Documenting maternal and childcare information of mothers presented to substance use treatment services: A qualitative study of reports in a clinical case register

Abstract

BackgroundMothers compose a significant proportion of women in substance use treatment services. These women have needs that, if not addressed, can negatively impact their capacity to parent. This study explores the feasibility of using free-text notes from electronic health records (EHRs) to identify factors that impair mothers' ability to care for their children. MethodThis study is a qualitative analysis of EHRs of 50 women attending substance use services in Southeast London who were parents of dependent children (defined as mothers of children aged <18 years independent of living together). We developed a sampling stratification process to ensure an adequate volume of data were available and analyzed per case. The study identified and tested search terms. We extracted data from clinical notes and letters of communication with other services/agencies (free-text notes) using the identified search terms and conducted deductive thematic analysis. ResultsThe mean number of documents per case was 92.17 (SD = 18.51). The study identified five themes with subthemes: childcare arrangements, family context, safeguarding issues, factors that might impact the treatment plan and care of the child, and communication between the health care and child welfare systems. ConclusionThe study demonstrates a novel approach for exploring parenting-related characteristics of mothers in substance use treatment. Despite a range of maternal and childcare-related information available on EHRs, the type of treatment and support being offered to patients in response to the reported information is less well documented. Findings highlight the need for further investments in implementing effective family centered strategies within substance use services.