|
First Author and Title | Participants | Population characteristics (number, gender, ethnicity, profession, diagnosis) | Setting | Data collection and analysis | Key themes |
|
(1) Ackerson [34] Coping with the dual demands of severe mental illness and parenting: the parents’ perspective | Parents | N = 13 (i) Diagnosis: not specified (ii) Gender: 12 female (92%) (iii) Ethnicity: not reported (iv) Age: not reported | Community Mental Health Centres Illinois, USA | Semistructured interviews grounded theory | (1) Problems with diagnosis and treatment (2) Stigma and discrimination (3) Chaotic interpersonal relationships (4) Strain of single parenthood (5) Custody issues (6) Relationship with children (7) Social support |
|
(2) Afzelius et al. [42] Children of parents with serious mental illness: the perspective of social workers | Practitioners | N = 13 (i) Profession: social service professionals (11 social workers, 1 trainee social worker, 1 treatment assistant) (ii) Gender: 12 female (92%) (iii) Age: M = 44 (29–57) | Children’s Social Care Services Sweden | Focus groups and semistructured interviews ontent analysis | (1) Identifying with the situation of the child (2) Handling parental severe mental illness |
|
(3) Barbour et al. [55] Assessing risk: professional perspectives on work involving mental health and child care services | Practitioners | N = 30–33 (not specified) (i) Profession: mixed (mental health (MH) and social services staff) (ii) Gender: not reported (iii) Age: not reported | Setting not reported UK | Focus groups thematic analysis | (1) The legacy of specialisation (2) Differing thresholds and codes (3) Assessing risk (4) Balancing risk and families’ rights |
|
(4) Barrow et al. [56] Context and opportunity: multiple perspectives on parenting by women with a severe mental illness | Both | Practitioners (n = 7) (i) Profession: housing shelters (ii) Gender: 4 female (57%) (iii) Age: not reported parents (n = 7) (iv) Diagnosis: not reported (v) Gender: 100% female (vi) Ethnicity: 3 African American, 3 Latina, 1 other (vii) Age: M = 36.7 (28–43) | Transitional Homeless Shelter New York, USA | Focus groups grounded theory | (1) Mother’s perspectives: “I want to always keep that good relationship” (2) Service provider perspectives: “It may be the client’s priority but not ours” |
|
(5) Caplan et al. [57] Indigenous and nonindigenous parents separated from their children and experiencing homelessness and mental illness in Canada | Parents | N = 36 (i) Diagnosis: not reported (ii) Gender: 12 female (33%) (iii) Ethnicity: 21 indigenous Canadian, 15 nonindigenous Canadian (white Canadian or white European) (iv) Age: M = 40 | Homelessness Project (At Home Chez Soi, AHCS) Canada | Semistructured narrative interviews thematic analysis and intersectional analysis | (1) Children as central in mothers narratives vs. peripheral in fathers (2) Cultural disconnection and reclamation of indigenous parents (3) Gender and ancestry of parent |
|
(6) Coates and Howe [58] Working with families who experience parental mental health and/or drug and alcohol problems in the context of child protection concerns: recommendations for service improvement | Both | Practitioners (n = 10): (i) Profession: 7 MH clinicians, 1 family support worker, 1 KTS-WFT site team leader, 1 psychiatrist (ii) Gender: not reported (iii) Age: not reported Parents (n = 20): (iv) Diagnosis: not specified (v) Gender: 17 female (85%) (vi) Ethnicity: not reported (vii) Age: not reported | Keep Them Safe Whole Family Team (KTS-WFT) Project - Central Coast Local Health District Outreach Service New South Wales, Australia | Semistructured interviews thematic analysis | (1) Service model improvement recommendations from the perspective of clinical staff (2) The KTS-WFT site from the perspective of discharged clients |
|
(7) Coates [39] Working with families with parental mental health and/or drug and alcohol issues where there are child protection concerns: inter-agency collaboration | Practitioners | N = 10 (i) Profession: 8 MH clinicians, 1 psychiatrist, 1 KTS-WFT Site team leader (ii) Gender: not reported (iii) Age: not reported | Northern Sydney Local Health District (NSLHD) Sydney, Australia | Open interviews grounded theory analysis | (1) Working collaboratively with child protection services |
|
