There are many factors to explore with parents to inform the assessment. Below are some practice considerations and conversation ideas to help assess safety where parent’s mental health is identified as posing a risk to the children.
Important points to consider before you start talking with parents
A parent may find it difficult to trust Child Safety. This may be due to their mental health concerns, their previous experiences with Child Safety, their perceptions of Child Safety, or other factors affecting them.
Even when a parent has a diagnosed mental illness, they may not be linked with a mental health service provider. Explore family and community connections as part of the work to expand on the parent’s safety and support network. Draw on these people if an immediate safety plan is required. Think about how to extend family connections for the parent as well as the child — connection is one of the most important factors for improving a person’s mental health.
Be curious about what the parent’s mental health issue might mean for them and their child — the symptoms and experience of their illness will say more about the child’s experience than the name of their diagnosis. Explore the parent’s pattern of mental health issues — be aware that parents will often move between feeling well and unwell. Be curious about what helps the parent to feel well. Remember that everyone is different and how a mental health issue affects one person won’t be the same for another person. A diagnosis doesn’t depict behaviour.
Try using curiosity statements that start with what you hear. For example, ’I just heard you say … Can you help me understand that a bit more?’ ‘When you said ... I was wondering what you mean by that?’
If the parent presents as unwell during your conversation think about the ethical responsibilities. Are they well enough to make decisions? Does the parent have capacity to consent to plans and agreements? To keep their child safe? To keep themselves safe? Think about the child’s safety in these circumstances — does a mental health service or even an ambulance need to be contacted? Who else can support the child and family?
To learn more about what to do when a parent is very unwell, refer to the part on Working with parents.
Talk to parents about mental health and illness
There are many words a family, individual or community may use to talk about their mental health — feeling low, high, down or blue are some common examples. To make a person more comfortable, use their own words when talking with them.
|Practice considerations||Conversation ideas|
Find out what parts of the parent’s behaviour they are worried about.
Ask what the parent is mainly worried about and how they can get help for this. Find out how/if/where the mental health issue fits with their biggest worry.
For many parents, mental health issues can co-occur with other problems. Mental illness might not be the parent’s biggest worry, or even a worry at all. This is important to notice so you can start to talk about change.
These conversation examples and scaling tools will help you start planning with the family for change. Learn more about creating change with families in the Case planning part of this kit.
Determine if the parent is able to hold the child’s needs in their mind.
What do you find the most difficult/easiest?
What would your mother/best friend/partner say they are worried about when it comes to you/[child]?
What do you think your child would say? Do you think they worry about you sometimes? What makes you say that?
What would [child] say is your biggest worry about them?
Are there other things that worry you? (Try to address what concerns they have for themselves and for each child.)
Just so I am clear about the concerns we’ve discussed, can I write these onto this scale of 1 to 10 where 1 is not worried at all and 10 is extremely worried?
How well do you feel right now? Tell me where that sits on this scale of 1 to 10.
Explore how the parent’s current behaviour affects their children.
Understand how the parent is able to meet/keep in mind their child’s emotional and developmental needs.
Understand if the parent has realistic expectations about the child’s behaviour, independence and levels of responsibility.
Understand if the parent is able to have empathy for their child.
When you are feeling [symptom], do you think it affects how you care for [child]?
What would [child] notice when you are not doing so well?
What does your [symptom/s] stop you from doing?
What would [child] say about that?
What are you able to keep doing even when you do feel [symptom\s]?
Are there things that [child] does to help you, like things around the house? Tell me about these.
I’m curious about how you manage to keep doing those things when [symptom/s]?
Tell me about the last couple of days?
What does life at its best and worst look like for you?
What do you think [child] would say?
Is there anything you would have liked to have done differently in life — for you and your child?
What do you think you might need for some of that to happen?
Explore the parent’s ability to seek help. See if you notice any history of the parent’s willingness to work with services.
Find out more about the family's safety and support networks.
Strong safety and support networks are important protective factors for individuals and families experiencing mental health issues.
Who helps you in your family? Your partner? Your friends? Neighbours and people in the community?
Do any of these people do anything that’s not helpful?
Do you work with any services at the moment? How do they help? How often do you see them?
What services or workers have you used before?
How helpful did you find these services?
How did you come to be going along to this service? Did you refer yourself?
If you contacted the service, how did you find them?
What hasn’t worked?
Why didn’t it work?
What are your concerns about school/ work/ neighbours?
Consider what else is happening for the parents and children
- Are there indicators of alcohol or other drug use and/or domestic and family violence?
- Is the family experiencing poverty, homelessness, social isolation or problems accessing other structural supports?
- Is neglect an issue for this child?
- Are there indicators for cumulative harm?
- How might these issues relate to the parent’s mental health?
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