The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis

Abstract

Background Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. Method Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. Results Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies ( n = 4871) was 26.0% (95% CI 20.0–32.0%) for mothers, and estimate based on three studies ( n = 2606) was 13.0% (95% CI 7.0%–18.0%) for fathers and 23.0% (95% CI 17.0–29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents’ PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. Conclusion There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.

A population level study into health vulnerabilities of mothers and fathers involved in public law care proceedings in Wales, UK between 2011 and 2019

“…Uniquely, this study examined both mothers and fathers interaction with healthcare services prior to court proceedings. However, there is an important body of related international research on the mental health needs and co-morbid substance use, for parents involved with child welfare services [32][33][34][35][36][37], and children in care [38][39][40]. Although the research we report is specific to parents who are involved in formal family court proceedings, our findings are consistent with the broader published research in reporting elevated rates of mental health need often co-occurring with substance use.…”

A focus on fathers with intellectual disabilities and child protection

“…The tendency described in Point 4 is confirmed in the literature, but the state of research on this subject is limited. Mayes and Llewellyn (2009) stated that the loss of a child, regardless of the circumstances, can lead to long‐term mental health effects, as confirmed by studies on fathers (Dugdale & Symonds, 2017), parents with intellectual disabilities (Booth & Booth, 2005), and parents without disabilities (Suomi et al, 2023).…”

Preliminary support for the use of narrative exposure therapy in a child protection context: Collective case‐study narratives

“…It has been reported that there are disproportionately high rates of birthparents involved in statutory child protection services that suffer from mental health problems, specifically trauma histories of abuse and neglect (Escobar‐Chew et al, 2015). Research suggests that many parents involved in child protection services are affected by PTSD, specifically C‐PTSD, with presentations of multiple, childhood and interpersonal trauma (Karatzias et al, 2017; Suomi et al, 2021). In addition, the removal of a child by statutory authorities has been identified as a significant trauma equivalent to that of experiencing the death of a child (Askren & Bloom, 1999; Masson & Dickens, 2015).…”

“…There is evidence that suggests that parents who are survivors of abuse and suffer from PTSD have an increased likelihood of abusing their own child (Banyard et al, 2008; Famularo et al, 1994; Fredman et al, 2019). Through their meta‐analysis, Suomi, Bolton & Pasalich (2021, p. 9) detailed that within child protection populations, the prevalence of PTSD among birthparents was 26% for mothers, 13% for fathers and 23% for all parents.…”