Divorce, parental separation and post-separation parenting are common life transitions for many families. Yet for some, these transitions are characterised by stigma and distress (Konstam et al.,
2016; Strizzi et al.,
2021). In particular, many litigated disputes involving children have high levels of conflict and lengthy court processes, which can exacerbate an already difficult time for families (Polak & Saini,
2019). In addition to these difficulties, parental mental illness is a common feature of parenting cases in the family courts (Kaspiew et al.,
2015). Parents who have a mental illness face a number of challenges in relation to supporting their family (Reupert & Maybery,
2016) and are more likely to be involved in parenting disputes than other families (Salzer et al.,
2020). Yet, stigma and fear of losing care of one’s child may prevent many parents from seeking support for their illness during this time (Dolman et al.,
2013). In light of these dynamics, and their potential negative impact on children, it is important to gain a comprehensive understanding of the experiences of parents with a mental illness who engage with the family courts to inform policy and the development of appropriate support systems.
Parental Mental Illness
Parents with a mental illness and their children often report feeling significant levels of stigma and shame in talking about mental illness (Reupert et al.,
2021). This can lead parents to avoid seeking support for their mental illness for fear of being judged by peers or services (Dolman et al.,
2013). Some parents also report not seeking help for their mental illness, even in times of great distress, for fear of losing their child through either family court or government interventions, such as child protection (Ackerson,
2003; Khalifeh et al.,
2009). In many cases, these fears may be appropriately founded, with research from the United States of America (USA) and Australia indicating that parents with a mental illness are more likely to be challenged for, and lose, parenting time with their children, compared to parents who do not experience a mental illness (Kaplan et al.,
2019; O’Donnell et al.,
2015; Salzer et al.,
2020).
A variety of genetic and environmental factors can contribute to an increased risk of behavioural, social and emotional difficulties in children of parents with a mental illness (Reupert & Maybery,
2016). Parents with a mental illness may have difficulty fulfilling parental responsibility due to the symptoms of their illness, such as fatigue, apathy and impaired functioning (Reupert & Maybery,
2016). However, not all children living in these families will report negative outcomes. Factors such as parenting competency, the availability and appropriateness of parenting support, child temperament, access to treatment, severity and chronicity of the parents’ symptomology, and economic and housing stability, all play a part in a person’s ability to care for their child (Reupert et al.,
2015). Although many mental illnesses are lifelong conditions, the functioning of the individual and their abilities as a parent are not static, and parenting capacity for those who have a mental illness can increase with appropriate social supports and interventions in place (Reupert et al.,
2015; Risley-Curtiss et al.,
2004). It is therefore important that a parent’s mental illness not be viewed in isolation, but that all factors contributing to their capacity to provide a safe and nurturing environment be considered.
Mental Illness in the Family Courts
In many countries, the foremost consideration of the family courts in parenting matters is the
best interest or
welfare of the child. This guiding principle is seen in all State laws in the USA (Child Welfare Information Gateway,
2020), and in many other countries such as in section 60CA of the Australian Family Law Act (
1975) (Cth) and the United Kingdom’s Children Act (
1989). What the court considers to be in the child’s best interests will depend on the particular child’s circumstances. However, it is not uncommon for legislation to direct judges to consider factors such as the need to protect the child from harm; the child’s physical, emotional and educational needs; and the capacity of each parent to provide for their children’s needs. Evidence of a parent’s mental illness may be relevant to each of these issues and could see the court limit a parent’s time with their child (Raub et al.,
2013; Salzer et al.,
2020).
There are, however, several other barriers which may further increase the chance of a parent with a mental illness having less time or contact with their child. One such barrier may be the court system itself. An adversarial court system, such as exists in Australia and England, has often been criticised as inappropriate for handling family court matters (Australian Law Reform Commission (
2019); Mitcham-Smith & Henry,
2007). The adversarial system encourages parents to build a ‘winning case’ by providing evidence for their own ability to parent, and in some cases, the lack of parental ability of the other parent (Mitcham-Smith & Henry,
2007). Through this lens, the focus for parents may shift away from the
best interests of the child, to instead focus on the win/lose outcome of the case. This system has been suggested to expose children to a higher-level conflict and trauma (Australian Law Reform Commission (
2019); Mitcham-Smith & Henry,
2007). Moreover, having a mental illness can increase the chances of housing instability, financial stress, family violence and substance abuse (Nishio et al.,
2017; Toftdahl et al.,
2016; Trevillion et al.,
2012), all of which may negatively impact the parent’s ability to participate in the court processes.
Previous studies suggest that parental mental illness may influence law proceedings related to children in a variety of ways (Kaplan et al.,
2019; O’Donnell et al.,
2015), and that, in turn, litigious court proceedings may exacerbate mental illness symptoms (Australian Law Reform Commission (
2019); Mitcham-Smith & Henry,
2007). Parents with mental illness may experience greater levels of poverty, leading to housing and financial instability and difficulty in accessing ongoing legal representation (Kaplan et al.,
2019). Discrimination against parents with a disability more generally is also applicable to legal proceedings involving children. Kaplan et al. (
2019) suggested that in child protection cases, clinicians and judges may hold biases against parents who have a mental illness. Additionally, a parent’s ability to participate may be reduced by the elevated stress associated with legal proceedings (Mitcham-Smith & Henry,
2007). To better understand the nature of these interactions, a scoping review of the literature was conducted regarding the experiences of parents, who have a mental illness, in the family courts. To facilitate the translation of the extant body of available qualitative and quantitative research to inform practice and policy, a systematic synthesis of the research is required. The aim of this review is to (a) identify and critique research relating to parental mental illness in the family courts and (b) understand the experiences of parents with a mental illness who engage with the family courts in parenting matters.
