Should doctors working with parents with mental health issues be compelled to pass that information to social services?

[JaneGMumsnet]

Hi,

BBC Radio 4 Woman's Hour are discussing depression tomorrow morning, in the light of an Ofsted report which says that children whose parents have mental health difficulties are poorly supported and protected, and they've asked us to ask you what you think.

In the light of the reports, Ofsted and the Care Quality Commission are proposing there should be a legal requirement for doctors and specialists working with parents with mental health issues to pass that information on to Social Services and other agencies. What do you think?

Would this improve joint working between children's social care and adult mental health services, and lessen risks for children?

Or would such a requirement mean that fewer mothers would be willing to talk about their mental health issues, including post-natal depression, with their doctors?

Many thanks for sharing your thoughts,
MNHQ

I think if something is said which puts a child at potential risk then it should be reported but I think informing SS of every case would a) make unrealistic workloads for SS and b) scare people out of getting help and make life more dangerous for some vulnerable families.

Because SS are just twiddling their thumbs waiting for more box-ticking to arrive on their desks? And would happily re-prioritise resources from families with severe current problems to those who may - but may not -have future problems of some kind?

And because mental health has never, ever been used to stigmatise anyone?

Dreadful idea.

Agree with above. I think it would put extra fear and stress on the ill parent too, which won't help! It could make the child feel insecure too.

If this happens it would mean that parents with MH problems would probably feel so anxious about SS involvement that they would avoid seeking medical help at all.

An awful idea.

Ouch. What about people who have had depression at some point and have been off antidepressants for years? Are they to be reported? I once read that 25% of people will experience it sometime in their lives. It's hard enough to persuade people to go see the GP now if they have it, since major symptoms include lack of trust, feeling that nobody can help, that it's hopeless. If they have fear of losing their children added to that, it can only make matters much worse.

Agree on the PND aspect too. It needs care and help, not perceived threats against the babies.

Carrots, not sticks.

No chance. As others say, it would result in some people not seeking help.

It should be that if there is a specific concern or safeguarding issue then ss can be brought in. But not disclosed as routine.

Terrible terrible idea.

As someone who has experienced PND, I know how reluctant the illness itself can make you to seek help. This would make it a lot worse. If people don't seek help then that is the worst possible situation for their children, surely?

In cases where there are concerns about individual children then could schools not take action on this basis, rather than doctors doing automatic referals?

< ahem > what if like me you have depression and kids but your also a sw? I'm already known to myself...

What nilgiri said!

It took me loing enough to seek help for my depression because of a fear of involvement of statutory authorities. I think lknowing that by asking for help I would definately be alerting social services I would just not have sought help at all. And god knows where we would be as a family now

By all means provide more help for parents with mental health issues, but social services should only be involved when there is a recognised child protection issue.

And to be honest, getting people talking about depression and trying to break down the barriers and associated stigma with campaigns such as Mind's Time to Change will be far more beneficial to sufferers and their families than a fear of social services involvement.

Very very bad idea. Though I can see that they are trying to avert tragedies such as a suicidal parent taking their children with them. there should be more support for those parents, and inter-agency co-operation only when it is needed.

It seems like the thin end of the wedge to me.... Start off with this - then what? Report parents who've tested positive for STDs because they obviously lead wreckless lives? Hmmmm.

Absolutely not unless the children are seen to be at risk through neglect etc...

I am pretty sure that even if they are depressed, most parents will strive to ensure that their children still get care and attention etc....

And what parameters are they going to use to judge depression? There's a huge difference between the type of depression one might regularly suffer with bipolar disorder or with a short bout of depression caused by bereavement/the end of a relationship etc....

Whatever happened to patient confidentiality?

If doctors and specialists explain why they would like to pass the information on (i.e. if they feel they more support might be beneficial to them and their families, or if there is sufficient reason to believe that there is a real potential for someone to be harmed - rare, thankfully) and the patient understands that and gives their consent, I don't see a problem with it.

No way should there be a legal requirement to do so though. Let professionals be human and use their judgement. Shouldn't be encouraging a fear of people who can help! There are enough flaws in the system as it is, we don't need another reactionary blanket law.

I heard this today on WH and think it is a terrible idea.

I had ante natal triggered OCD, depression and anxiety. I received superb care from all health professionals involved - including my GP, the CMHT, psychiatrist, mental health specialist midwife and obstetric consultant.

Initially I was terrified to admit how I was feeling because one of my fears was that my baby would be taken away at birth. I honestly think if I knew I would be referred to social services automatically I wouldn't have sought help. All the HCPs involved in my care reassured me at every stage.

Surely if a pregnant woman is known to HCPs she acknowledges her illness and wants to improve her situation? I can't see how an automatic referral simply because of a MH diagnosis will help anyone, mother or child.

No way! Ensure people are trained so that warning signs of possible neglect and harm of children are spotted, as should and does happen now. It will just stop people seeking help, thereby increasing the risk of someone getting worse. Look at the horror on here from totally normal families when a and e trips were going to be joined up - people were really worried about that.

No - only if they feel the child is at risk because of the MH problem

Ridiculous idea - suggest passing on info to HVs or Homestart, or any other local resources like children's centres, but if you mention SS people think of child protection and taking away, not support. If there is a support team then docs are probably mentioning them already, if not, publicising them.
And treat docs like the professionals they are, don't add more unnecessary checking up to social services' workloads.

I am now on anti-depressants after struggling but refusing to go to the GP out of fear.

If this was the case I would not have seeked help and I was very low at the point I did.

FWIW, I was referred to SS after breaking down and crying at a MW/Consultant appt when I was around 35 weeks pg with DS, it was because of physical pain and the Consultant tried to tell the MW about this, she wouldn't listen and made some disgustingly hurtful remarks to me "sometimes people slip through the net and tragedies happen", that killed.

The SW seen me and gave me the details of the MW to complain as she could see that she completely wasted her time and ignored the advice of the Consultant and because of a lot of her comments to me, she discharged me straight away.

That has really stuck with me and that's what stopped me going to get help when I needed it, it really affected my bonding experience with DS as well, as I thought I was useless and the MW must have thought that so it must be true. :(

Other then overloading an already stretched, and sometimes failing social services! I know that I wouldn't have spoken to my health visitor or GP about having PND if I thought it would be forwarded to social services. I thought they already had the power to advise social services if they thought a child was at risk? Which is how it should be.

FWIW - The SW asked me if I would like to be referred to a charity/group for disabled parents, she was really lovely but because of the worry at the time, I still declined.

The MW could have referred me to there instead of everything that she did.

Scho, that's awful behaviour from your midwife!! I'm glad the social worker saw sense! What a horrible way to add even more stress to you.

Schro*

Fairy - maybe you need to report you to yourself?

Yeah, she actually told me she thought I was going to hurt my DS. This was the first time she had met me, 5 minutes into an appointment where my Consultant who I seen every week was there.

The Consultant said she didn't have the power to change the decision but was obviously very annoyed.

I am a bit better about it now but it was a horrid experience, they actually had the SW visit me while I was in hospital, hours after a very traumatic birth.

I really worry what the effects would be if this was standard procedure.