Understanding the health needs of mothers and children involved in family court cases

The Nuffield Foundation has funded a number of highly influential projects in family justice using administrative data from the case-management system held by the Children and Family Court Advice and Support Service (Cafcass).  These projects have looked at: the enforcement of contact orders in private law; the use of supervision orders and special guardianship orders as alternatives to adoption in public law; and the proportion of cases that involve mothers who have had one or more children subject to potential removal by the state. 

This new, path breaking project, led by Professor Ruth Gilbert, builds on the third of these studies, which highlighted the very limited availability of interventions to address the needs of vulnerable mothers who repeatedly appear before the family courts. It will link together administrative health and courts data for the first time, in order to explore the potential for healthcare services to reduce the chances of mothers or children becoming involved in care proceedings, once or multiple times. 

The study will involve linking Cafcass data, which includes a range of information relating to individual family court cases and the people involved in them, with the Hospital Episodes Statistics (HES) database, which records details of all admissions to NHS hospitals in England, and with the Clinical Record Interactive Search (CRIS) database, which contains information on all contacts with outpatient mental health services in four South London boroughs.

The linked data will be used firstly to identify in the Cafcass data a cohort of mothers involved in care proceedings and examine the extent to which past healthcare characteristics are associated with different patterns of subsequent involvement in care proceedings (in particular recurrent vs. non-recurrent proceedings).  Secondly, a cohort of vulnerable mothers will be identified in health data, and analysis undertaken to identify which characteristics are associated with subsequent involvement in the family courts.  The aim of these analyses would be to identify whether additional inputs from healthcare services could reduce the chance of a mother or child becoming involved in care proceedings, and improve their health and welfare outcomes.

In addition to generating substantive outputs, the data linking process will be both ground-breaking (the first time family justice data and methodologically challenging.  All linkage algorithms would be made available for future research, and a methodological paper will be produced to inform the wider research community about the challenges involved in this innovative data linkage and how these were overcome.