(8) Darlington et al. [23] Complexity, conflict and uncertainty: issues in collaboration between child protection and mental health services | Practitioners | N = 232 (i) Profession: 156 statutory child protection, 69 adult MH services, 50 child and youth MH services, 13 integrated MH services, 12 Other (ii) Gender: 73% female (iii) Age: M = 37.7 (21–65) | Department of Families and Queensland Health Australia | Self-administered cross-sectional survey analytical method not reported | (1) The nature of child protection needs and parental mental health (2) The extent of collaboration (3) The impact of uncertainty on collaboration (4) Positive experiences and difficulties with collaboration |
|
(9) Darlington et al. [24] Practice challenges at the intersection of child protection and mental health | Practitioners | N = 36 (i) Profession: 17 child protection workers, 15 adult MH workers, 4 child and youth MH workers (ii) Gender: 31 female (86%) (iii) Age: M = 36.3 (25–56) | Department of Families and Queensland Health Australia | Case-based interviews thematic analysis | (1) Factors associated with effective collaboration between child protection and adult mental health: communication, knowledge, role clarity, and resource factors (2) Challenges to collaborative work: mental illness characteristics, balancing conflicting needs |
|
(10) Darlington and Feeney [59] Collaboration between mental health and child protection services: professionals’ perceptions of best practice | Practitioners | (See: [23]) | Department of Families and Queensland Health Australia | Self-administered, cross-sectional survey | Suggestions for improving interagency collaboration: (1) Improving communication (2) Enhancing the knowledge base of professionals in both sectors (3) Providing adequate resources and appropriate service models |
|
(11) Darlington and Feeney [60] Clients’ and professionals’ experiences of traversing mental health and child protection systems: implications for practice | Both | Practitioners (n = 4): (i) Profession: child protection caseworkers (1 family support worker, 2 child protection workers, 1 MH social worker) (ii) Gender: 100% female (iii) Age: M = 36.5 (26–50) Parents (n = 4): (iv) Diagnosis: 2 X psychosis, 1 X PTSD, 1 X depression (v) Gender: 100% female (vi) Ethnicity: not reported (vii) Age: M = 31 (19–36) | Department of Families and Queensland Health Australia | Semistructured interviews around 4 client-caseworker dyads thematic analysis | (1) Assessment and case planning issues (2) Service coordination and collaboration issues |
|
(12) Davidson et al. [61] Championing the interface between mental health and child protection: evaluation of a service initiative to improve joint working in Northern Ireland | Practitioners | N = 109 (i) Profession: 12 “champions” in MH, 59 MH team members, 12 “champions” in childcare, 26 children”s social workers (ii) Gender: 84% female (iii) Age: not reported | Northern Health and Social Care Trust (NHSCT), Northern Ireland, UK | Questionnaires analytical method not reported | Service evaluation, themes not reported |
|
(13) Diaz-Caneja and Johnson [16] The views and experiences of severely mentally ill mothers--a qualitative study | Parents | N = 22 (i) Diagnosis: 8 X schizophrenia delusional, 4 X bipolar disorder, 4 X severe depression with psychotic symptoms (ii) Gender: 100% female (iii) Ethnicity: 13 White British, 3 White other, 1 Black British, 1 Black Caribbean, 1 Black African, 2 Asian, 1 mixed (iv) Age: >20 | Camden and Islington Community Mental Health Team London, UK | Semistructured interviews thematic analysis | (1) Positive aspects of motherhood (2) Difficulties associated with motherhood (3) Stigma (4) Effect of mental illness on children (5) Views about services |
|
(14) Ghaffar et al. [62] Exploring the experiences of parents and carers whose children have been subject to child protection plans | Parents | N = 47 (i) Diagnosis: not reported (ii) Gender: 39 female (83%) (iii) Ethnicity: 36 White British, 5 X British Asian 6 X not specified (iv) Age: <20 (n = 2), 20–29 (n = 20), 30−29 (n = 12), 40–49 (n = 7), >50 (n = 1) | Local authorities in Northern England, UK | Semistructured interviews thematic analysis | (1) Power differentials between service users and professionals (2) Opportunities for building effective relationships (3) family involvement in decision-making |
|
