Mental health service use among mothers involved in public family law proceedings: linked data cohort study in South London 2007-2019.
Mental health service use among mothers involved in public family law proceedings: linked data cohort study in South London 2007-2019.
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DOI：
10.1007/s00127-022-02221-1
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发表时间：
2022-10
影响因子：
4.4
通讯作者：
Gilbert, Ruth
中科院分区：
文献类型：
--
作者：
Pearson, Rachel J.;Grant, Claire;Wijlaars, Linda;Finch, Emily;Bedston, Stuart;Broadhurst, Karen;Gilbert, Ruth
在英格兰，经历过法院强制安置的儿童的母亲中，心理健康问题和药物滥用很常见，但描述这些健康需求的研究有限，无法为循证政策提供信息。在这项描述性研究中，我们的目的是提供有关参与有关儿童安置的公共家庭法程序（“护理程序”）的妇女的心理健康和药物滥用需求的类型、严重程度和时间的证据。这是一项回顾性、匹配队列研究，使用关联的家庭法庭和心理健康服务记录，对 2007 年至 2019 年间南伦敦和莫兹利 NHS 心理健康信托 (SLaM) 服务区参与护理程序的 3226 名女性中的 2137 名 (66%) 进行了研究。我们将心理健康服务的使用情况和死亡风险与 2007 年至 2019 年间访问 SLaM 的 17,096 名女性匹配对照进行了比较，这些对照的年龄为 16-55 岁，并且没有参与护理程序。大多数女性 (79%) 在护理程序开始之前就知道 SLaM。女性患精神分裂症谱系障碍（19% vs 11%）、人格障碍（21% vs 11%）和物质滥用（33% vs 12%）的比例较高。他们更有可能因 SLaM 住院（27% 比 14%）或被分割（19% 比 8%）。根据年龄进行调整后，与匹配对照相比，女性的死亡风险高出 2.15 倍（95% CI 1.68-2.74）。参与护理程序的妇女承受着严重和复杂的心理健康和药物滥用需求的特别沉重的负担。诉讼后妇女死亡风险的增加凸显出，针对孕产妇心理健康和家庭法庭内药物滥用的干预措施应提供持续、长期的支持。在线版本包含可在 10.1007/s00127-022-02221-1 获取的补充材料。
Mental health problems and substance misuse are common among the mothers of children who experience court-mandated placement into care in England, yet there is limited research characterising these health needs to inform evidence-based policy. In this descriptive study, we aimed to generate evidence about the type, severity, and timing of mental health and substance misuse needs among women involved in public family law proceedings concerning child placement into care (‘care proceedings’). This is a retrospective, matched cohort study using linked family court and mental health service records for 2137 (66%) of the 3226 women involved in care proceedings between 2007 and 2019 in the South London and Maudsley NHS Mental Health Trust (SLaM) catchment area. We compared mental health service use and risk of dying with 17,096 female-matched controls who accessed SLaM between 2007 and 2019, aged 16–55 years, and were not involved in care proceedings. Most women (79%) were known to SLaM before care proceedings began. Women had higher rates of schizophrenia spectrum disorders (19% vs 11% matched controls), personality disorders (21% vs 11%), and substance misuse (33% vs 12%). They were more likely to have a SLaM inpatient admission (27% vs 14%) or to be sectioned (19% vs 8%). Women had a 2.15 (95% CI 1.68–2.74) times greater hazard of dying, compared to matched controls, adjusted for age. Women involved in care proceedings experience a particularly high burden of severe and complex mental health and substance misuse need. Women’s increased risk of mortality following proceedings highlights that interventions responding to maternal mental health and substance misuse within family courts should offer continued, long-term support. The online version contains supplementary material available at 10.1007/s00127-022-02221-1.
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