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At the Edge of Care: A systematic review and thematic synthesis of parent and practitioner views and experiences of support for parents with mental health needs and children’s social services involvement

Bacon, G., Lever Taylor, B., Batchelor, R. , Grant, C., Mantovani, N., Peter, S., Singer, J. ORCID: 0000-0003-0590-7165 & Sweeney, A. (2023). At the Edge of Care: A systematic review and thematic synthesis of parent and practitioner views and experiences of support for parents with mental health needs and children’s social services involvement. Health and Social Care in the Community, 2023, article number 6953134. doi: 10.1155/2023/6953134


A range of professionals and services are involved in supporting parents with mental health needs where there are child protection concerns. However, they do not always meet the needs of this population who tend to experience inadequate support and mistrust of services. This review aimed to synthesise parent and practitioner experiences and views of support for parents with both mental health needs and children's social services involvement. We performed electronic searches of the following databases: PsycINFO, CINAHL, HMIC, Medline, Embase, Social Policy and Practice, Social Services Abstracts, Social Science Citation Index, OpenGrey, Social Care Online, and ProQuest. Following searching and screening, 41 studies were identified including 359 parents and 1370 practitioners. We worked with a Lived Experience Advisory Group to develop the following themes: 1) a downward spiral of service intervention; 2) working with parents, not against them; 3) support wanted versus support provided; and 4) constrained by service rigidity. We found that families were often parenting amidst trauma and adversity. However, service involvement could trigger a 'downward spiral' of stressful processes and pressure over which parents felt they lacked control. Instead of improving their situations, support sometimes added to families’ difficulties, worsening parents’ mental health and making them feel marginalised, criticised and re-traumatised. There were, however, also examples of positive practice, where practitioners and parents developed trusting, open, and mutually respectful relationships. Practitioners often felt they were limited in their ability to offer collaborative, holistic care because services were fragmented, under-funded, crisis-driven, and inflexible. Difficulties mentioned most often by parents, such as financial issues, tended not to be a focus of available interventions. We conclude that the key issues identified must be targeted to improve support.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article which has been accepted for publication in Health and Social Care in the Community by Wiley. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords: parental mental health, child protection, social services, mental health services, parenting support, systematic review, qualitative research
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Nursing
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