(15) Hanley and Long [63] A study of Welsh mothers’ experiences of postnatal depression | Parents | N = 10 Diagnosis: postnatal depression Gender: 100% female Ethnicity: not reported Age: 17–33 | Wales, UK | Semistructured interviews content analysis | (1) Previous knowledge of postnatal depression (2) Early traumatic life events (3) Self-awareness of health status (4) Attachment strengths and weaknesses (5) Intimate relationships (6) Social relationships (7) Support systems (8) Valued experiences (9) Prevention strategies and lifestyles |
|
(16) Hetherington and Baistow [64] Supporting families with a mentally ill parent: European perspectives on interagency cooperation | Practitioners | N = not reported (i) Profession: adult MH workers and child welfare workers (ii) Gender: not reported (iii) Age: not reported | The Icarus Project Brunel University, UK | Focus groups analytical method not reported | Reported cross-country differences in structures, resources, expectations, and attitudes and how these affect professional responses and the experiences of families |
|
(17) Hinden et al. [37] The invisible children’s project: key ingredients of an intervention for parents with mental illness | Both | Practitioners (n = 9) (i) Profession: 3 case managers, 6 child welfare workers (ii) Gender: not reported (iii) Age: not reported Parents (n = 9) (iv) Diagnosis: 5X Major Depressive disorder, 1X schizoaffective, 1X substance abuse, 1X adjustment disorder, 1X bipolar disorder (v) Gender: not reported (vi) Ethnicity: 6 Caucasian, 3 African American (vii) Age: 26–40 | Invisible Children’s Project Department of Social Services New York, USA | Semistructured interview general inductive approach | (1) Identification of essential services for parents with mental illness (2) Mediators of successful outcomes |
|
(18) Hollingsworth et al. [65] The role of positive and negative social interactions in child custody outcomes: voices of US women with serious mental illness | Parents | N = 3 (i) Diagnoses: 2 X bipolar disorder with psychosis, 1 X schizoaffective disorder (ii) Gender: 100% female (iii) Ethnicity: African American (iv) Age: 28–38 | National Institute of Mental Health—longitudinal study of the meaning of motherhood University of Michegan, USA | Semi-structured interviews thematic Analysis | (1) The relationship between a mother’s social interactions and the presentation of threats to her child (ren)’s safety (2) The relationship between a mother’s positive and negative interactions and losing or relinquishing custody of her child (ren) (3) The relationship between a mother’s social interactions and her efforts to regain custody (reunification) or to adjust to permanent placement |
|
(19) Honey et al. [66] Living with mental illness and child removal | Parents | N = 8 (i) Diagnoses: 3X depression, 3X bipolar, 3X psychotic disorder, 2X anxiety disorder, 1X post-traumatic stress disorder (ii) Gender: 100% female (iii) Ethnicity: not reported (iv) Age: not reported | Setting not reported University of Sydney, Australia | Semistructured interviews interpretive phenomenological approach | (1) Chaotic lives preremoval (2) Pain and loss (3) Protecting myself (4) Constrained mothering |
|
(20) Humphreys et al. [67] Beyond co-occurrence: addressing the intersections of domestic violence, mental health and substance misuse | Practitioners | N = 28 (i) Profession: senior practitioners working in child protection, family support, specialist domestic violence, MH and substance misuse (ii) Gender: not reported (iii) Age: not reported | STACY Project – Domestic Violence Services Australia | Semistructured interviews, ethnographic notes, transcripts thematic synthesis | (1) Partnering with nonoffending parent (2) Addressing the intersection of domestic violence with mental health (3) Pivot to the perpetrator (4) Differing frameworks across services |
|
(21) Kageyama and Yokoyama [68] Social workers’ support skills for parents with mental disorders: a qualitative descriptive study in child-welfare social workers | Practitioners | N = 8 (i) Profession: child welfare social workers (ii) Gender: 6 female (75%) (iii) Age: M = 50.8 (42–60) | Research for child welfare department Japan | Semistructured interviews qualitative descriptive analysis | (1) Identification of goals social workers supported parents in (2) Support skills used by social workers |
|
