2.3.5 Joint Protocol to meet the Needs of Unborn Children whose Parents or Carers have a Mental Illness |
Contents
- Foreword
- Introduction
- Aims
- Principles
- Identifying the Needs of Children, Their Parents or Carers, or Pregnant Women With Mental Health Problems
- Decision Making Flowcharts
- Guidance for Referral to the Perinatal Mental Health Services
- Guidance for Referral to Adult Mental Health Services
- Guidance for Referral to Mental Health for Older Adults Service
- Guidance for Referral to Child and Adolescent Mental Health Service
- Guidance for Referral to Children and Young People’s Services
- Primary Care
- Adult Protection
- Interagency Information Sharing
- Review and Ongoing Work
- Conflict Resolution and Escalation Where There is a Disagreement
- Legal and Policy Framework
- Mental Illness of a Carer or Parent
- Who to Contact
- Resources and Information Sources
- Definitions and Glossary of Terms
1. Foreword
This Protocol is important for the safeguarding of children and families in Lambeth. It should be read and implemented, where necessary, by all practitioners and managers working with children or with parents / carers or pregnant women who have mental health.
It was drafted jointly by Lambeth Council, South London and Maudsley NHS Foundation Trust and Lambeth Primary Care NHS Trust on behalf of the Lambeth Safeguarding Children Board which agreed the protocol in March 2007.
Research and local experience have shown that mental health problems in parents/carers or pregnant women can have significant impact on parenting and increase risk, especially for babies and younger children. This does not mean that parents who experience mental health problems are poor parents. However, the impact of mental health problems can, on some occasions, lead to children and families needing additional support; or in a small number of cases support and multi-agency action to prevent significant harm.
The most effective assessment and support comes through good information sharing, joint assessments of need, joint planning, professional trust within inter-agency network and joint action in partnership with families.
The Lambeth Safeguarding Children’s Board expects all agencies working with children or adults who are parents in Lambeth to implement this Protocol and ensure that all relevant staff are aware of it and how to use it. It should be used in all new contacts with children or families, identification of pregnancy in women with mental health problems or where their partner has a mental health problem and when there are serious changes in a parent’s mental health. It should also be used where adults with mental health problems are living in the same household as children or when they look after children.
List of signatories for different agencies.
e.g.
Mayor of London Borough of Lambeth
Chief Executive of London Borough of Lambeth
Chief Executive of Lambeth NHS Primary Care Trust
Chief Executive of King College London NHS Trust
Chief Executive of Guy’s and St Thomas’ NHS Foundation Trust
Chief Executive of South London and Maudsley Foundation Trust
Date
2. Introduction
| 2.1 | This joint protocol has been developed to meet the new requirements set out in Every Child Matters (2005) and Working Together to Safeguard Children (2006) that all services will work more closely together to promote the health and well being of children, young people, their families and carers. This is a local protocol for Lambeth service; it does not override existing legal framework and statutory requirements, but it is derived from it. |
| 2.2 | This protocol has been based on the Southwark Joint Service Protocol to meet the needs of children and unborn children whose parents or carers have mental health problems and the Croydon Joint Service Protocol to meet the needs of children and unborn children whose parents or carers have mental health, substance misuse problems or learning difficulties. We are grateful to both Southwark and Croydon services for permitting us to use their protocol. |
| 2.3 | This protocol applies whenever there are concerns about the well-being or safety of children whose parents, carers or someone in their household have mental health problems, specifically where these difficulties are impacting, or are likely to impact, on their ability to meet the needs of the children. This protocol also applies to pregnant women who have mental health problems or where their parents are known to have mental health problems. |
| 2.4 | This protocol is a live document and will be reviewed at least annually. |
3. Aims
| 3.1 | To ensure children in Lambeth are safeguarded. |
| 3.2 | To increase the understanding of the impact of an adult’s mental health problems on children’s lives. |
| 3.3 | To ensure that universal and specialist services improve the identification of children in need. |
| 3.4 | To ensure the provision of co-ordinated services to families in which there are dependent children of parents, carers or pregnant women with mental health problems. |
