Citation

Wall-Wieler E, Roos LL, Brownell M, Nickel N, Chateau D, Singal D. Can. J. Psychiatry 2018; 63(3): 170-177.

Affiliation

Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba.

Copyright

(Copyright © 2018, Canadian Psychiatric Association, Publisher SAGE Publications)

DOI

10.1177/0706743717741058

PMID

29202664

Abstract

OBJECTIVE: The objective of this study is to examine suicide attempts and completions among mothers who had a child taken into care by child protection services (CPS). These mothers were compared with their biological sisters who did not have a child taken into care and with mothers who received services from CPS but did not have a child taken into care.

METHODS: A retrospective cohort of mothers whose first child was born in Manitoba, Canada, between April 1, 1992, and March 31, 2015, is used. Rates among discordant biological sisters (1872 families) were compared using fixed-effects Poisson regression models, and mothers involved with CPS (children in care [ n = 1872] and received services [ n = 9590]) were compared using a Poisson regression model.

RESULTS: Compared with their biological sisters and mothers who received services, the adjusted incidence rate ratio (aIRR) of death by suicide was greater among mothers whose child was taken into care by CPS (aIRR = 4.46 [95% confidence interval (CI), 1.39-14.33] and ARR = 3.45 [95% CI, 1.61-7.40], respectively). Incidence rates of suicide attempts were higher among mothers with a child taken into care compared with their sisters (aIRR = 2.15; 95% CI, 1.40-3.30) and mothers receiving services (aIRR = 2.82; 95% CI, 2.03-3.92).

CONCLUSIONS: Mothers who had a child taken into care had significantly higher rates of suicide attempts and completions. When children are taken into care, physician and social workers should inquire about maternal suicidal behaviour and provide appropriate mental health.

Language: en

Keywords

child protection services; cohort study; epidemiology; linkable administrative data; maternal health; siblings; suicide