Involvement in the child welfare system among mothers with serious mental illness.
OBJECTIVE
This study sought to determine the association between maternal schizophrenia and major affective disorders (serious mental illness) and child custody arrangements in a sample of Medicaid-eligible mothers.


METHODS
Medicaid eligibility and claims data were merged with data from the child welfare system in Philadelphia for 1995 to 2000. The sample comprised 4,827 female residents of Philadelphia between the ages of 15 and 45 as of 1996, who were initially eligible for Medicaid through Aid to Families With Dependent Children between 1995 and 1996 and who had at least one family member younger than 18 years at the beginning of the study period. Logistic regression was used to determine association between maternal mental illness and involvement in the child welfare system.


RESULTS
Among the 4,827 mothers, 7.2 percent had a serious mental illness and 4.4 percent had other psychiatric diagnoses. More than 14 percent of mothers with serious mental illness received child welfare services, compared with 10.8 percent of those with other psychiatric diagnoses, and 4.2 percent of those without a diagnosis. After the analyses adjusted for a past inpatient episode, race or ethnicity, and age, mothers with serious mental illness were almost three times as likely to have had involvement in the child welfare system or to have children who had an out-of-home placement.


CONCLUSIONS
The results suggest the urgent need for increased planning and coordination between the child welfare and mental health systems, including provision of parenting support as part of mental health treatment for mothers.
Park
Jung Min
JM
School of Social Work, University of Illinois at Urbana-Champaign, 1207 West Oregon Street, Urbana-Champaign, Illinois 61801, USA. parkjm@uiuc.edu
Solomon
Phyllis
P
Mandell
David S
DS
D000293:Adolescent; D000328:Adult; D002655:Child Custody / Q000706:statistics & numerical data*; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D008484:Medicaid; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D015143:Philadelphia; D012559:Schizophrenia