| 3.5 | To ensure good co-operation and collaborative decision-making between services. |
| 3.6 | To ensure there is a clear understanding of referral routes across agencies. |
| 3.7 | To ensure timely intervention. |
4. Principles
| 4.1 | All those who come into contact with children, their parents and families in their everyday work, including practitioners who do not have a specific role in relation to child protection, have a duty to safeguard and promote the welfare of the child. |
| 4.2 | The welfare of the child is of paramount importance. |
| 4.3 | Parents, carers and pregnant women with mental health problems have a right to be supported in fulfilling their parental roles and responsibilities. |
| 4.4 | While many parents, carers and pregnant women with mental health problems safeguard their children’s well-being, children’s life chances may be limited of threatened as a result of those factors, and professionals need to consider this possibility for all clients with children. |
| 4.5 | Efforts should be made to work in partnership with families, children and professionals in the network. |
| 4.6 | A multi-agency approach to assessment and service provision is in the best interests of the children and their parents/or carers. |
| 4.7 | Risk to children is reduced through effective multi-agency and multi-disciplinary working. |
| 4.8 | There will be appropriate professional confidentiality and respect for service users. |
| 4.9 | We will value and appreciate diversity. However, cultural factors neither explain nor condone acts of commission or omission, which cause a child to be placed at risk. Anxiety about possible accusations of racist practice should never prevent necessary action being taken to protect a child or vulnerable adult. |
| 4.10 | Ensure the safety of children by integrating strategies, policies and services relevant to abuse within the framework of: Working together to safeguard children (2006). |
5. Identifying the Needs of Children, Their Parents or Carers, or Pregnant Women With Mental Health Problems
| 5.1 | The birth of any new child changes relationships and often brings new pressures to parents, carers and household members. Agencies need to be sensitive and responsive to the changing needs of parents or carers with mental health problems. |
| 5.2 | Parents, carers or pregnant women with mental health problems may have difficulties, which impact on their ability to meet the needs of their children or new baby. This protocol acknowledges that such children may be in needs of assessment for services provided by a range of agencies, from universal ad early intervention to specialist services for those with more acute or complex needs. |
| 5.3 | If an adult with mental health problems is known to care for, parent or live with a child, consideration needs to be given to how this impacts on the adult’s ability to care for and nurture the child. |
| 5.4 | If a child is known to service, thought needs to be given to their parent’s or carer’s mental health needs. |
| 5.5 | Consideration is needed when decisions are made about how best to meet the needs of children when adults are experiencing mental health problems. |
| 5.6 | When mental ill health is present as well as substance misuse or a learning difficulty it is important to keep in mind that the risks are increased. |
6. Decision Making Flowcharts
Click here to view Child Being Seen by Services Flowchart
Click here to view Adult Know to Services Flowchart
7. Guidance for Referral to the Perinatal Mental Health Services
Woman with Severe Mental Illness identified as pregnant
SLAM Policy for the Care and Support of Pregnant Women with a Diagnosis of Severe Mental Illness (2006) |
| 7.1 | Pregnant women who have a past history of serious psychiatric disorder, postpartum or non-postpartum, should be assessed by a psychiatrist in the antenatal period. A management plan regarding the high risk of recurrence following delivery should be agreed with the woman, her maternity team and GP and placed in her handheld records (Department of Health. Why Mothers Die 2000-2002. The Confidential Enquiries into Maternal Death in the United Kingdom. London:Stationery Office. 2004.) |
| 7.2 | All agencies are responsible for identifying pregnant women with mental health problems who may be in need of additional services and support. |
| 7.3 | When an agency identifies a pregnant woman experiencing mental health problems an assessment must be undertaken to determine the services she requires. This must include gathering relevant information from the GP, Adult Mental Health Services, Health Visitor, midwife and other agencies involved to ensure that the full background is obtained about any existing or previous diagnosis and/or treatment for mental illness. |
| 7.4 | Effective multi-agency working, information sharing and pro-active planning for the care and support of women with a history of severe mental illness who become pregnant is essential. This should start early in pregnancy and should be a collaborative process involving the pregnant woman, her partner and others she wishes to involve. |