(22) Keddell [69] Constructing parental problems: the function of mental illness discourses in a child welfare Context | Both | Practitioners (n = 22): (i) Profession: social workers (ii) Gender: 19 female (86%) (iii) Age: not reported Parents (n = 8) (iv) Diagnosis: not specified (majority depression) (v) Gender: 7 female (88%) (vi) Ethnicity: not reported (vii) Age: not reported | Child-welfare NGO Aoteatora, New Zealand | Semistructured case-based interviews secondary discourse analysis of paired social worker and service user narratives | (1) Dominance of a family maintenance discourse that framed decision-making (2) Defining children’s best interests as relational needs and rights (3) The use of mental illness and lack of support to construct nonculpable causes of original family problems (4) “Safety” in addition to risk (5) Strong commitment to “respect for persons” |
|
(23) Lever Taylor et al. [70] Experiences of social work intervention among mothers with perinatal mental health needs | Parents | N = 18 (i) Gender: 100% female (ii) Diagnosis: 4 X depression, 1 X anxiety, 9 X personality disorder, 4 X bipolar disorder/psychosis/schizophrenia (iii) Ethnicity: 12 White British, 1 White other, 4 Black Caribbean, 1 Black African (vi) Age: M = 28.7 | NHS Mental Healthcare Services, UK | Semistructured interviews thematic analysis | (1) Labelled as “bad mothers” (2) Set up to fail (3) Turning points |
|
(24) Marziali et al. [71] Supportive group therapy for parents who chronically neglect their children | Parents | N = 6 (i) Diagnosis: complex emotional needs (ii) Gender: not reported (iii) Ethnicity: not reported (vi) Age: not reported | Personality Disorder Group Therapy Service Evaluation Canada | Observed and transcribed group sessions analytical process not reported | (1) The search for boundaries (2) Attack and despair (3) Mourning and repair (4) Integration of self-control |
|
(25) Mason et al. [72] Experiences of child protection workers in collaborating with adult mental health providers: An exploratory study from Ontario, Canada | Practitioners | N = 339 (i) Profession: family service workers (31.2%), children’s service workers (13.3%), intake workers (10.0%), investigation workers (9.1%), other (36.4%) (ii) Gender: not reported (iii) Age: 52.1% between the ages of 25 to 44 years | Children’s Aid Societies, Ontario, Canada | Survey data (open-ended questions) thematic qualitative analytic procedures [73] | (1) Collaborative strategies (2) Barriers and facilitators to collaboration (3) Ideas to improve collaboration between child welfare and adult mental health services |
|
(26) McPherson et al. [48] Evaluating integrative services in edge-of-care work | Practitioners | N = 24 (i) Profession: MH practitioners, enhanced therapists, PIMHAP lead, trainee clinical psychologists, children’s services managers, children’s services social workers, children’s centre managers, midwives, allied project consultants, and administrators (ii) Gender: not reported (iii) Age: not reported | Norfolk Parent Infant Mental Health Attachment Project (PIMHAP) Service Evaluation | Focus groups | (1) A safe place to leave professional defences behind (2) Working within financial and professional constraints (3) Creating solutions to long-standing dilemmas (4) Holding really tough stuff without switching off |
|
(27) Mind [74] A right to know, a right to be involved: a survey of the views of people with mental health problems who were parents experiencing local authority statutory children’s services | Both | Practitioners (n = 9) (i) Profession: child and family social workers, independent Reviewing Officer, family resilience workers, community MH workers, solicitors (ii) Gender: not reported (iii) Age: not reported Parents (n = 14) (iv) Diagnosis: not reported (v) Gender: not reported (vi) Age: not reported (vii) Ethnicity: not reported | Mind’s Parenting Advocacy Service, Croydon, UK | Survey data (open questions) and 1 : 1 telephone interviews not reported | Service evaluation, themes not reported |
|
(28) Ostler [75] Dysregulation of the caregiving system in the context of maternal depression: the role of mistrust in the development and causation of abusive parenting behaviour | Parents | N = 8 (i) Diagnosis: depression (ii) Gender: 100% female (iii) Ethnicity: 4x African American, 3x Caucasian, 1X Hispanic backgrounds (iv) Age: 21–44 | State Child Protective Services, Illinois, USA | Parent interviews, record reviews, observational and standardized measures deductive thematic analysis | (1) Mistrust as an extreme defense (2) Reported childhood experiences (3) Abusive and role-reversed parenting behaviours (4) Attachment-relevant triggers of abusive parenting (5) Context of depression |
