Patients as parents: the risk to children

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Abstract
Traditionally adult psychiatrists have been more concerned with their patient's family of origin than with the family of procreation. When considering the management of the seriously mentally ill, the family is regarded as a potential source of stress or care, and little attention is given to the role of the patient as a parent (Rutter, 1966; Bennett, 1996). This position is exemplified by the absence of questions relating to childcare on the Health of the Nation Outcome Scale (HoNOS; Wing et al, 1995). This scale is likely to be widely used in the Care Programme Approach in England and Wales as an indicator of illness severity and outcome. Such questions should include the effect of the illness and disability on the physical and emotional development of the child, and the patients' ability to manage the responsibilities of childcare.

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