| 7.5 | All women with current or previous severe mental illness should be referred to Perinatal Mental Health Services. |
| 7.6 | The appropriate Perinatal Mental Health Service is determined by the hospital at which the woman is booked for maternity care. For women living in Lambeth, in the majority of cases, this will either be St. Thomas’ Hospital or King’s College Hospital. The perinatal mental health services at both these hospitals offer outpatient and obstetric liaison services. (If the woman has not yet booked for antenatal care, or is having her maternity care at another hospital, then either MAPPIM or the King’s Perinatal Mental Health Service can be contacted for advice.) The Lambeth specialist worker in Perinatal Psychiatry can also be contacted for advice. |
| 7.7 | Perinatal mental health services do not offer an emergency service to women in the community. If a woman requires an urgent assessment she should be seen initially by local emergency general adult mental health services or in the Accident and Emergency Department. The perinatal mental health service should be informed as soon as possible. |
| 7.8 | Women with mild to moderate mental health problems should generally be offered treatment and support in primary care, without the involvement of perinatal mental health services. If there is any uncertainty regarding the nature or severity of the mental illness then either perinatal service can be contacted to advise whether referral is appropriate. Perinatal Services can also be contacted for advice regarding treatment, for example prescribing in pregnancy. |
| 7.9 | If a woman requires psychiatric admission during pregnancy or in the postnatal period admission to the Channi Kumar Mother and Baby Unit should be considered. The unit can be contacted directly to discuss whether the referral is appropriate. |
| 7.10 | The need for discussion with and/or referral to Children and Families Social Services should be considered in each individual case. The reasons for the decision either to refer or not should be clearly recorded. Guidance on pre-birth referral and assessment is provided in the London Child Protection Procedures, Section 6 Referral and Assessment, 6.8 Pre-birth Referral and Assessment. |
| 7.11 | When the need for referral to Perinatal Mental Health Services or Children and Families Social Services is unclear this must be discussed with a line manager or professional adviser before referring to the appropriate services. If a referral is not made this must be clearly documented Staff must ensure that all decisions and the agreed course of action are signed and dated. |
8. Guidance for Referral to Adult Mental Health Services
| 8.1 | The Assessment and Treatment Team (A&T) service within the borough of Lambeth comprises of 3 teams who each provide a service to clients registered with GP practices, within localities. A service is also provided to people living in those areas that are not registered with a GP. The Assessment and Treatment Team is a community team and will provide interventions at the team base, in individual’s homes and at other venues as agreed. Rapid Response is a core function of the team. The 3 locality teams are as follows:
|
| 8.2 | The Assessment and Treatment Team provides a single entry point to secondary care mental health services through the completion of a detailed assessment of need, highlighting provision of appropriate treatment. It is anticipated that individuals will be referred to the service by another agency. However this does not preclude clients from self-referring to the service. These may include GP, A&E Departments, primary care psychology, housing workers, inpatient units, differing CMHTs/services within SLaM, solicitors and the police. Each police station within the borough is linked to the following teams:
|
| 8.3 | The Assessment and Treatment Team will accept referrals at the team base. If a self- referral is received contact will be made with the relevant GP regarding ongoing care and treatment. |
| 8.4 | Routine referrals should be made in writing to the team. Urgent referrals should be made by telephone and followed-up by a fax ensuring that all relevant information is received from the referrer. During the weekend and ‘out of hours’ ALL referrals should be made in writing and faxed through to the team base. If the referral is of an urgent nature the answer machine will give the relevant contact information for the Emergency Duty Team (EDT). |
| 8.5 | Urgent referrals are defined as a situation that must be assessed within a maximum of 24 hours. Examples of person’s who require such an assessment would include people who present a high suicide risk, risk of harm to others or who require urgent medical or social intervention. |
