Aims To determine whether parental stress factors are present in a significant proportion of a community paediatric caseload.
Methods Analysis of routinely collected service activity data using parental factors codes defined in the national Child and Adolescent Mental Health Services dataset (CAMHS), that is, parental sensory impairment, physical illness, mental illness, drugs and alcohol problems, learning disability, history of being in care or the victim of abuse as a child, history of known violence or child abuse as an adult and other unspecified parenting difficulties. These data relates to cases seen generically, that is, outside dedicated child protection and LAC sessions.
Results Over the financial year 2009/2010 the service had 2230 new and 4802 follow-up successful contacts. A total of 1519 separate instances of parental factors were identified in 436 new (19.55%) and 747(15.55%)of follow-up contacts. Specific factors (each contact may have more than one & up to four factors could be coded for each contact) were identified as follows: mental illness in 364, known history of violence in 208, learning disability in 159, physical illness in 157, problem drinking/drugs in 132, known history of child abuse in 40,period of care in childhood in 30,childhood abuse in 24, sensory impairment in 18 and physical disability in 13.Unspecified parenting difficulties which could not be included in the previous categories were identified in another 374 instances.
Conclusion This study identifies for the first time the frequent presence of both specific and unspecified parenting difficulties, most often reflecting adverse aspects of adult mental health, in this generic community paediatric caseload; this is another dimension of case mix complexity which has implications for training as well as planning and funding of services; it also illustrates the need for coordinated working across agencies as well as across services for vulnerable children and vulnerable adults & demonstrates the increasing overlap between CAMHS and community paediatrics. In our view the forthcoming child health dataset should therefore also include the CAMHS dataset parental stress factors codes.
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