Experiences of child welfare social workers in addressing substance use among maltreated young mothers to prevent child maltreatment

Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well-being. Mothers who have experienced child maltreatment are more likely to use substances than mothers without a history of maltreatment. This study explores how child welfare social workers experience supporting young, maltreated mothers struggling with substance use to prevent the intergenerational transmission of child maltreatment. Semi-structured in-depth interviews were conducted with four social workers working with young mothers with a history of maltreatment and substance use. Interpretative Phenomenological Analysis revealed two themes: (1) grappling with system challenges and (2) supporting strategies for disrupting intergenerational transmission of child maltreatment. The results highlight the need for systemic changes around support for social workers who work with young mothers who use substances and have a history of maltreatment, and substance use treatment and mental health programs themselves. Mothers need access to prenatal programs that are trauma-informed, non-judgemental and that support participants' basic needs and parenting skills.     

A preliminary review of the parenting assessment and skill development service: A 10-day residential service for families at risk of child maltreatment

Tweddle's Parenting Assessment and Skill Development Service (PASDS) is a 10-day residential programme for families at risk of child maltreatment. The service aims to conduct a comprehensive parenting capacity assessment to inform case management and improve parenting practices. The aims of the study were to (1) describe the psychosocial functioning of parents taking part in PASDS, (2) describe the key parenting assessment outcomes, and (3) explore parents' experiences of participation in PASDS including (a) perceived barriers and enablers of participation and (b) perceived outcomes for their family. Participants were 18 parents who participated in Tweddle's PASDS in Melbourne, Australia. A mixed methods study comprising a case file review and qualitative interviews was conducted. Parents accessing PASDS had experienced adverse childhood events, and many were experiencing mental health difficulties. Interviews with parents revealed perceived benefits of PASDS in improving parenting knowledge and skills, family relationships, and parenting confidence. At the time of discharge, 33% of families were assessed as unable to provide independent care for their child. The current findings have important implications for the further evaluation of evidenced-based services which can improve the accuracy of parenting capacity assessments, aiding in child protection decision-making related to child placement and safety.     

Worries and problems of young carers: issues for mental health

This paper reports on a research study which explored the worries and problems of young carers in Edinburgh. Sixty‐one young carers took part in the study, conducted between April and June 2002. Findings indicate that young carers identify significant worries and problems in relation to their well‐being, and that these come over and above any ‘normal’ adolescent difficulties. It is suggested that these findings may have important implications for young carers’ mental health, now and in the future, and contain important lessons for child and family social work in general.     

‘Not a good person’: family stigma of mental illness from the perspectives of young siblings

The purpose of this paper is to critically examine family stigma as one form of the stigma of mental illness in child and youth mental health. Presented are the outcomes of a thematic content analysis of in‐depth, semi‐structured interviews conducted with seven (n = 7) young siblings, ages 13 to 21 years old, with a brother or sister identified as having a mental‐health issue. The focus of the interviews was on the ways the siblings experienced their other sibling's mental health and how those experiences shaped their sense of self and family. From the analysis, young siblings had predominately negative experiences, struggled with making sense of their brother or sister and the family as ‘flawed’ against the mental illness as ‘bad’ and experienced considerable family stress and overt family stigma. Current practice theories fail to consider the complexity of these factors and, in doing so, fail to adequately explain the nature and extent to which stigmatization occurs for immediate family members. The importance of peer support and understanding stigma in social work practice with children and their families is discussed.     

Risk factors for child maltreatment in South Korea: An investigation of a nationally representative sample

This study investigated the risk factors associated with the occurrence of child physical and psychological abuse in South Korea based on the ecological theory of child maltreatment. A subsample of 3‐ to 18‐year‐old children from “A Study on the Current State of Child Abuse and Neglect,” a nationally representative study on child abuse and neglect, was utilized for secondary data analysis. The sample was divided into two age groups (third graders in elementary school and below and fourth graders and above). We utilized hierarchical logistic regression for each age group separately to analyze the data. The variables at each level of the system (i.e., ontogenic development, microsystem, and exosystem) were entered into the model in sequential order. The results showed the common risk factors for both age groups are the caregiver's experience of abuse in childhood, the child's problem behavior, exposure to domestic violence, community size, and informal social control. The child's age was also significant in both groups but in the opposite direction. Social support was a significant predictor for the younger age group only, while the caregiver's level of education was significant for the older age group only. Implications for future research and practice are discussed based on the study results.     