| 8.6 | The aim of conducting an urgent assessment will be to fully assess a situation, put in place appropriate risk management plans and to carry out any subsequent appropriate assessments such as an assessment under The Mental Health Act 1983 (MHA 83). Any such work carried out will be communicated in writing to the referrer. All urgent assessments will be dealt with by the Rapid Response Team, which is based within The Assessment and Treatment Team. |
| 8.7 | If a referral is received and not assessed as urgent, it will be treated as routine. Following initial screening such referrals will be allocated to team members for a joint assessment. A routine assessment will be completed within 4 weeks. This is the maximum waiting time. Where required, referrals may be allocated for completion of an assessment within a shorter time scale, based on presenting need. |
| 8.8 | Following completion of an assessment the multi-disciplinary team (MDT) will then present the outcome to the team meeting and, following discussion; the case will be allocated if agreed criteria are met. |
| 8.9 | There will however be some people who following assessment do not meet the agreed criteria. These individuals will either be discharge from The Assessment and Treatment Team service or referred on to more appropriate services. Any such decision will be feedback in writing to the referrer. |
| 8.10 | All clients referred and accepted by The Assessment and Treatment Team will be reviewed regularly to ensure they are receiving the most appropriate service in accordance with the Care Programme Approach (CPA) |
9. Guidance for Referral to Mental Health Services for Older People
This section is under review
10. Guidance for Referral to the Child and Adolescent Mental Health Service
This section is under review
11. Guidance for Referral to the Children and Young People's Services
This section is under review
12. Primary Care
This section is under review
13. Adult Protection
This section is under review
14. Interagency Information Sharing
| 14.1 | It is essential for all services to accurately record the names (as well as alias names and names the family members are also know as), dates of birth, involvement of other agencies and areas of concern for all children in families known to them. If parents, carers or pregnant women decline to provide basic information about themselves or their families this should be recorded and, if necessary, advice sought. |
| 14.2 | Any areas of identified concern or support need to be discussed with the parents, carers or pregnant women. The need for involvement of another service should be explained, while taking account of parents’, carers’ or pregnant women’s right to confidentiality about their illness or disability. |
| 14.3 | Personal information held by professionals and agencies is subject to a legal duty of confidence and should not normally be disclosed without the informed consent of the subject. Unless it is assessed that a child is suffering, or is likely to suffer, from significant harm, the informed consent of parents or carers should normally be obtained before making a referral to any other service. |
| 14.4 | If parents / carers do not share a professional’s concerns, the requirement to pass information to other agencies must be made clear to them and their views recorded. |
| 14.5 | All information passed to other agencies should be recorded in the case record in such a way that what has been said, and any action taken is clearly stated, ensuring that all entries are dated and signed. |
| 14.6 | If there is any uncertainty about sharing information, advice must be sought from your line manager or your agency’s identified child protection lead officer/ adviser. |
| 14.7 | When information about a client or patient is received from another agency it must be treated with respect and with a high level of regard for confidentiality. It must be shared only on a need-to-know basis. The Framework for the Assessment of Children in Need and their Families provides guidance on consent and confidentiality. |
| 14.8 | Personal Information about a child and family should always be respected but, in order to achieve good outcomes for the child, it may be appropriate to share it between professionals and teams within the same agency. Sensitive and careful judgments are required in the child's best interests. |
| 14.9 | The Data Protection Act (1998) allows for disclosure without consent of the subject in certain conditions, including for the purposes of the prevention or detection of crime, or the apprehension or prosecution of offenders, and where failure to disclose would be likely to prejudice those objectives in a particular case. |
| 14.10 | Disclosure should be appropriate for the purpose and only to the extent necessary to achieve that purpose. |
| 14.11 | The needs of the child must come first in any potential conflict between responsibilities of professionals towards children & other family members. Where there are concerns that a child is or may be at risk of significant harm, the overriding principle must be to safeguard the child. |
Please see for further information:
What To Do If You Are Worried A Child Is Being Abused.
