{"id":2171,"date":"2025-05-30T13:38:33","date_gmt":"2025-05-30T12:38:33","guid":{"rendered":"https:\/\/sites.manchester.ac.uk\/mhsci\/?p=2171"},"modified":"2025-06-09T14:01:34","modified_gmt":"2025-06-09T13:01:34","slug":"the-hidden-cost-of-trauma-maternal-mental-health-and-child-removal","status":"publish","type":"post","link":"https:\/\/sites.manchester.ac.uk\/mhsci\/2025\/05\/30\/the-hidden-cost-of-trauma-maternal-mental-health-and-child-removal\/","title":{"rendered":"The hidden cost of trauma: maternal mental health and child removal"},"content":{"rendered":"

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Katy Cleece<\/strong> is a qualified social worker and currently the Social Work Research Lead for Lancashire and South Cumbria NHS Foundation Trust. She has extensive experience in mental health, with particular interests in trauma and whole-family approaches. Katy has worked across both adult and children\u2019s services, and previously qualified and practised as a substance misuse practitioner, supporting children, adults, and families on the edge of care.<\/em><\/p>\n

A rising trend in child removals<\/h2>\n

The number of children being removed from their families and placed into state care in the UK continues to rise year on year<\/a>. Increasingly, parental mental ill-health\u2014particularly maternal mental health\u2014has become the leading reason for safeguarding assessments. This trend is not occurring in isolation: evidence consistently shows<\/a> that socioeconomic disadvantage significantly heightens the risk. These patterns demand urgent attention. Services and practitioners must look beyond presenting symptoms to understand the deeper, structural causes\u2014and commit to implementing preventative, trauma-informed approaches before families reach crisis point.<\/p>\n

Understanding the trauma beneath the diagnosis<\/h2>\n

But who are the women behind these numbers? To truly understand the rise in child removals linked to maternal mental health, we must first confront the gendered and traumatic experiences that often lie at the heart of their distress.<\/p>\n

Working in substance misuse and then adult mental health, my professional experience is that many of these women have experienced trauma perpetrated by men – specifically, intimate partner violence, sexual assault or abuse, or rape. Often, it is a combination of all these experiences, which
has led to long-term post trauma symptoms, resulting in problematic drug or alcohol use, mental health intervention, or both.<\/p>\n

A 2014 study by the UCL and Kings College London<\/a> found that 40% of women with severe mental illness had been victims of rape or attempted rape, compared with 7% in general society. The figures were drawn from a random sample of psychiatric patients and compared with the 2011\/12 National Crime Survey of 2011\/12. The National Crime Survey 2021<\/a> found that 63% of women who had been subject to rape or assault by penetration experienced mental health problems. The mental health impact was reportedly more prominent than any physical or social impact. Similarly, a 2017 report by the Mental Health Foundation<\/a>\u00a0found that 61% of women surveyed had experienced sexual violence in adulthood.<\/p>\n

Shame and guilt are common responses to sexual trauma, often delaying help-seeking. Secrecy and fear frequently accompany these experiences, especially if they occurred in formative years. According to Rape Crisis England and Wales<\/a>, five in six women who have been raped do not report this to the police.<\/p>\n

Traumatised or disordered?<\/h2>\n

In my professional experience, the response women receive typically depends on their socioeconomic standing. Women educated to a higher level and occupying higher-class status more readily receive a diagnosis linked to their trauma, such as post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (CPTSD), which facilitates access to evidence-based treatment provided by NHS mental health trusts.<\/p>\n

Women with lower levels of education, from minority ethnic backgrounds, or lower socioeconomic groups are more likely to receive a diagnosis of Personality Disorder(s). This diagnosis often excludes them from access to trauma-focused treatments. Women in this group are also more likely to be viewed by mental health professionals and children\u2019s social workers as presenting a higher risk to themselves and others.<\/p>\n

