Department of Occupational Therapy, University of Alberta, Edmonton, Canada.
Community Ment Health J. 2012 Feb;48(1):29-37. doi: 10.1007/s10597-011-9374-0. Epub 2011 Jan 18.
Many mothers with mental health issues are caught up in the child protection system and face the prospect of having their children removed from their care. The aim of this study was to determine prevalence and outcomes for mothers with mental health issues and their children in child maltreatment cases opened for investigation in Canada. The method was secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) core data. This CIS-2003 contains process and outcome data on a nationally representative sample of 11,652 child maltreatment investigations. Maternal mental health issues were noted in 2,272 (19.7%) cases opened for investigation. The most common child protection concerns were neglect, emotional maltreatment and exposure to domestic violence. A significant association was found between maternal mental health issues and child maltreatment investigation outcomes, with many potentially confounding variables held constant. Broad spectrum, multi-disciplinary services are needed to support mothers with mental health issues. Effective mental health care is vital but insufficient. Addressing trauma, strengthening social relationships and alleviating poverty are also key. Systemic advocacy is needed to ensure that mothers with mental health issues can access broad spectrum supports.
许多有心理健康问题的母亲都陷入了儿童保护系统,面临着孩子被剥夺抚养权的前景。本研究旨在确定在加拿大开展的儿童虐待案件中,有心理健康问题的母亲及其子女的患病率和结局。方法是对加拿大报告的儿童虐待和忽视发生率研究(CIS-2003)核心数据进行二次分析。CIS-2003 包含了对全国代表性的 11652 例儿童虐待调查的过程和结果数据。在为调查而开设的 2272 例(19.7%)案件中注意到了母亲的心理健康问题。最常见的儿童保护问题是忽视、情感虐待和家庭暴力的暴露。在保持许多潜在混杂变量不变的情况下,发现母亲的心理健康问题与儿童虐待调查结果之间存在显著关联。需要提供广泛的、多学科的服务来支持有心理健康问题的母亲。有效的心理健康护理至关重要,但还不够。解决创伤、加强社会关系和减轻贫困也是关键。需要进行系统宣传,以确保有心理健康问题的母亲能够获得广泛的支持。