Maternal Mental Health Disorders and Reports to Child Protective Services: A Birth Cohort Study

Summary

Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. In the present study, we used linked administrative records to identify the prevalence of maternal mental health (MH) disorders documented at birth and determine the associated likelihood of maltreatment reports during infancy. Vital records for California’s 2006 birth cohort were linked to hospital discharge and child protective services (CPS) records. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing codes from the mother’s delivery hospitalization were used to determine diagnosed maternal MH disorders for 551,232 infants born in 2006. Reports of alleged maltreatment were documented from CPS records.

Overview of Findings

Among infants in this statewide birth cohort, 2.8% were born to a mother with a documented MH disorder. 41.3% of infants with mothers who had a MH disorder had documented maternal substance abuse issue vs. less than 0.5% of infants born to mothers without a diagnosed MH disorder. 34.6% of infants born to mothers with a MH disorder were reported within one year; a majority of those reports were made within the first month of life (77.2%). In contrast, among children born to mothers without any MH disorder, 4.4% were reported to CPS during infancy. Being born to a mom with a MH disorder (but no substance use disorder) more than doubled the likelihood of a child being reported to CPS, and more than quintupled it in the case of mothers with MH and substance use disorders.

Administrative records provide a method for identifying infants born to mothers with MH disorders, enabling researchers to track rates over time and generate population-level data to inform policy development and improve service delivery.

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