London Child Protection Procedures or Working Together to Safeguard Children (2010).
15. Review and Ongoing Work
| 15.1 | Assessment and identification of parents, carers or children’s need for services is not a static process. The assessment should also inform future work and build in evaluation of the progress and effectiveness of any intervention. Agencies should always take into account the changing needs of adults and children. |
| 15.2 | Where more than one agency continues to be involved in a joint assessment or provision of services for parents or carers with mental health, substance misuse problems, a learning disability, and their children, regular review dates must be set to jointly review the situation and to ensure that inter-agency work continues to be co-ordinated. Each agency should document their own actions and responsibilities clearly and also the roles and responsibilities of other agencies. |
| 15.3 | There should always be the flexibility for cases to be reviewed at any time, or jointly re-assessed speedily before planned review dates, if new concerns or support needs are identified. |
16. Conflict Resolution and Escalation Where There is a Disagreement
| 16.1 | Research and case enquiries have shown that difference of opinion between agencies can lead to conflict resulting in less favourable outcomes for the child. If disagreement remains between agencies every effort should be made to reach satisfactory resolution under the guidance provided in the London Child Protection Procedures, Working Together to Safeguard Children (2006) and local policy. |
| 16.2 | Where a professional requires advice and guidance on child protection matters they should first discuss this with their line manager and/or, their Designated, Named or lead professional for child protection. If further clarification and guidance is required they can seek this from the Quality Assurance Unit, Tel:. |
| 16.3 | If agreement cannot be reached on action required following discussion between first line managers (who should normally seek advice from his / her Designated / Named / lead officer / child protection advisor), then the matter must be referred without delay through the line management to the equivalent of Service Manager / DI / Head Teacher or designated professional |
| 16.4 | Where conflict and disagreement still remains (following the above process) the matter must be referred through the head of service to the Quality Assurance Unit. |
| 16.5 | Records of discussions and any decisions must be maintained by all agencies involved. |
Appendix 1 - Legal and Policy Framework
Documents
Association of Directors of Social Services, Department of Education and Skills, Department of Health, Home Office, Foreign and Commonwealth Office (2004) Young and vulnerable adults Facing Forced Marriage. Practice for Social Workers.
Department of Health (2000) Safeguarding Children Involved in Prostitution. Home office.
Department of Health (2002) Safeguarding Children in whom Illness is Fabricated or Induced. Home office.
Department of Health (2002) Complex Child Abuse Investigations: Interagency Issues. Home office.
Department of Health (1985) Female Genital Mutilation Act. Home office.
Department of Health (2003) Female Genital Mutilation Act. Home office circular 10/2004.
Department of Education and Skills (2006) Working together to Safeguard Children.
Lambeth Inter-Agency Adult Protection Procedure
Appendix 2 - The Mental Illness of a Carer or Parent
Working Together to Safeguard Children 2006 (part two): Non Statutory Practice Guidance, Lessons from Research and Inspection sets out some key messages which have informed this protocol.
Mental illness in a parent or carer does not necessarily have an adverse impact on a child’s developmental needs, but it is essential always to assess its implications for each child in the family. Parental illness may markedly restrict children’s social and recreational activities. With both mental and physical illness in a parent, children may have caring responsibilities placed upon them inappropriate to their years, leading them to be worried and anxious. If they are depressed, parents may neglect their own and their children’s physical and emotional needs. In some circumstances, some forms of mental illness may blunt parents’ emotions and feelings, or cause them to behave towards their children in bizarre or violent ways. Unusually, but at the extreme, a child may be at risk of severe injury, profound neglect, or even death. A study of 100 reviews of child deaths where abuse and neglect had been a factor in the death, showed clear evidence of parental mental illness in one-third of cases. In addition, postnatal depression can also be linked to both behavioural and physiological problems in the infants of such mothers
The adverse effects on children of parental mental illness are less likely when parental problems are mild, last only a short time, are not associated with family disharmony, and do not result in the family breaking up. Children may also be protected from harm when the other parent or a family member can help respond to the child’s needs. Children most at risk of significant harm are those who feature within parental delusions, and children who become targets for parental aggression or rejection, or who are neglected as a result of parental mental illness.
