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Factors predicting child protective services' provision of and referral to services for parents with a mental illness
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Thesis/Dissertation
Date
2024-05
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Public Health
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http://dx.doi.org/10.34944/dspace/10224
Abstract
Background: Parents with a serious mental illness (SMI), compared to parents who do not have a mental illness, have a greater likelihood of having contact with child protective services and afterwards, of experiencing negative outcomes such as loss of custody. Child protective service (CPS) workers may be able to connect parents with an SMI with services and resources to help address mental health, parenting, and other needs. The purpose of this dissertation was to gain a better understanding of factors that contribute to the provision of services and referrals by the child welfare system for parents with an SMI. Aims: The specific aims were as follows: 1) Determine whether child welfare agencies’ structure, policies, and climate are related to CPS workers providing or referring parents with an SMI to mental health and parenting services. 2) Determine child protective service workers’ knowledge of and attitudes towards serious mental illness. 3) Determine child protective service workers’ perceptions about providing or referring parents with an SMI to mental health and parenting services. 4) Determine whether child protective service workers’ knowledge, attitudes, and perceptions (as specified in Aims 2 and 3) vary between parents with major depression and parents with schizophrenia.
Methods: Secondary analysis of the second National Survey of Child and Adolescent Well-Being (NSCAW II) was conducted to see how child welfare agencies’ structure, policies, and climate are related to workers’ provision of services or referrals to parents with a serious mental illness. Aims 2-4 were addressed by the development and dissemination of a survey to child welfare workers. As there are no existing measures of child welfare workers’ attitudes related to serious mental illness and perceptions around working with parents with a serious mental, some survey items were adapted from existing measures and questionnaires. These included measures of mental health stigma and knowledge given to healthcare professionals. Other survey items were developed based on existing literature in parental mental illness and child welfare.
Results: For Aim 1, no factors were statistically significantly related to an agency’s rate of provision of mental health services and referrals. Only percent of the county in poverty, percent of the county that was White, and an agency having one caseworker from the beginning to the end of a case were statistically significantly related to an agency’s rate of provision of parenting skills training services and referrals. The survey for Aims 2-4 had an overall sample size of 456 participants. For Aim 2, participants were knowledgeable about both major depression and schizophrenia. They had relatively low levels of stigmatizing attitudes towards parents with a serious mental illness although many undervalued the benefits of parenthood for people with an SMI. For Aim 3, participants identified mental health treatment, emotional support from family and friends, and practical resources as the three most important needs of parents with an SMI. Participants rated their capability in supporting parents’ non-mental health needs more highly than supporting their mental health needs. Participants identified possible barriers to the provision of services and referrals including caseloads and leadership support. Participants strongly supported child welfare agencies providing parents with an SMI with services and referrals.
Conclusion: This dissertation expands our understanding of factors impacting the provision of services and referrals by the child welfare system to parents with an SMI. It highlights the importance of workers having the time and resources to work with parents with an SMI and identifies areas in need of improvement.
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