|
Abstract
|
BACKGROUND: Child protective services (CPS), or equivalent systems, have statutory power to remove children from birth parents via public family care proceedings in instances of child abuse, neglect, or concerns around parenting capacity. Parents who have children subject to care proceedings, referred to here as birth parents, often have complex health and social care needs that can predispose them to CPS involvement. We aimed to review what is known about the health needs of these birth parents and the interventions available to support their needs.
METHODS: In this scoping review, we searched PubMed, Scopus, and grey literature using the search terms "health", "care proceedings", and "parents". We included all publications in English that reported parental health in the context of care proceedings from Jan 1, 2000, to March 1, 2021.
FINDINGS: 1328 studies were identified by the search, of which we included 61 (4ยท5%) in our review. 35 (57%) of 61 studies reported on maternal health, 25 (40%) on the health of both parents, and one (2%) on the health of fathers alone. 41 (67%) studies described parental health need and these were conceptually categorised into mental health, physical health, substance misuse, developmental disorders, and reproductive health. Health inequities and poor access to services were described across all categories, with health needs often predating care proceedings, and sometimes the child's birth. 20 (33%) studies described interventions to support parental health and these were all targeted at mothers, with eight (40%) of the 20 studies formally or informally also supporting fathers. We grouped interventions into alternative family courts; holistic, tailored services; and specialist advocacy or peer support.
INTERPRETATION: Parents who have children subject to care proceedings have complex health needs. The studies included in our review strongly suggest that health issues are exacerbated by child removal, triggering deteriorating mental health, poor antenatal health for subsequent pregnancies, and avoidable mortality. Our findings highlight the need for targeted and timely intervention for parents to improve whole-family outcomes. There are models that have been designed, implemented, and tested using trauma-informed, relationship-based, multidisciplinary, family-focused, and long-term approaches. FUNDING: There was no funding for this study.
Language: en |