By Georgina Ireland, Linda Wijlaars, Matthew A Jay, Claire Grant, Rachel Pearson, Johnny Downs and Ruth Gilbert
This study aimed to determine the risk of mothers being involved in public law family court care proceedings and their social and health characteristics by analysing linked administrative family court and healthcare records. Involvement in care proceedings reflects serious concerns for the care or safety of a child. Local Authority (LA) social care departments can bring care proceedings under Section 31 of the Children Act 1989 due to concerns about significant harm, or risk of significant harm to the child attributable to care given by the parents or the child being beyond parental control. Each year, around 10,000 mothers in England are involved in care proceedings. In 80% of these proceedings, the child is placed with friends or family, unrelated foster carers, in residential care or for adoption. One fifth remain with one or both birth parents, with or without a supervision order.
Recent developments in national and regional linkages of administrative health data to family court or social services data have contributed insights into maternal health needs in Wales, Sweden and Canada, but evidence is lacking for England (5-15). Similar linked data for England would contribute new insights due to the population size, the regional and ethnic variation in England, and variability in determinants of service access and outcomes across different population subgroups. From a policy and practice perspective, evidence from linked data on the health of parents involved in family court care proceedings could inform how and when healthcare and related services could intervene to improve parental health and support, and thereby prevent or mitigate child maltreatment, and in some cases, avoid care proceedings.
Aims and objectives
This study aimed to address the evidence gap in England on the health of mothers involved in care proceedings compared with their peers. We conducted two sub-studies:
In the first, we studied all first-time mothers between 2007-19 in the English NHS, including those involved in care proceedings, to:
Create a database of first-time mothers using hospital admission data, linked to care proceedings in England and assess linkage accuracy.
Estimate the 10-year risk of care proceedings for first-time mothers in England and describe differences in maternal social and health characteristics at a first birth.
Compare the number of births within 10 years to first-time mothers involved and not involved in care proceedings.
Assess maternal and birth characteristics associated with recurrent care proceedings.
Estimate differences in mortality among mothers involved and not involved in care proceedings.
2. Second, we studied mothers involved in care proceedings and other women using mental health service records in four LAs in south London to:
Create a research database that linked records of mothers involved in care proceedings in south London to mental health service data and assess linkage accuracy.
Compare the characteristics of mental health service use among mothers involved in care proceedings and other women using mental health services.
Compare the risk of death among mothers involved in care proceedings with other women using mental health services.
Evaluate patterns of mental health service use before and after start of care proceedings.
London: Nuffield Foundation, 2024. 63p.