|
(29) Pause [76] How can maternal mental health services best support women who have experienced the removal of children from their care? | Both | Practitioners (n = 9) (i) Profession: MH Clinicians (ii) Gender: not reported (iii) Age: not reported Parents (n = 32) (iv) Diagnosis: not reported (v) Gender: 100% female (vi) Age: not reported (vii) Ethnicity: not reported | Maternal Mental Health Service Cheshire and Merseyside, UK | Virtual focus group, individual conversations, and an online survey analysis not reported | (1) Women who have experienced the removal of children are currently not routinely offered maternal mental health services (2) Women will be feeling overwhelmed and may be fearful of services (3) Maternal mental health services should offer support early, build trusting relationships, work collaboratively with other services, and be open and honest with women (4) Services should understand the impact of trauma, ask and listen to women’s preferences |
|
(30) Perera et al. [32] There is a lot to it: being a mother and living with a mental illness | Both | Practitioners (n = 11) (i) Profession: 6 social workers, 2 psychiatric nurses, 2 medical offers, 1 parent peer leader (ii) Gender: 9 female (81%) (iii) Age: not reported Parents (n = 8) (iv) Diagnosis: 5 X schizophrenia, 2 X psychotic depression, 1 X bipolar disorder (v) Gender: 100% female (vi) Ethnicity: not reported (vii) Age: M = 36 (26–44) | Adult public mental health service Melbourne, Australia | Semistructured interviews constructivist grounded theory | (1) Positive aspects of motherhood for women living with mental illness (2) Challenging aspects of motherhood |
|
(31) Powell et al. [77] Perceived community-based needs of low-income parents with psychiatric disabilities who experienced legal challenges to their parenting rights | Parents | N = 12 (i) Gender: 10 female (83%), 2 men (17%) (ii) Diagnosis: mixed (anxiety, bipolar disorder, depression, post-traumatic stress disorder (PTSD), and schizophrenia) (iii) Ethnicity: 7 White, 1 Black/African American, 1 Asian, 3 multiracial (iv) Age: not reported | Setting not reported USA | Semistructured telephone interviews content analysis | (1) Types of supports parents reported as useful for their well-being (2) Chronic economic hardships and material deprivation |
|
(32) Rouf et al. [78] Making decisions about parental mental health: an exploratory study of community mental health team staff | Practitioners | N = 13 (i) Profession: 3 community psychiatric nurses (CPNs), 3 psychologists, 3 social workers and 4 psychiatrists, 5 named nurses for child protection (ii) Gender: 100% female (iii) Age: not reported | Community Mental Health Team, Oxford and Buckinhamshire Mental health Trust UK | Semistructured interviews (all staff) diaries (named nurses) interpretative phenomenological analysis (IPA) | (1) The tensions of working across systems (2) Trying to balance the perceptions and feelings involved in sense-making (3) The role that interpersonal dynamics play in the understanding and management of risk |
|
(33) Scott et al. [79] What does “recovery” from mental illness and addiction mean? Perspectives from child protection social workers and from parents living with mental distress | Both | Practitioners (n = 11) (i) Profession: child protection workers (ii) Gender: not reported (iii) Ethnicity: not reported (iv) Age: not reported Parents (n = 13) (v) Ethnicity: 11 New Zealand Europeans, 1 Māori, 1 Asian (vi) Gender: 9 (69%) female (vii) Diagnosis: mixed (viii) Age: 20+ | Child Custody Research Project (CCRP) Aotearoa, New Zealand | Semistructured interviews, primary thematic analysis, and secondary discourse analysis | (1) Child protection worker perspectives on symptom management and recovery (2) Parents on their experiences of recovery and on the views of child protection workers |
|
(34) Siverns and Morgan [15] “If only I could have said, if only somebody was listening”: mothers’ experiences of placing their child into care | Parents | N = 3 (i) Diagnosis: not specified; receiving service support for trauma (ii) Gender: 100% female (iii) Ethnicity: 2 White British, 1 Asian British (iv) Age: 21–50 | Mental Health Services (NHS and private healthcare providers) UK | Semistructured interviews interpretive phenomenological analysis (IPA) | (1) Fractured sense of motherhood (2) Feelings of failure, shame, and regret (3) Dehumanisation and disempowerment |
