Mental health articles

PROTECTIVE FACTORS AGAINST REPETITION OF ABUSE
For the parent, protective factors include (Egeland, Bosquet & Chung, 2002):
• availability of support (social, cultural and professional)
• a stable, safe social and personal situation
• willingness to ask for help and use it
• acceptance of responsibility for the parenting role and their past and present
behaviours
• minimal current mental illness or substance misuse.
Factors that promote resilience in the infant and child long term include
(Ferguson & Horwood, 2003; Sameroff, Gutman & Peck, 2003):
• a well parent or other involved adult
• social supports
• professional intervention
• consistency in other relationships and activities
• being good at something.
There is an interaction between individual characteristics of children and the
environment in which they develop that enhances or mitigates against resilience,
but as Luthar and Zelazo (2003) put it, ‘resilience based interventions must
address the quality of parent–child relationships and, more generally, the wellbeing of caregivers'.

EXAMPLE: LISA, CONTINUED
Lisa decided to proceed with the pregnancy, and, before the birth of the second
child, moved in with her parents. She began seeing a psychiatrist regularly and
was referred to the social worker at the maternity hospital. After a period of great
hostility, relations with her husband improved enough for her financial situation
to stabilise and for him to express an interest in seeing his children. The second
child, a boy was born uneventfully and Lisa felt immediately very fond of him.
He was an easy and settled baby. Despite this, about six weeks after his birth, Lisa
became troubled by intrusive thoughts that the children would be better off
without her. She had intense mood swings and frequent thoughts of suicide. She
was admitted to a psychiatric hospital for six weeks with the new baby. Her
daughter Hilary, now aged 21 months, stayed with her grandparents.
Despite intervention and support, Lisa suffered a severe recurrence of postnatal
psychiatric illness. Her intrusive thoughts were of harming herself, not her
children, but clearly the well-being of the children was linked to her recovery.
The stability and quality of caregiving provided to the children by grandparents
and hospital staff during Lisa’s illness contributed to the long-term effect of this
period on their development. Concerns about immediate risk to their safety
would increase if she had delusional or preoccupying depressive ideas that included the children, or if she did not seek or refused medical and parenting
assistance while she was unwell.
Concerns about the immediate or long-term safety of an infant or a caregiver
need to be addressed openly and directly with the caregivers and referral agency.
Appropriate intervention must follow, and processes put in place for monitoring
the ongoing safety and well-being of family members.

Tags: abuse