Research

Question 1

Linking data on women in public family law court proceedings concerning their
children to mental health service records in South London

Pearson, RJ, Jewell, A, Wijlaars, L, Bedston, S, Finch, E, Broadhurst, K, Downs, J, and Gilbert, R

Answer 1

Introduction
Maternal mental health problems and substance misuse are key risk factors for child neglect or abuse and court-mandated placement into care. Linkage between mental health records and family court data could raise awareness about parent mental health needs and inform approaches to address them.

Objectives
To evaluate data linkage between administrative family court data and electronic mental health records for a population-based mental health service for 1.3 million people in South London.

Methods
We deterministically linked administrative family court data for women (n=5463) involved in care
proceedings in South London with service user records from the South London and Maudsley NHS
Mental Health Trust (SLaM). We restricted the cohort to women involved in proceedings between
2007 and 2019, in local authorities where SLaM solely provides secondary/tertiary mental health
services and the Improving Access to Psychological Therapies (IAPT) (n=3226). We analysed the
associations between match status and sociodemographic/case characteristics using multivariable logistic regression.

Results
Two-thirds (2317/3226; 66%) of women linked to a SLaM service user record at some point; most
(91%) who linked accessed secondary/tertiary mental health services, indicating serious mental
illness. Accounting for possible missed matches, we estimated that 70-83% of women accessed SLaM
services at some point. Older women at index proceedings (>35yrs OR: 0.69, 95%CI: 0.54-0.88vs
<25yrs) and Black women or women from other ethnic groups (Black ethnic groups 0.65, 0.50-0.83;
other ethnicity 0.59, 0.43-0.81 vs White ethnic groups) had lower odds of linking. Odds of linking were higher for women with an infant in proceedings (1.42, 1.18-1.71), or with curtailed/terminated
parental responsibility (1.44, 1.20-1.73).

Conclusion
Our linkage supports growing evidence of a high burden of mental health problems and substance
misuse among women whose children enter care in England, compared to the general population.
Research using this linkage should inform strategies to address the considerable mental health needs
of vulnerable women and their children.