Parents with Mental Health Issues Rarely Asked about Children, Says Audit

According to an audit presented at the 2010 International Congress of the Royal College of Psychiatrists, patients with mental health issues are infrequently asked whether or not they have children, which is not only a violation of the guidelines published by the National Patient Safety Agency (NPSA) in May 2009, but also and a misstep that puts the children of these patients at risk.

The audit, which was conducted by Aarohee Desai-Gupya, MD, a specialty trainee in psychiatry from Manchester, and colleagues, found that more 37% of homicides of children in England and Wales between 1997 and 2004 were committed by a parent or step-parent with a mental illness. However, in half of all cases, psychiatrists and mental health workers forgot to ask the adult patients if they were a parent or took care of children, and 72% said that they never contacted family or friends of the patient to find out if the patient was responsible for any children. Also, in four cases, staff members who were concerned for the welfare of a child did not discuss their concerns with a consulting psychiatrist.

The researchers also collected data from a survey of 34 doctors and liaison nurses who worked in accident and emergency departments. Among the survey findings:

• 35% of respondents said they had no training in safeguarding children

• 35% said they did not routinely ask patients about their contact with children

• 32% said they did not ask their patients whether they harbored thoughts of harming children as part of a suicide plan

• 53% said they failed to ask patients whether they contemplated harming children as part of delusional beliefs.”

According to the researchers, the NPSA guidelines are not adequately met in the practice setting, but they hope that this research will ultimately help patients and their children.

“Asking the right questions can be overlooked while managing a busy case load,” Desai-Gupya said. “We hope that publishing our results will motivate mental health professionals across the country to conduct similar audits to see whether or not the guidelines are actually being implemented and to see whether or not the policy and procedures they are have in place are effective. There is scope for improvement of training provision on safeguarding children for doctors at all stage in training and A&E liaison nurses.”