Mental illness affects our thoughts, beliefs, emotions and moods and these “symptoms” can influence the way we behave and therefore respond to our children especially when we are ill.
Considerations for Children When a Parent is Mentally ill
In assessing the impact of the mental illness on the parent’s capacity to parent consider:
- Symptoms – how they affect behaviour
- Pattern of illness, first or recurrent episode, prognosis
- Childhood experiences and adversity
- Engagement with treatment and help
- Insight
- Previous mental health and offending history
- History of violence, self harm, suicide
- Co existing conditions – drugs, alcohol
- Quality of social supports and relationship with & mental health of partner / significant family
In assessing the impact of parental behaviours and symptoms on the child consider:
- Extent and nature of care provided by the ill parent including safety
- Nature, severity and duration of symptoms
- Is the child incorporated into the parent’s abnormal beliefs?
- Quality and duration of periods of “wellness”
- How is care different when the parent is well / ill, if it is different at all? ( Not all parenting difficulties may be due to symptoms)
To assess this consider:
- Intrusiveness of the illness on parental functioning
- Modifiability of symptoms and behaviours
- Pervasiveness of symptoms and behaviours
- Pattern of illness
- Timing and duration of illness
- Child’s involvement in and exposure to parental symptoms
When assessing the impact of parental mental illness on children differentiate between:
- The nature of the child’s experiences associated with their exposure to parental symptoms
- How the parent’s actual parenting has changed due to the illness
- The quality of parenting skills when well
Factors contributing to difficulties for children:
- What is more significant in contributing to mental ill health in children is parent to parent and parent to child hostility, irritability, aggression and violence.
- Exposure to parental mental illness – exposure is greater if children are not at school, under five / during school holidays or if the sole parent/carer is mentally ill
Appendix 3 - Who to Contact
Adult Mental Health Services
Mental Health Services for Older Adults
Child and Adolescent Mental Health Services
Children’s Section
CLAMHS (Children Looked After Mental Health Service)
Adolescent Section
Special Needs Section
Children and Young People’s ServiceChild Protection Register:
Custodian
Independent Reviewing Services Manager
392-394 Brixton Road
London SW9 7AW
Office Hours: 020 7926 4526
Fax: 020 7926 5105
Child Care and Child Protection Officers: 020 7926 4698
Emergency Duty S/W (outside office hours) 020 7926 1000
Lambeth Children's Social Care Area Offices:
North & South District
International House
6 Canterbury Crescent
London SW9 7QE
Office Hours: 020 7926 4538
Duty Desks: 020 7926 6508 / 6586
Fax: 020 7926 5478
Lambeth Children's Social Care Hospital Social Work Departments:
King’s College Hospital
Denmark Hill
London SE5 9RS
Office Hours: 020 7346 3176
Fax: 020 7346 3391
St Thomas’ Hospital
Lambeth Palace Road
London SE1 7EH
Office Hours: 020 7922 8080
Fax: 020 7928 0351
Police
Lambeth Child Abuse Investigation Team:
Acting Detective Inspector Peter Hannam
9 Wren Road
Camberwell
London SE5 8QP
Office Hours (8:00am - 7:00pm) 020 7232 6374
