Background to the research

This study was fuelled by a desire to understand the response of a range of health and social care agencies to two contrasting sets of needs in families. We were also aware that the organisational changes described in Chapter Two of this book were driving services for children and adults further apart. The research design for such a project was inevitably going to be multi-layered and would involve a range of different participants. Funding for the project also came from a number of sources, including the University of Hull, a NHS trust and a health authority. This chapter describes the development and details of the methodology employed for the study. We begin by introducing the findings from a small pilot study completed in 1997. The results of this pilot fed into the design of the main study, which is the focus of the second part of this chapter. The latter sections provide details of the areas included in the study and outline the methodology.

The pilot study

Before embarking on a full-scale research study, we decided to test several of our assumptions, for example, that divides between health and social care, and between children's and adults’ services, might affect professional practice with families where mothers had mental health problems. Therefore, we planned and implemented a pilot study (Stanley and Penhale, 1999) designed to examine issues of interprofessional communication and coordination. As this work provided the backdrop to the larger study, it is worth considering it here in some detail.

The pilot study was exploratory in nature and took place in a locality not subsequently used for the main research study. Detailed analysis of 13 families’ files was undertaken in one local authority in the east of England. The study explored the nature of serious mental health problems in mothers whose children were on the child protection register, and examined the extent to which different professionals worked together to meet the family's needs.

Each of the families selected for inclusion in the pilot study had been subject to a child protection case conference, and each had one or more child's name included on the child protection register. In all 13 families, which were identified for the pilot study by social work team managers, mothers were considered to have serious mental health problems.