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Background. Deinstitutionalization leads to more people with mental illness in the communityServices focus on job readiness and dealing with parents and siblings (not parenting)Women with mental illness equally as likely to have children as women withoutMale focused treatment paradigms do not fit for parenting womenAt higher risk for losing their children.
Parents with Mental Illness in the Child Protection System

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1. Parents with Mental Illness in the Child Protection System Susan Smalling

2. Background Deinstitutionalization leads to more people with mental illness in the community Services focus on job readiness and dealing with parents and siblings (not parenting) Women with mental illness equally as likely to have children as women without Male focused treatment paradigms do not fit for parenting women At higher risk for losing their children

3. Concerns for mentally ill parents in the child protection system False assumptions about parenting capacity Parenting assessments looking at intellectual functioning and diagnosis versus functional assessments of parenting Lack of understanding among mental health professionals of the child protection system Lack of communication between the mental health and child protection systems Available services for parents insufficient

4. Research questions What is the prevalence of parental mental illness in the child protection cases for St. Louis County? To what extent are parents with mental illness involved in the child protection system receiving mental health treatment and/or case management addressing their parenting needs? To what extent do child protection workers feel they are able to coordinate with the mental health system to best meet parenting needs?

5. Research Design Three phases of research Quantitative 50 sampled child protection cases Survey of worker opinions on the issues Qualitative 10 interviews with child protection workers

6. Sampled Child Protection Cases Surveyed 50 cases for the following data Presence or absence of a diagnosis of mental illness Whether or not the worker suspected mental illness was present (also asked to indicate why) Whether or not the client receives Rule 79 case management Whether or not the client receives mental services in the community Demographic information (age of primary caregiver, ethnicity and number of children)

7. Child Protection Worker Survey How well the child protection and mental health systems coordinate Quality of parenting assessments Ability of both the systems and workers to meet the needs of parents with mental illness and their children Training needs Interviews ask for elaboration on these issues

8. Results

9. Prevalence of Parents with Mental Illness

10. Mental health services received Of the 24 cases with a diagnosis of mental illness, 5 receive Rule 79 case management (21%) Of the 24 cases with a diagnosis of mental illness, 17 receive other mental health services (71%) 79% of those with diagnosis receive services of some kind Only three specify parenting services (parenting group at HDC, family services through CAIR) Seven received unspecified services through HDC or CAIR (may have had specific parenting component) Only half of those receiving services appear to be getting services specific to their parenting needs

11. Parents with suspected mental illness None receive Rule 79 case management One third receive other mental health services

12. Differences by ethnicity: White Primary caregivers 25 of 47 cases with white primary caregiver 12 of the 25 have diagnosis of mental illness (48%) 3 of remaining 13 have suspected mental illness (12%) 60% of white primary caregivers have either a diagnosis or suspected mental illness

13. Differences by ethnicity: American Indian primary caregivers 16 of 47 cases with American Indian primary caregiver 10 of the 16 have diagnosis of mental illness (62%) 3 of remaining 6 have suspected mental illness (19%) 81% of American Indian primary caregivers have either a diagnosis or suspected mental illness

14. Child protection worker survey results

15. Survey results continued

16. Survey results

17. Themes emerging from the qualitative interviews Biggest barrier is the court system Parents struggle to understand timelines and requirements Adversarial nature of court action Parents need mental health advocate to explain things effectively Parenting assessments including home visits (and more than one shot assessment) Waiting list for psychological evaluations

18. Interview themes Communication good among workers from different perspectives Parents need support system (primary protective factor) Parents tend to be isolated (primary risk factor) Fostering medication compliance More specific parenting programs


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