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患有严重精神疾病的父母中与儿童保护服务介入相关的风险因素。

Risk Factors Associated With Child Protective Services Involvement Among Parents With a Serious Mental Illness.

作者信息

Ostrow Laysha, Kaplan Katy, Zisman-Ilani Yaara, Brusilovskiy Eugene, Smith Carina, Salzer Mark S

机构信息

Live & Learn, Morro Bay, California (Ostrow, Smith); City of Philadelphia and Department of Rehabilitation Sciences, Temple University, Philadelphia (Kaplan); Department of Social and Behavioral Sciences, Temple University, Philadelphia (Zisman-Ilani, Brusilovskiy, Salzer).

出版信息

Psychiatr Serv. 2021 Apr 1;72(4):370-377. doi: 10.1176/appi.ps.202000036. Epub 2020 Sep 10.

Abstract

OBJECTIVE

People with serious mental illnesses are as likely to be parents as people in the general population but are much more likely to have contact with child protective services (CPS) and experience an out-of-home placement of their children. This study sought to identify risk factors for CPS involvement among parents with serious mental illnesses.

METHODS

Parents with a serious mental illness were identified through a national, representative survey. Data from a follow-up interview were used to compare characteristics of parents who had a CPS contact (N=36) with those who did not (N=38). The interview assessed demographic and health characteristics, social support, traumatic life events, and other general risk factors for CPS involvement.

RESULTS

Compared with parents without CPS contact, parents with a CPS contact were more likely to be nonwhite and to be less educated. They were also more likely to have less attachment-related social support, more parenting-related needs in numerous areas, and more substance use-related issues and to have experienced adverse childhood and traumatic events. One-quarter of the parents with CPS contact reported not having a mental disorder diagnosis at the time of the first contact, and those in the CPS group were less likely to have taken medications at the time of the first contact than were parents who did not have a CPS contact.

CONCLUSIONS

Results suggest a need for policies, programs, and practices that attend to common risk factors associated with CPS involvement that are present in the general population rather than concentrating efforts on addressing behavioral health factors specific to parents with serious mental illness.

摘要

目的

患有严重精神疾病的人与普通人群中的人一样有可能成为父母,但他们与儿童保护服务机构(CPS)接触并让孩子被安置到家庭外的可能性要大得多。本研究旨在确定患有严重精神疾病的父母中涉及儿童保护服务机构的风险因素。

方法

通过一项全国性的代表性调查确定患有严重精神疾病的父母。随访访谈的数据用于比较有儿童保护服务机构接触经历的父母(N = 36)和没有该经历的父母(N = 38)的特征。访谈评估了人口统计学和健康特征、社会支持、创伤性生活事件以及其他涉及儿童保护服务机构的一般风险因素。

结果

与没有儿童保护服务机构接触经历的父母相比,有该经历的父母更有可能是非白人且受教育程度较低。他们也更有可能在与依恋相关的社会支持方面较少,在众多领域有更多与养育子女相关的需求,有更多与物质使用相关的问题,并且经历过童年不良事件和创伤性事件。四分之一有儿童保护服务机构接触经历的父母报告在首次接触时没有精神障碍诊断,并且儿童保护服务机构组的父母在首次接触时服药的可能性低于没有儿童保护服务机构接触经历的父母。

结论

结果表明需要制定相关政策、项目和措施,关注普通人群中与涉及儿童保护服务机构相关的常见风险因素,而不是将精力集中在解决患有严重精神疾病的父母特有的行为健康因素上。

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