whose parents had been hospitalised for a mental illness had lower school results and were not able to start secondary education, compared to children without parental mental illness (5).…”

Section: Introductionmentioning

confidence: 99%

Adult Mental Health Outpatients Who Have Minor Children: Prevalence of Parents, Referrals of Their Children, and Patient Characteristics

et al. 2019

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Background: A strong connection exists between parental mental illness and lifetime mental health risk for their children. Thus, it is important to determine, when parents attend for treatment for their illness, the prevalence and characteristics of parents with a mental illness and identify referral actions for their children. Previous studies indicate that 12–45% of adult mental health service patients are parents with minor children. There is a need for studies with larger sample sizes that investigate the prevalence and characteristics of parents, and factors associated with referral actions for their children. Method: Data on 23,167 outpatients was drawn from a national census study across 107 Norwegian adult mental health outpatient clinics during 2 weeks in April 2013. Clinicians identified various socio-demographic characteristics of patients who were parents and referral actions for their children. Results: Eight thousand thirty-five (36%) of outpatients had children under 18 years. Thirty-one percent were provided with referrals for their children and 58% were reported to have children with no need for referral. Three percent were reported to have children with unmet needs who were not referred. There were missing data on children's needs and referral actions for 8% of parents. Patients who care for minor children were more likely to be refugees, and less likely to be single, male, not own a house/apartment, and have a schizophrenia spectrum illness or substance use disorder. Children were more likely to be referred when their parent was single, with no income from paid work, low education, not owning house/apartment, poor family network, long outpatient treatment, and an individual care plan; and less likely for men with a moderate or less severe mental illness. Children were referred to child protection agencies, child and adolescent mental health services and school psychological/pedagogic services. Discussion: The prevalence of outpatients with children is similar to other studies. Referrals were made for children of one third of outpatients with minor children. Needs and referrals of children was unknown for one in ten outpatients. Mental health outpatient clinics must improve procedures to identify parenting status and ascertain and act on children's needs.

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“…This included scholastic/language and particularly school attendance. Other research supports this finding with Bell et al (2018) recently highlighting the poor school readiness of children starting primary school when their parents had been hospitalized for a psychiatric condition, compared to their age-typical peers. A Swedish study by Hjern et al (2017) revealed that double the number of children whose parents had been hospitalized for a mental illness showed lower results at school and were unable to commence secondary education, compared to children without parental mental illness.…”

Section: Discussionmentioning

confidence: 61%

Impact of parental mental illness on children's HoNOSCA results in a regional child and adolescent mental health service

Naughton

Maybery

Sutton

et al. 2019

Int J Mental Health Nurs

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Use of routine outcome measures are frequently used to ascertain improvement in children's symptomology, this study examined whether living with a parent with a mental illness impacted outcome measures. The study examined 134 children attending a Child and Adolescent Mental Health Service (CAMHS). The majority lived with a parent reporting mental illness. Routine HoNOSCA and CGAS outcome measures were collected over a 6‐month period. Children of parents with a mental illness scored higher on most outcome measures. All children improved on most variables over the 6 months of CAMHS intervention with children of parents with mental illness showing greater improvement compared to other children on behaviour but less improvement on all other variables. They did not, however, improve as much on education‐related factors and showed lower improvement in overall functioning. Younger children with a parent with a mental illness improved least in the area of behaviour. This study highlighted the need for greater use and integration of measures where children live with a parent who has a mental illness. Findings suggest parental mental illness impacted on overall child outcomes, and this influence remained irrespective of clinical intervention. The common occurrence of parental mental illness, where children also have a mental illness, indicates focusing on a wider set of outcome measures for more effective intervention. Analysis of a larger cohort sample is warranted.

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Children of parents who have been hospitalised with psychiatric disorders are at risk of poor school readiness

Cited by 22 publications

References 74 publications

Associations between pre-pregnancy psychosocial risk factors and infant outcomes: a population-based cohort study in England

Associations between pre-pregnancy psychosocial risk factors and infant outcomes: a population-based cohort study in England

Adult Mental Health Outpatients Who Have Minor Children: Prevalence of Parents, Referrals of Their Children, and Patient Characteristics

Impact of parental mental illness on children's HoNOSCA results in a regional child and adolescent mental health service

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