Novel Linkage of Administrative Health and Family Court Data to Examine Mental Health Need Among Women Whose Children Enter Care

Abstract

Introduction
An estimated 23% of children in England are exposed to maternal mental health problems, with growing concern around how maternal mental health affects parenting capacity and entries into public care for their children. There is limited evidence on the prevalence of mental health service need among women whose children enter care and on whether these needs are sufficiently met. With England’s family justice system and children’s social care sector increasingly overstretched, there is a need to identify opportunities for an improved response to maternal mental health.

Objectives and Approach
We linked administrative family court data for women (n = 5463) involved in public family court proceedings (care proceedings) across eight London boroughs between 2007 and 2019, with patient records from South London and Maudsley NHS mental health trust (SLaM). Work is ongoing to (1) describe the frequency, type and timing of mental health service use among women who link and (2) compare these findings to general population trends.

Results
2843 (52%) women linked to a SLaM patient record via deterministic linkage. Matches had better recording of identifiers and were more likely to have returned to court than non-matches (36% vs 26%). The majority of women (75.0%) were referred for treatment before the start of their (first) care proceeding, while 34.8% had a diagnosis recorded in a structured field. To appraise linkage quality, we manually reviewed de-identified clinician notes for 100 randomly selected women who linked; we confirmed ‘true’ match status for 95 women and found no evidence contradicting match status for the remainder.

Conclusion / Implications
This novel linkage between mental health and family court data supports growing evidence that women whose children enter care in England have high prevalence of mental health problems. Research using this linkage will help to inform strategies to improve maternal mental health and outcomes for vulnerable women and their children.