Abstract
Little is known about mental health problems of children and young people (CYP) involved with public and private law family court proceedings, and how these CYP fare compared to those not involved in these significant disruptions to family life. This study examined records of depression/anxiety in CYP involved in public and private law proceedings using linked population-level data across Wales. Retrospective e-cohort study. We calculated the incidence of primary-care-recorded depression/anxiety among CYP involved in these proceedings and in a comparison group, using Poisson regression. Depression/anxiety outcomes following proceedings were evaluated using pairwise Cox regression, with age- and gender-matched controls of CYP who had no involvement with the courts. CYP in the public group had twice the risk of depression (adjusted incidence rate ratio aIRR = 2.2; 95% CI 1.9-2.6) and 20% higher risk of anxiety (aIRR = 1.2; 95% CI 1.0-1.5) relative to the comparison group. The private group had 60% higher risk of depression (aIRR = 1.6; 95% CI 1.4-1.7) and 30% higher risk of anxiety (aIRR = 1.3; 95% CI 1.2-1.4). Following private law proceedings, CYP were more likely to have depression (hazard ratio HR = 1.9; 95% CI 1.7-2.1), and anxiety (HR = 1.4; 95% CI 1.2-1.6) than the control group. Following public proceedings, CYP were more likely to have depression (HR = 2.1; 95% CI 1.7-2.5). Incidence of anxiety or depression following court proceedings was around 4%. Findings highlight the vulnerability of CYP involved in family court proceedings and increased risk of depression and anxiety. Schools, health professionals, social and family support workers have a role to play in identifying needs and ensuring CYP receive appropriate support before, during and after proceedings.
Highlights
Little is known about mental health problems of children and young people (CYP) involved with public and private law family court proceedings, and how these CYP fare compared to those not involved in these significant disruptions to family life
We acknowledge the possibility of some selection bias, which can occur if subgroups of individuals have different linkage rates;15 87% of the Cafcass Cymru records were successfully matched in Secure Anonymised Information Linkage (SAIL), enabling linkage to health records, and we report on characteristics of the final sample with GP data
This study reports on problems only for CYP who had at least 12 months of GP data and who were included in the final sample; there is a possibility that we have excluded children with poorer mental health due to residential mobility,[16] with mobility more common in CYP involved in public law proceedings.[17]
Summary
Depression/anxiety outcomes following proceedings were evaluated using pairwise Cox regression, with age- and gender-matched controls of CYP who had no involvement with the courts. Study design This was a retrospective e-cohort study to investigate incidence rates (IRs) and incident rate ratios (IRRs). A matched cohort design was used to investigate risks of depression and anxiety following initiation of court proceedings. Data source and linkage All data within the SAIL Databank are treated in accordance with the Data Protection Act 2018 and are compliant with the General Data Protection Regulation. During the anonymisation of data sources within the SAIL Databank, individuals are assigned an anonymised linking field (ALF) enabling linkage of person-level data-sets. Relevant case information for this study included: child’s week of birth and gender, and the date and type of court application (public or private)
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