|
(35) Stanley et al. [40] Working on the interface: identifying professional responses to families with mental health and child-care needs | Both | Practitioners (n = 500) (i) Profession: 104 children’s social workers, 67 health visitors, 58 adult psychiatry staff, 56 community psychiatrist nurses, 54 MH social workers, 22 child care voluntary agency staff, 19 child and adolescent psychiatry staff, 19, GP’s, 18 family centre workers, other (occupational therapists, guardians, police, paediatricians, MH volunteers, residential care workers) (ii) Gender: not reported (iii) Age: not reported parents (n = 11) (iv) Diagnosis: not reported (v) Gender: 100% female (vi) Ethnicity: not reported (vii) Age: not reported | 2 local authority areas in the northeast of England UK | Semistructured postal survey (practitioners) semistructured interviews (parents) thematic analysis | (1) Professional roles and remits (2) Focusing on users’ needs (3) Interprofessional coordination (4) Identifying a lead service (5) The mothers’ perspectives |
|
(36) Staudt and Massengale [80] Parents involved with child welfare: their perceptions of mental health services | Parents | N = 20 (i) Diagnosis: not reported (ii) Gender: 100% female (iii) Ethnicity: 3 African American, 17 European American (iv) Age: not reported | Public child welfare agencies Tennesee, USA | Semistructured interviews grounded theory | (1) Relationships with therapists (2) Perceived treatment benefits (3) Availability and accessibility of services and therapists (4) Treatment expectations |
(37) Stephens [53] Recognizing complex trauma in child welfare-affected mothers of colour | Parents | N = 20 (i) Diagnosis: not specified—all had experience traumatic event (ii) Gender: 100% female (iii) Ethnicity: 8 Black or African American, 7 Latina or Hispani, 5 mixed race (iv) Age: M = 43 | CW-affiliated community-based organizations (e.g., social service providers, mental health centres) New York, USA | Semistructured interviews Interpretive phenomenological analysis and directed content analysis | (1) Chronic and compound exposure to potentially traumatic events (PTEs) (2) Interpersonal violations of trust (3) Pervasive mistrust of others (4) Revictimization (5) The absence of appropriate MH treatment (6) Grown while living with complex trauma |
|
(38) Tchernegovski et al. [81] How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study | Practitioners | N = 11 (i) Profession: MH clinicians (ii) Gender: 8 female (73%) (iii) Age: M = 39.3 | Clinical adult mental health sector-public services Victoria, Australia | Semistructured telephone interviews interpretive phenomenological analysis | (1) Managing sensitive parenting conversations (2) Making decisions about child safety in unclear or unpredictable situations (3) Working with child protection services |
|
(39) Björkhagen Turesson [82] Conceptions, norms, and values in the work of child protective services with families at risk: an analysis of social workers’ diaries | Practitioners | N = 3 (i) Profession: Social workers (ii) Gender: not reported (iii) Age: not reported | Child protective Services Sweden | Social workers’ diary entries thematic analysis | (1) The Janus face of child protective services (2) Clienthood and its conditions (3) Child protective services and good and bad parenting (4) The fathers |
|
(40) Yoo et al. [83] Psychotherapy for child welfare cases: clinicians’ and parents’ perspectives | Both | Practitioners (see [84]) Parents (N = 7): (i) Diagnosis: not reported (ii) Gender: 100% female (iii) Ethnicity: 4 White American, 3 African American (iv) Age: M = 29.4 (19–39) | Child welfare agencies Illinois, USA | Semistructured interviews thematic analysis | (1) Psychotherapy as a place for safety and empathy (2) Psychotherapy as a place for challenge (3) Psychotherapy as a place for problem resolution |
|
(41) Yoo et al. [84] They’re not bad parents. They’ve just made bad choices: “Mental health clinicians” perspectives of parents involved with child protective services | Practitioners | N = 10 (i) Profession: 3 family therapists, 3 counsellors, 3 social workers, 1 clinical psychologist (ii) Gender: 9 female (90%) (iii) Age: M = 43.5 | Child welfare agencies Illionois, USA | Semistructured interviews thematic analysis | (1) Parents strengths: potential and capacity for care (2) Parents challenges: reasons behind maltreatment |
|