Abstract
Objective
To detail the relationship between parental mental illness and the likelihood of out-of-home care (OHC) among their children, and to identify factors which modify this relationship.
Methods
Using Swedish national registers, children born in 2000-2011 (n=1,249,463) were linked to their parents. Time-dependent maternal or paternal mental illness (non-affective and affective psychosis, alcohol/drug misuse, depression, anxiety/stress, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism, and intellectual disability), were identified through ICD codes.
Results
Following adjustment for socioeconomic factors, children living with mentally ill parents were 4 times as likely to be placed in OHC than children without (95% CI 4.24-4.61). The highest HR was in the youngest children aged 0-1 year (5.77, 95% CI 5.42-6.14), exposed to maternal illness (HR 4.56, 95% CI 4.37-4.76), and parental intellectual disability (HR 4.73, 95% CI 4.09-5.46). Children with parental mental illness with multiple risk factors were at particularly high risk. Compared to children without parental mental illness, and those with university-educated parents, children whose parents had mental illness and only had education to age 16, had a 15 times higher risk of OHC (95% CI 13.75-16.54).
Conclusion
Children with parental mental illness are considerably more likely to be removed from home into care during childhood, particularly during the first year of life and if they are from socially disadvantaged families. Greater knowledge of these risks should lead to increased support for vulnerable new families.
To detail the relationship between parental mental illness and the likelihood of out-of-home care (OHC) among their children, and to identify factors which modify this relationship.
Methods
Using Swedish national registers, children born in 2000-2011 (n=1,249,463) were linked to their parents. Time-dependent maternal or paternal mental illness (non-affective and affective psychosis, alcohol/drug misuse, depression, anxiety/stress, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism, and intellectual disability), were identified through ICD codes.
Results
Following adjustment for socioeconomic factors, children living with mentally ill parents were 4 times as likely to be placed in OHC than children without (95% CI 4.24-4.61). The highest HR was in the youngest children aged 0-1 year (5.77, 95% CI 5.42-6.14), exposed to maternal illness (HR 4.56, 95% CI 4.37-4.76), and parental intellectual disability (HR 4.73, 95% CI 4.09-5.46). Children with parental mental illness with multiple risk factors were at particularly high risk. Compared to children without parental mental illness, and those with university-educated parents, children whose parents had mental illness and only had education to age 16, had a 15 times higher risk of OHC (95% CI 13.75-16.54).
Conclusion
Children with parental mental illness are considerably more likely to be removed from home into care during childhood, particularly during the first year of life and if they are from socially disadvantaged families. Greater knowledge of these risks should lead to increased support for vulnerable new families.
| Original language | English |
|---|---|
| Journal | Pediatrics |
| DOIs | |
| Publication status | Published - 1 Mar 2024 |