An agenda for future research regarding the mental health of young people with care experience

Young people who are currently or were previously in state care have consistently been found to have much higher rates of mental health and neurodevelopmental difficulties than the general youth population. While a number of high-quality reviews highlight what research has been undertaken in relation to the mental health of young people with care experience and the gaps in our knowledge and understanding, there is, until now, no consensus, so far as we aware, as to where our collective research efforts should be directed with this important group. Through a series of UK wide workshops, we undertook a consultative process to identify an agreed research agenda between those with lived experience of being in care (n = 15), practitioners, policy makers and researchers (n = 59), for future research regarding the mental health of young people with care experience, including those who are neurodiverse/have a neurodevelopmental difficulty. This consensus statement identified 21 foci within four broad categories: how we conceptualize mental health; under-studied populations; under-studied topics; and underused methodologies. We hope that those who commission, fund and undertake research will engage in this discussion about the future agenda for research regarding the mental health of young people with care experience.     

Practice challenges at the intersection of child protection and mental health

This paper examines the complexity of collaboration between child protection and mental health services, where a parent has a mental illness and there are protection concerns for children. The paper reports on data from focused in‐depth interviews with 36 child protection workers, adult mental health workers and child and youth mental health workers. Data were analysed thematically, using NVivo to facilitate data management and analysis. Two dimensions were identified. The first, the process of collaboration, relates to four factors that assisted the collaborative process: communication, knowledge, role clarity and resources. The second dimension considers the challenges presented to collaborative work when a parent has a mental illness and a child is in need of protection, and identifies issues that are inherent in cases of this kind. Two types of challenge were identified. The first related to characteristics of mental illness, and included the episodic and/or unpredictable nature of mental illness, incorporating information from psychiatric and parenting capacity assessments, and the provision of ongoing support. The second type of challenge concerned the tension between the conflicting needs of parents and their children, and how this was viewed from both the adult mental health and the child protection perspective. Implications for policy and practice are identified in relation to the need for service models that provide ongoing, flexible support that can be intensified or held back as needed.     

Relation between young children's anger and fathers' mental health during the COVID-19 epidemic: Moderating role of gender and child number

The father–child interaction deserves attention during the COVID-19 epidemic. This study administrated the Child Anger Questionnaire and the SCL-90 Symptom Checklist to collect primary data from 1862 fathers of Chinese young children during the COVID-19 outbreak, examined the relation between young children's anger and their fathers' mental health, and verified whether the relation was moderated by the gender or the child number. The results demonstrated that the detection rate of anger among Chinese young children was 60.08%, the scores of SCL-90 factors of their fathers were significantly lower than the Chinese normal adult male norms and those of infant parents, and the anger of young children had a significant effect on their fathers' mental health. Gender and child number moderated this relation. It is of great significance to strengthen the attention to the anger of young children and the mental health of fathers during the period of public health emergencies, and to promote the harmonious interpersonal relationship between young children and their fathers.     

‘Problematising’ Australian policy representations in responses to the physical health of people with mental health disorders

Australia, like other jurisdictions, is recognising the poorer physical health of people with mental health disorders. This paper explores policy responses to this issue through discourse analysis of 22 Australian Federal and State government policy documents published in 2006–2011. The paper utilises Bacchi's ‘what's the problem represented to be?‘ approach to explore policy solutions in relation to the representation of the issue, enabling identification of issues which are not problematised and policy solutions that have not been considered. The poor physical health of people with mental health disorders is attributed in policy to poor lifestyle habits and limited access to monitoring of physical health care. Three policy solutions are offered: collaborative care delivery involving greater use of fee‐for‐service primary care to manage physical health; the monitoring of physical health status by mental health teams; and the promotion of lifestyle change. These solutions fail to address ongoing issues with collaboration between specialist mental health and primary care services. Reliance upon fee‐for‐service primary mental health care may, in fact, reduce rather than increase access to services. The strategies are discussed in light of neoliberal ideals of governance and personhood which are underpinned by informed consumer choice and personal responsibility for health.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

