Enquiry about the needs of children whose mothers are admitted to psychiatric hospitals

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The objective of this study is to assess whether children's needs are taken into consideration in female patients who are admitted to an adult psychiatric hospital. A retrospective case note audit of 100 female inpatients aged between 18 and 55 years over a 6‐month period were randomly selected. The medical and nursing case notes of patients with children aged between 0 and 17 were assessed using a proforma. The information collected on mothers consisted of diagnosis of illness, type of admission (whether voluntary or detained), duration of admission, previous psychiatric admissions, patient age, marital status, whether or not employed, relationship with partner, mental health of partner, history of violence, medical history of relevance, family history of mental illness, and whether other agencies were involved. Children data collected consisted of number of children per patient and their ages, an enquiry into the child's welfare, emotional and behavioural development, educational/cognitive development, physical health and development, relationship with family and peers, children's knowledge of parent's illness, alternative care arrangements for child during mother's admission and their relationship to carer, child's involvement in their parents' illness as a carer and actions taken on behalf of the child. Of the 100 patients, 62 had children aged between 0 and 17 years. There was an enquiry into children's welfare in 15 (24%) cases and an enquiry into children's knowledge of their parents' illness in three (4.8%). Actions were taken on behalf of children in 13 (21%) cases, in five cases this was not necessary as children resided elsewhere, and in one case a social work assessment was requested but no subsequent documentation of this being completed. There was no documentation of actions taken in the remaining 43 (69.4%) cases. The results of this retrospective case note audit suggest that children's welfare is not routinely enquired about in female patients admitted to psychiatric hospitals. Actions taken on behalf of children occurred often when there was social services involvement. As a result of this study guidance was issued to all new junior psychiatric staff as part of their induction process to make enquiries about children and their welfare.