Predictors of social services supervision of babies of mothers with mental illness after admission to a psychiatric mother and baby unit.
BACKGROUND
There is insufficient information on the predictors of parenting difficulties in mothers with severe mental illness. Using data from mother and baby units in the UK we aimed to examine the social and clinical characteristics of mothers whose babies were supervised by social services on discharge.


METHODS
A case-control study was carried out using data from mother and baby units and facilities entered onto the Marce database.


RESULTS
Of 1197 mothers, 23% were discharged with their babies under some form of social services supervision. Factors independently associated with an increased risk of supervision included social class (OR 3.16, 95% CI 1.99-5.03), single marital status (OR 2.10, 95% CI 1.38-3.20), behavioural disturbance (OR 1.69, 95% CI 1.08-2.65) and psychiatric illness in the partner (OR 2.67, 95% CI 1.59-4.49). The diagnostic groups independently associated with the highest risk of having a supervised baby were schizophrenia (OR 5.16, 95% CI 2.61-10.21) and personality disorder (OR 9.29, 95% CI 3.46-24.91).


CONCLUSIONS
Mothers with schizophrenia are at particularly high risk of having their baby supervised by social services. Preventative interventions should be targeted at socio-economic difficulties, early detection of psychiatric disorders postpartum and treatment of perinatal mental illness in the context of the whole family.
Howard
Louise
L
Health Services Research Dept., Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Shah
Nisha
N
Salmon
Margaret
M
Appleby
Louis
L
D000328:Adult; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D001523:Mental Disorders / Q000523:psychology* / Q000534:rehabilitation*; D009035:Mothers / Q000523:psychology*; D010343:Patient Admission; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital; D012947:Social Work / Q000458:organization & administration*