Families in the Legal Enforcement System: A Case Example of Blending Infant Mental Health and Family Partner Services.
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Infant mental health
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Is home-based early intervention an invasion of the family that inadvertently undermines its self-confidence, or is it a life-saving service to families whose children are at risk of abuse and neglect?
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Infant mental health
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Infant mental health
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Parent-infant emotional health is probably one of the most complex arenas in which mental health, maternity and health visiting services operate. This critical period can be highly emotionally charged, not only for the infant but also be for the parent. While most parents essentially get it right, severe ruptures in the parent-infant relationship can occur, and can have serious consequences. This paper describes a comprehensive and cost-effective parent infant mental health service based on a psychodynamic model. The service aims to meet the needs of all parents from those with a high level of need through to a universal provision. Strategic and theoretical underpinnings of the service model are described.
Psychodynamics
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Mental health service
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Although France has one of the most generous health and social care systems for infant and maternal well-being in the Western world, professionals have been increasingly concerned by the rising number of children being referred for mental health problems. The present article describes the first home-visiting program in France to specifically target mental health questions in families living in vulnerable contexts. The CAPEDP project, involving 440 women and their families, took place in Paris and its inner suburbs from 2006 to 2011. To be eligible for inclusion, women had to be (i) under 26 years old, (ii) less that 27 weeks pregnant, (iii) sufficiently fluent in French to give truly informed consent to participate in the study and benefit from the intervention and (iv) presenting with one or more of the following social vulnerability factors: low income, low educational level, and/or intending to bring up the child without the child’s father. The intervention consisted of 44 home visits from the third trimester of pregnancy through to the child’s second birthday. The aim of the intervention was to promote infant mental health and reduce the incidence of infant mental health problems at the age of two years. The intervention paid particular attention to postnatal maternal depression and promoting parenting skills and attachment security, particularly through the use of video during home-visits. A major issue was that of adapting international best practice recommendations with regard to home-visiting programs to the particularities of the existing French social and health care system. An original aspect of the intervention was to use trained clinical psychologists to conduct all home visits.
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Protecting children whose parents have mental health problems has long been considered to be a major child welfare issue. A survey conducted by the National Society for the Prevention of Cruelty to Children showed that 16% of parents in the community have mental health problems.1 At the same time, the Children’s Act specifies that children should be with parents wherever possible.2
The Department of Health document “Crossing bridges” is designed to enhance practice and improve services for families with a mentally ill parent.3 It suggests that the service provision could be improved by attending to seven key principles for the development of interagency and interprofessional cooperation.
We audited our services against these recommendations. The names of children were randomly selected from the Child Protection Register (September 2004). Social services records were reviewed for evidence of parental mental problems, assessments parents underwent and services …
Child Protection
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Child rearing
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