Young people's and carers' perspectives on the mental health needs of looked-after adolescents

While the mental health needs of looked‐after young people have been described in a number of clinical studies, the views of looked‐after adolescents themselves concerning their mental health needs have only rarely been reported. This study used focus groups to elicit the ideas and experiences of looked‐after young people in two local authorities in England. Front‐line carers in the region were also surveyed. Young people and carers were agreed in highlighting the damaging effects of the discontinuity and change experienced in the looked‐after system. Young people emphasized the importance of exercising choice and control when seeking and receiving support and identified the value of positive role models provided by ‘survivors’ of the care system. Carers reported high levels of risk behaviour, particularly self‐harm, among young people in children's homes. These differing perspectives need to be openly acknowledged and negotiated within care settings in order that relevant and accessible therapeutic and support services can be offered to looked‐after adolescents.     

The effectiveness of selected interventions for previous maltreatment: enhancing the well-being of children who live at home

The authors critically assessed reviews of the literature published between 1984 and 2002 to describe the state‐of‐knowledge about the effectiveness of interventions aimed at protecting or improving the welfare of child victims of maltreatment and who remain in the family home. The interventions studied target children, parents or families. They chiefly involve cases of sexual abuse, physical abuse or neglect; very few concern psychological abuse or exposure to violence. For the most part, the intervention effectiveness indicators measure changes in parents’ and children's knowledge (e.g. better knowledge of child development), attitude (e.g. gains in enthusiasm), emotion (e.g. decreased anxiety) and behaviour (e.g. decreased rates of aversive behaviours). Few assessments follow up on participants to determine whether the changes are lasting. The small number of evaluative studies, methodological limitations and disparities in the content and the carrying out of interventions make it difficult to draw sound conclusions about the effectiveness of interventions, even for interventions most often and most favourably assessed, such as behavioural and cognitive‐behavioural interventions with maltreating parents. Implications for practice, research and policy are underlined.     

Unemployment and mental health: evidence from research in the Nordic countries

In this article we examine research on effects of unemployment on mental health in Denmark, Finland, Norway and Sweden. We describe studies that use cross-sectional, longitudinal and time-series data, and we discuss studies that investigated the duration-dependence issue in exit rates out of unemployment. Not surprisingly, cross-sectional studies reveal that unemployed persons have worse mental health than do others. Most longitudinal studies suggest that unemployment is associated with deteriorating mental health, even though it is somewhat unclear how long such an effect persists. Most duration-dependence studies were done using Swedish data. It turns out that unemployment benefits and labour-market policies affect the pattern of exit rates out of unemployment.     

Punitive welfare reform and claimant mental health: The impact of benefit sanctions on anxiety and depression

Internationally, policymakers assume that sanctioning claimants of unemployment benefits will engender both improved employment outcomes and wider positive effects. A growing evidence‐base challenges these expectations, though additional insight is needed from large‐scale longitudinal research. This article contributes by conducting a quantitative investigation into the mental health impacts of benefit sanctions. To do so, it focuses on a recent period in UK sanctions policy in which rates of sanctions varied markedly and their length was substantially increased. Using quarterly panel data for local authorities in England (Q3 2010–Q4 2014) and fixed effects models that control for important confounders, the analysis provides robust evidence that Jobseeker's Allowance (JSA) sanctions lead to increases in self‐reported anxiety and depression. Evidence of this adverse impact is particularly clear following the increase in the length of sanctions in October 2012. The results have important implications for contemporary social security policy, which is underpinned by a similarly punitive sanctions regime. Whilst additional individual‐level research is needed to fully consider the causal relationships in operation, the findings support a precautionary approach that should seek to minimise the harm associated with sanctions. This implies taking steps to reduce both the severity and frequency of applied sanctions.     

