Assessment issues in working with mothers who induce illness in their children

Mothers who induce illness in their children are abusing them. What must be uppermost in the mind of the child protection worker is the effect of the mother’s behaviour on the child. A good assessment of the mother is essential in making decisions about the child’s safety. Schreier & Libow (1993) estimate that nearly 10% of mothers who deliberately induce illness in their children ultimately kill them. The construction with the mother of a comprehensive genogram is an essential tool for assessment. Denial by the mother is usual and overt confrontation is usually not a helpful technique. Key assessment questions are: What are the mother’s real feelings about this child? Can the mother imagine what life will be like with a well child? Is this mother more than extremely anxious or overprotective towards her child? This difficult, complex work can arouse intense feelings in individual workers and within the assessment team. Good supervision is essential.     

Building bridges: the interface between adult mental health and child protection

Bringing together two distinct professional systems such as adult mental health and child protection challenges our strategies for making effective working together/working in partnership arrangements. And yet failures to make these arrangements increase the risk for children who may be suffering or likely to suffer significant harm as an outcome of their parents'/carers' mental health problems. This paper offers an analysis of the challenges inherent in bringing these systems together at the assessment interface, and offers some insights into the contribution each system can make to an integrated assessment process for children and their families. Copyright © 1999 John Wiley & Sons, Ltd.