Child custody loss among women with persistent severe mental illness

Abstract

The author analyzed quantitative data from an NIMH-funded longitudinal study of 322 women with persistent severe mental illness (SMI) and qualitative data from semistructured interviews with 82 of the women who ever lost custody of a child. The purpose was to test the hypothesis, derived from human ecology theory, that individual and environmental factors combine with mental illness to predict a history of child custody loss. The final model supported the increased likelihood of child custody loss for most women with persistent mental illness. Results provide support for directing policy advocacy and services toward ensuring a network of formal and informal support and resources and strengthening parenting skills and values for mothers with persistent SMI. Key words: child custody loss; human ecology theory; parenting; qualitative research; severe mental illness ********** A diagnosis of persistent severe mental illness (that is, schizophrenia, schizoaffective disorder, bipolar disorder with or without psychosis, and major depression with or without psychosis, is increasingly being used to fast track the termination of parents' rights to the custody of their children (Ackerson, 2003b; Jacobsen & Miller, 1998). Women with these disorders are consistently found to be at increased risk of losing long-term or permanent responsibility for their children's care (Bagedahl-Strindlund, 1997; Nicholson, Biebel, Hinden, Henry, & Stier, 2001). Children not in their biological mothers' care are most often placed with their biological father, extended kin, or in the foster care, adoption, or group residential system (Coverdale & Aruffo, 1989; McLennan & Ganguli, 1999; Nicholson, Sweeney, & Geller, 1998; Sands, Koppelman, & Solomon, 2001). A study in one state, however, tbund that children of African American women with mental illness were less likely to be living with a father and more likely to be living with a grandmother, in foster care, or adopted (Gamache, Tessler, & Nicholson, 1995). To plan effective policies and interventions, it is important to address the question of the relation of mental illness to child custody loss--that is, what are the circumstances under which women with severe mental illness lose custody of their children? This article reports findings from a quantitative and qualitative study of individual and environmental factors that may predict a history of child custody loss among women with a mental illness who are parents. Much of the research on child custody loss among people with mental illness has been descriptive. Custody losers have been found to have certain psychiatric diagnoses, including schizophrenia or other illnesses involving psychosis (Miller & Finnerty, 1996; White, Nicholson, Fisher, & Geller, 1995), general mental health problems (Mental and Physical Disability Law Reporter, 1986; Zuravin & DePanfilis, 1997; Zuravin & Greif, 1989), and more extensive use of drugs, alcohol, or both (Zuravin & DePanfilis), although in one study (Tyler, Howard, Espinosa, & Doakes, 1997), custody loss was associated with fewer years of alcohol use. Other characteristics have been observed. In some studies women who lost custody were more often black, but other studies found a larger proportion of custody losers who were white (Lewis, Giovannoni, & Leake, 1997; Sands, 1995; Zuravin & Greif, 1989). Parents who lost custody have also been characterized as having problems with parenting knowledge and skills (Ackerson, 2003a; Brunette & Dean, 2002), being younger at the birth of one's first child (Zuravin & DePanfilis, 1997), having had a larger number of live births (Nicholson et al., 1998; Zuravin & Greif), never being employed or having a lower work history and lower productivity, record (White et al., 1995; Zuravin & Greif), never or not currently married (Ackerson, 2003a; White et al. …