Personality Disorder diagnoses have existed since the publication of the first DSM in the 1950s. Community treatment is typically managed by Community Mental Health Teams (CMHT), while crisis presentations – such as suicide attempts, suicidal ideation, or self-harm \u2013 are handled by Home-Based Treatment Teams (HBTT). The British Medical Association reports that the number of adults aged 16 to 74 accessing mental health services rose by 71% between 2000 and 2014. Referrals increased by a further 22% from 2019-2022, and in 2021, the waiting list was estimated at 1.4 million people.<\/p>\n

Gaps in mental health services<\/h2>\n

Despite the wide implementation of the Family Safeguarding model<\/a>, which aims to integrate adult mental health practitioners into children\u2019s social care teams, the impact on this group of women is limited or absent. The threshold for service involvement is lower-level mental health difficulties, treated by brief intervention of up to 12 sessions. The risk associated with this presentation is too great for those teams to manage, plus the identified treatment is longer term, therefore they fall beyond the scope of this integrated service.<\/p>\n

Traditional service models mean that children\u2019s social care and adult mental health services, employed by different organisations, work in silo, each concentrating on the symptoms or risks present, but rarely having the opportunity to identify and treat the root cause while simultaneously meeting the needs of the child. Timescales for children in the statutory social care arena are limited, with guidelines set at 26 weeks for completion<\/a> of court processes.<\/p>\n

With caseloads at record highs and a staff retention crisis, children\u2019s social workers are working with the highest-need families and have little to no opportunity to offer therapeutic, whole-family or preventative interventions. Treating the underlying causes of trauma is a slow process. Unlike the most common mental health problems, such as depression or anxiety, medication or solution-focused brief therapy are not the primary treatments. NICE guidelines<\/a> recommend psychological therapies, which should not be brief intervention (less than three months), and that treatment should be part of a process in which the recipient can form a trusting relationship. This is not compatible with the timescale constraints for the family courts, nor with the reality of waiting times for NHS mental health assessment, care planning and therapy lists.<\/p>\n

The consequences of removal<\/h2>\n

Forced removal of children from their birth families causes trauma for both mother and child. Research shows<\/a> that one in four women in the UK who have had a child removed will face further care proceedings within seven years. The loss of a child can exacerbate maternal mental health issues. Coupled with the stigma of being a mother living apart from her children, it often creates further trauma<\/a>, negatively affecting future pregnancies and parenting capacities.<\/p>\n

Mental health exists on a broad spectrum, and it is estimated that 1 in 4 people<\/a> will experience mental health difficulties at some point in their lives. Experiencing poor mental health, in and of itself, is not a reason for children\u2019s social care to intervene in family life – and for the vast majority of people, it does not lead to such involvement.<\/p>\n

However, the stigma surrounding mental illness is intensified for mothers who are parenting alone and living in poverty. Fear of intervention from children\u2019s social care and ultimately fear of having their children removed often forces women to hide their symptoms and avoid seeking help.<\/p>\n

The overlooked link: trauma, diagnosis, and child removal<\/h2>\n

Despite growing awareness of trauma-informed practice, there remains a significant gap in research exploring the relationship between women’s mental health diagnoses, particularly Personality Disorders, and the removal of children through safeguarding interventions. To my knowledge, no published data systematically tracks the mental health profiles of women whose children are removed following social care involvement. This absence of evidence obscures a critical pattern: women with histories of sexual trauma often have unmet psychological needs, are misdiagnosed or excluded from trauma-specific services, and disproportionately become subject to care proceedings.<\/p>\n

One such case I encountered involved a woman whose own childhood was marked by removal from her family due to her mother\u2019s struggles, including involvement with children\u2019s social care. As an adult, now reunified with her mother, she has had three children of her own. Her eldest now lives with their father, while the two youngest have recently been court-ordered to be separated\u2014one placed in long-term foster care and the youngest adopted. This woman\u2019s mental health difficulties are longstanding and stem from severe sexual and physical violence experienced in her intimate relationships. Despite repeated contact with children\u2019s services, she has never been offered dedicated, trauma-focused treatment. Her story is not unique\u2014it reflects a system that fails to see past behaviour to underlying harm, and that too often pathologises women instead of supporting their recovery.<\/p>\n

Summary<\/h2>\n