The mental health status of Latino children in the public child welfare system: a look at the role of generation and origin

As the number of Latino children in public child welfare continues to grow, it is necessary to understand how their mental health is faring. The paper examines emotional and behavioural needs among Latino children who had contact with the public child welfare system. The purpose of this longitudinal study was twofold: to examine the severity of emotional and behavioural problems, and to assess the predictive role of generation status and Latino origin. Latent growth models were completed using the National Survey on Children and Adolescent Well‐Being. The predictive model for the externalizing CBCL scale revealed that generation status and Latino origin were significant predictors. At baseline, Puerto Rican children exhibited higher rates of externalizing problems compared with Mexican children. Over time children who were first/second generation tended to have lower scores compared with the third‐plus generation children. Implications for practise are discussed.     

Predicting the recipients of social work support,and its impact on emotional and behavioural problems in early childhood

This paper examines the recipients of social work support in the Millennium Cohort Study. Using panel analysis and fixed effects models, it investigates the factors that lead to the receipt of any type of social work support for individuals with young children and the effects of this support on changes in the prevalence of emotional and behavioural problems in these children. We find that divorce or separation, and episodes of homelessness are two important factors that lead to the receipt of social work support. Mothers with male children are also more likely to receive social work support. However, we find no clear evidence that social work support has any effect on changes in children's emotional and behavioural problems over time. The implications of these findings for social work research and for practice and policy are discussed.     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

‘I want to be better than you:’ lived experiences of intergenerational child maltreatment prevention among teenage mothers in and beyond foster care

The growing body of research on teenage motherhood in foster care has largely focused on the risks involved for both mother and child, yet these mothers depict a much more complex picture of their own experience of becoming and being mothers. The current study employed interpretative phenomenological analysis to explore 18 in‐depth, qualitative interviews from six participants on the meaning and experience of motherhood among teenage mothers in foster care and in the years immediately after ageing out. This study focused on a particular dimension of motherhood: participants' efforts to break the cycle of child abuse and neglect with their own children. Two themes emerged as characteristic of these experiences: (i) treating children well/parenting differently and avoiding the system; and (ii) reducing isolation and enhancing support. Given the increased likelihood of the children of teen mothers – particularly those who have been maltreated – becoming involved with the child welfare system, study findings suggest possible strategies for disrupting cycles of intergenerational child welfare involvement generated by young mothers themselves. Practice implications for addressing possible substance abuse, mental health and relational and parenting needs are discussed.     

Household stress and adolescent behaviours in urban families: the mediating roles of parent mental health and social supports

Using exploratory data analysis techniques, we propose a model of parent psychosocial well‐being that links financial strains and household stressors to adolescents' pro‐social behaviours and vulnerability through parent mental health and social supports. Parents of urban youth (n = 781) who planned to attend a summer camp for at‐risk youth responded to questions surveying household, parent and child factors related to early adolescent development. We expected that the relationship of household stressors – including financial strain and household difficulties – with adolescent behaviours would be mediated by parent depression and anxiety. We also anticipated that parent social supports would have both direct and indirect effects (via parent mental health) on adolescents' pro‐social behaviours. Study findings are consistent with our hypotheses and the model performed similarly for both adolescent males and females. Implications for practice and policy in the context of programmes for urban youth are discussed.     

Building home on a fault line: Aging out of child welfare with a serious mental health diagnosis

Youth aging out of foster care are at high risk for homelessness. This research explains how and why homelessness occurs among youth with serious mental health struggles after aging out of residential and transitional living programmes. Using a longitudinal constructivist grounded theory design, we analyse 20 in‐depth interviews exploring youth's transition experiences and perceptions of transition success within 4 months of emancipation and at 6 and 12 months postemancipation. Monthly 15‐min check‐ins prevented attrition. A three‐phase transition process was observed driven by participant desires and actions to cultivate psychological home through establishing physical home alone away from social networks. Pre‐emancipation, the promise of home was privacy and opportunity for self‐redefinition. Shortly after emancipation, home became a physical and social space to be, a valuable resource to share and a demonstration of personal transition success. However, later in the year postemancipation, maintaining physical home proves nearly impossible given the risk context. Findings speak to how and why youth aging out appear overly self‐reliant upon emancipation. Cultivating a psychological sense of home has practice implications for child welfare providers who aim to prepare youth to live independently postemancipation.