Fax: 020 7232 6368
Out of office hours – please phone local station or if Urgent dial 999
Primary Care
Community Child Health:
Lambeth Primary Care Trust
Mary Sheridan Centre for Child Health
5 Dugard Way, Off Renfew Road
London SE11 4TH
Office Hours: 020 7414 1400
Fax: 020 7414 1371
Dr Mary Rees
Designated Doctor Child Protection
Mary Sheridan Centre for Child Health
Wooden Spoon House
5 Dugard Way, Off Renfrew Road
London SE11 4TH
Tel: 020 7414 1456
Fax: 020 7414 1519
Dr Alison Barnwell
Named Doctor Child Protection
Mary Sheridan Centre for Child Health
Wooden Spoon House
5 Dugard Way, Off Renfrew Road
London SE11 4TH
Tel: 020 7414 1391
Fax: 020 7414 1484
Ms Avis Williams-McKoy
Designated Nurse / Nurse Consultant Child Protection
Mary Sheridan Centre for Child Health
Wooden Spoon House
5 Dugard Way, Off Renfrew Road
London SE11 4TH
Tel: 020 7414 1486
Fax: 020 7414 1448
Ms Jane Hatt
Named Nurse Child Protection
Mary Sheridan Centre for Child Health
Wooden Spoon House
5 Dugard Way, Off Renfrew Road
London SE11 4TH
Tel: 020 7414 1485
Education
Lambeth Education Social Inclusion
5th Floor, International House
Canterbury Crescent
London SW9 7QE
Office Hours: 020 7926 9590
Fax: 020 7926 9504
Probation
London Probation Area
117 Stockwell Road
London SW9 9TN
Office Hours: 020 7326 7700
Fax: 020 7326 7701
Voluntary Sector
National Society for the Prevention of Cruelty to Children
NSPCC Croydon Service Centre,
The Courtyard,
254 High Street,
Croydon,
CR0 1NF,
Tel. 020 8253 1850
Safeguarding Children
London Borough of Lambeth Safeguarding Children Board
Phyllis Dunipace (Chair LSCB)
Children's Service Director
Mary Seacole House
91 Clapham High Street
London SW4 7TF
Tel: 020 7926 9771
Fax: 020 7926 9778
Jane Pell
Policy, Planning & Development Officer
International House
6 Canterbury Crescent
London SW9 7QE
Tel: 020 7926 4760
Fax: 020 7926 5105
Guy’s & St Thomas’ NHS Trust
Dr Dipak Kanabar
Named Doctor Child Protection
Evelina Children’s Hospital
St Thomas Street
London SE1
Tel: 020 7188 4693
Ms Helen Chambers
Named Nurse Child Protection
Evelina Children’s Hospital
St Thomas Street
London SE1
Tel: 020 7188 4653
King’s College Hospital Healthcare NHS Trust
Dr Martha Ford-Adams
Named Doctor Child Protection
Paediatric Department
King’s College Hospital
Denmark Hill
London SE5 9RS
Tel: 020 7346 3984
Ms Carrol Henry
Named Nurse Child Protection
Paediatric Nursing Department
King’s College Hospital
Denmark Hill
London SE5 9RS
Tel: 020 7346 3319
Fax: 020 7346 3445
South London & Maudsley Mental Health Trust (SLaM):
Aircall: 07965 9152233
Dr Malcolm Wiseman
SLaM Named Doctor Child Protection
Lewisham Park Child & Family Therapy Centre
78 Lewisham Park
London SE13 6QJ
Tel: 020 8690 1086
Ms Sue Lewis
SLaM Named Nurse Child Protection
Children’s Department
The Maudsley Hospital
Denmark Hill
London SE5 8AZ
Tel: 020 3228 3483
Mrs Jane Padmore
Lambeth Lead Nurse Child Protection
19 Brixton Water Lane
SW2 1NU
Tel: 020 3228 6760
Dr Peter Hindley
Lead Doctor Child Protection
Perinatal Mental Health Services
Kings Perinatal Mental Health Service
Outpatient Dept,
Maudsley Hospital,
Denmark Hill,
London SE5 8AZT
Tel: 0203 299 3234
Fax: 0203 299 1550
Referrals for women having maternity care at King’s College Hospital who are pregnant or up to one year postnatal
MAPPIM
Adamson Centre,
St Thomas’ Hospital,
Lambeth Palace Rd,
London SE1 7EH.
