Linking data on women in public family law court proceedings concerning their children to mental health service records in South London

Abstract Introduction Maternal mental health problems and substance misuse are key risk factors for child neglect or abuse and court-mandated placement into care. Linkage between mental health records and family court data could raise awareness about parent mental health needs and inform approaches to address them. Objectives To evaluate data linkage between administrative family court data and electronic mental health records for a population-based mental health service for 1.3 million people in South London. Methods We deterministically linked administrative family court data for women (n=5463) involved in care proceedings in South London with service user records from the South London and Maudsley NHS Mental Health Trust (SLaM). We restricted the cohort to women involved in proceedings between 2007 and 2019, in local authorities where SLaM solely provides secondary/tertiary mental health services and the Improving Access to Psychological Therapies (IAPT) (n=3226). We analysed the associations between match status and sociodemographic/case characteristics using multivariable logistic regression. Results Two-thirds (2317/3226; 66%) of women linked to a SLaM service user record at some point; most (91%) who linked accessed secondary/tertiary mental health services, indicating serious mental illness. Accounting for possible missed matches, we estimated that 70-83% of women accessed SLaM services at some point. Older women at index proceedings (>35yrs OR: 0.69, 95%CI: 0.54-0.88vs <25yrs) and Black women or women from other ethnic groups (Black ethnic groups 0.65, 0.50-0.83; other ethnicity 0.59, 0.43-0.81 vs White ethnic groups) had lower odds of linking. Odds of linking were higher for women with an infant in proceedings (1.42, 1.18-1.71), or with curtailed/terminated parental responsibility (1.44, 1.20-1.73). Conclusion Our linkage supports growing evidence of a high burden of mental health problems and substance misuse among women whose children enter care in England, compared to the general population. Research using this linkage should inform strategies to address the considerable mental health needs of vulnerable women and their children

[1]  P. Bywaters,et al.  Born into care: Evidence of a failed state , 2020 .

[2]  D. Ford,et al.  Data Resource: population level family justice administrative data with opportunities for data linkage , 2020, International journal of population data science.

[3]  L. Wijlaars,et al.  Data Resource: Children and Family Court Advisory and Support Service (Cafcass) public family law administrative records in England , 2020, International journal of population data science.

[4]  K. Broadhurst,et al.  Child removal as the gateway to further adversity: Birth mother accounts of the immediate and enduring collateral consequences of child removal , 2020 .

[5]  Lindsay Youansamouth,et al.  Linked lives: Gender, family relations and recurrent care proceedings in England , 2019, Children and Youth Services Review.

[6]  R. Stewart,et al.  The Maudsley Biomedical Research Centre (BRC) data linkage service user and carer advisory group: creating and sustaining a successful patient and public involvement group to guide research in a complex area , 2019, Research Involvement and Engagement.

[7]  K. Abel,et al.  Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis , 2019, The Lancet. Public health.

[8]  Joan K. Morris,et al.  Prevalence of Down's Syndrome in England, 1998–2013: Comparison of linked surveillance data and electronic health records , 2019, International journal of population data science.

[9]  L. Roos,et al.  Prenatal care among mothers involved with child protection services in Manitoba: a retrospective cohort study , 2019, Canadian Medical Association Journal.

[10]  Christian Borgs,et al.  Sociodemographic differences in linkage error: an examination of four large-scale datasets , 2018, BMC Health Services Research.

[11]  J. Leventhal,et al.  Maternal Mental Health Disorders and Reports to Child Protective Services: A Birth Cohort Study , 2017, International journal of environmental research and public health.

[12]  Daryl J. Higgins,et al.  Adverse childhood experiences, non-response and loss to follow-up: Findings from a prospective birth cohort and recommendations for addressing missing data , 2017 .

[13]  M. Canfield,et al.  Maternal substance use and child protection: a rapid evidence assessment of factors associated with loss of child care. , 2017, Child abuse & neglect.

[14]  K. Broadhurst,et al.  Birth Parents and the Collateral Consequences of Court-ordered Child Removal: Towards a Comprehensive Framework , 2017 .

[15]  Harvey Goldstein,et al.  Utilising identifier error variation in linkage of large administrative data sources , 2017, BMC Medical Research Methodology.

[16]  Rebecca G. Mirick.  Challenges in recruiting parents to participate in child welfare research: implications for study design and research practice , 2016 .

[17]  A. Memon,et al.  Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England , 2016, The Lancet.

[18]  Andrea C. Fernandes,et al.  Cohort profile of the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register: current status and recent enhancement of an Electronic Mental Health Record-derived data resource , 2016, BMJ Open.

[19]  Melissa J. Green,et al.  New South Wales Child Development Study (NSW-CDS): an Australian multiagency, multigenerational, longitudinal record linkage study , 2016, BMJ Open.

[20]  K. Broadhurst,et al.  Vulnerable birth mothers and recurrent care proceedings:estimating recurrent care proceedings using CAFCASS administrative data - a technical appendix , 2015 .

[21]  L. Dearden,et al.  Changes in first entry to out-of-home care from 1992 to 2012 among children in England☆ , 2015, Child abuse & neglect.

[22]  Angus Roberts,et al.  Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records , 2013, BMC Medical Informatics and Decision Making.

[23]  L. Lix,et al.  The Whole Is Greater Than the Sum of the Parts: Using Data Linkage and Cohort Designs to Create Data Synergy at MCHP. , 2011, Healthcare Policy | Politiques de Santé.

[24]  Graham Thornicroft,et al.  The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data , 2009, BMC psychiatry.

[25]  M. C. Borja,et al.  An Introduction to Generalized Linear Models , 2009 .

[26]  Eric R. Ziegel,et al.  An Introduction to Generalized Linear Models , 2002, Technometrics.

[27]  A. J. Bass,et al.  Research use of linked health data — a best practice protocol , 2002, Australian and New Zealand journal of public health.

[28]  D. Makepeace.  The Children Act. , 1949, Journal. Royal Sanitary Institute.

[29]  K. Broadhurst,et al.  Vulnerable Birth Mothers and Recurrent Care Proceedings Final Summary Report , 2017 .

[30]  Jeesun Jung,et al.  Epidemiology of DSM-5 Drug Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III. , 2016, JAMA psychiatry.