Tel: 020 7188 3610 - enquiries
020 7188 3607 - referrals
Fax: 020 7188 3611
Referrals for women having maternity care at St Thomas’ Hospital who are pregnant and up to 6 weeks postnatal.
Channi Kumar Mother and Baby Unit
Bethlem Royal Hospital,
Monks Orchard Road,
BR3 3BX
Tel. 020 3228 4255
Inpatient services for mothers who are experiencing symptoms of mental illness and their babies up to 12 months old.
Lambeth Specialist Worker in Perinatal Psychiatry
Department of Psychological Medicine
1st Floor, Cheyne Wing
Kings College Hospital
Denmark Hill
London SE5 9RS
Tel: 020 3299 3277
Appendix 4 - Resources and Information Sources
Websites
Lambeth Safeguarding Children’s Board website
South London and Maudsley Foundation Trust website
Documents
Perinatal Mental Health
SLAM Policy for the Care and Support of Pregnant Women with a Diagnosis of Severe Mental Illness (2006)
Department of Health. Why Mothers Die 2000-2002. The Confidential Enquiries into Maternal Death in the United Kingdom. London:Stationery Office. 2004
Protocols, Care Pathways & Management Recommendations for Pregnant and Postnatal Women with Mental Health Problems. – London and South Thames Clinical Network in Perinatal Psychiatry. April 2004
Adult Mental Health
Older Adult Mental Health
Child and Adolescent Mental Health
Child and Young People’s Service
Appendix 5 - Glossary of Terms and Definitions
Abuse and Neglect
‘Abuse and neglect are forms of maltreatment of a child. Someone may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Children may be abused in a family or in an institutional or community setting, by those known to them or, more rarely, by a stranger. They may be abused by an adult, or another child or children.’ Working together to safeguard children.
Neglect
‘Neglect is a persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:
Provide adequate food, clothing and shelter (including exclusion from home or abandonment.
Protect a child from physical and emotional harm or danger.
Ensure adequate supervision (including the use of inadequate care-givers)
Ensure access to appropriate medical care or treatment.
It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.’ Working together to safeguard children.
Sexual Abuse
‘Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts. They may include non-contact activities, such as involving children in looking at, or in the production of, sexual on line images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways.’ Working together to safeguard children.
Physical Abuse
‘Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.’ Working together to safeguard children.
Emotional Abuse
‘Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child's emotional development. It may involve conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s developmental capacity, as well as overprotective and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying, causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone.’ Working together to safeguard children.| ACPC | Area Child Protection Committee. |
| CAF | Common Assessment Framework. |
| CAMHS | Child and Adolescent Mental Health Service. |
| Carer | Child Anyone who has not yet reached their 18th birthday. |
| Child in need | ‘Those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development will be significantly impaired, without the provision of services, plus those who are disabled.’ Working together to safeguard children. |
| CMHT | Community Mental Health Team.
|
| Co-mobidity | The presence of more than one disorder. |
| CPA | Care Programme Approach. |
| CYPS | Children and Young People’s Service |
| Disability | |
| GP | General Practitioner. |
| ‘In the household’ | Any person living in the same household as the child or in the household where the child frequently visits (such as the home of the other parent or grandparents). |
| LEO | Lambeth Early Onset. |
| LEO CAT | Lambeth Early Onset Community Assessment Team. |
| LSCB | Lambeth Safeguarding Children’s Board. |
| MAPPA | Multi Agency Public Protection Agreement. |
Mental Health Problems Mental illness |
|
| MHA | Mental Health of Adults. |
| MHOA | Mental Health of Older Adults. |
| NSF | National Service Framework. |
| Parent | |
| PCT | Primary Care Trust. |
| SENCO | Special Education Needs Co-ordinator. |
| SLaM | South London and Maudsley NHS Foundation Trust. |
| SMI | Severe Mental Illness. |
| Young Carer | |
| YOT | Youth Offending Team. |
| YOS | Youth Offending Service. |
End