Discussion
The aim of this review was to identify and critique the scope of research relating to parental mental illness in the family courts and understand the experiences of parents with a mental illness who engaged with the family courts on parenting matters. Results from the review indicated that parental mental illness influenced court proceedings and outcomes of parenting cases but did not always predict it. Parents did however perceive their mental illness to have a negative impact on their ability to engage with the court, and on their parenting outcome. In particular, mothers who had experienced family violence reported that their mental illness disadvantaged them by being used against them by their ex-partner in court or by reducing their capacity to engage in the court processes. Both parents and authors noted that engaging with the courts exacerbated mental illness when paired with other risk factors. Parents also identified their best supports when engaging in family court proceedings along with supports they would have liked to receive. The MMAT results indicated that the overall quality of the included articles was good. A small number of articles required greater transparency about the methodology employed and to take further steps to include a diverse and representative sample.
The presence of parental mental illness was not found to be a predictor of outcomes in all the identified studies. A questionnaire conducted in the US found parents with a mental illness reported an increased risk of having less time with their child through family court proceeding than those without a mental illness (Salzer et al.,
2020). However, a separate US study using court clinic recommendations did not find mental health treatment, or a history of psychiatric hospitalisations, predicted a parent being awarded sole parenting time (Raub et al.,
2013). Additionally, a New Zealand analyses of court judgements reported that having a mental illness did not reduce the likelihood of a child being allowed on overnight stay with their parent (Woodhead et al.,
2015). These studies employed different collection methods (questionnaire/analyses of court documents), were conducted in different countries (USA/New Zealand), and examined different predictors (less time/sole parenting/overnight stay) which may account for differences in findings. Additionally, both Raub et al. (
2013) and Woodhead et al. (
2015) analysed other risk factors as predictors of loss of parenting time alongside mental illness, with a history of arrests and child protection involvement found to result in a reduced likelihood of parenting time (Raub et al.,
2013). Such data were not examined by Salzer et al. (
2020). Parenting cases will frequently include a number of risk factors, all of which will be discussed in the judgement or recommendations if bought up during the proceedings, however not all factors discussed will influence the parenting case outcome. An Australian Family Law Council (
2015) report noted a survey of Family Reports (as used in parenting cases) found 31% of cases had three risk factors, and 26% had four or more risk factors. This finding may indicate that although mental illness may be considered a risk factor when making parenting orders, it is not the primary risk factor directly impacting outcomes. Conversely, given that mental illness is associated with a greater risk of family violence (Trevillion et al.,
2012) and substance abuse (Toftdahl et al.,
2016) it may be that the causative and exasabating nature of mental illness was represented fully in addtion to these areas.
Although mental illness may not necessarily predict family court outcomes, how parents perceived the court to view their mental illness was highlighted in a number of qualitative studies. Parents reported concealing their mental illness or being reluctant to seek support, due to fears about this having a negative impact in the court (Douglas,
2018; Gutowski & Goodman,
2020; Powell, Mitra, et al.,
2020; Powell, Parish, et al.,
2020; Websdale,
2020). This finding supports other community-based research indicating parents with a mental illness experience stigma (Reupert et al.,
2021) and fear losing custody of their child (Ackerson,
2003; Khalifeh et al.,
2009). Although parents’ reluctance to seek mental health support during family court proceedings is understandable, it may also be counterproductive. Other parents have found that engaging with formal and informal support can increase parental capacity and the ability to cope with stressors (Reupert et al.,
2015; Risley-Curtiss et al.,
2004), which in turn may increase chances of time with one’s child.
Family violence and CSA allegations were discussed by authors and participants in numerous qualitative studies (Death et al.,
2019; Douglas,
2018; Gutowski & Goodman,
2020; McInnes,
2014; Websdale,
2020). When highlighted, the authors and participants indicated the court treated mothers unfairly or reported that the system was more challenging for the mother. Many mothers posited that they were placed in a system that did not acknowledge the trauma that family violence had inflicted (Douglas,
2018; Gutowski & Goodman,
2020). Mothers reported that the trauma and lasting negative effects of family violence impeded their ability to participate in court (Gutowski & Goodman,
2020). This finding is consistent with research into the impact of trauma on cognitive functioning. For example, Van der Kolk, B (
2014) discussed how trauma can reduce cognitive functioning, including the ability to make decisions, regulate emotions and plan. Given the complexity of the legal system and the stressful nature of the litigious court room, it is possible the effects of trauma would impede mothers’ active participation. Additionally, some authors suggested mothers who made allegations of CSA were subsequently accused of having a mental illness (Death et al.,
2019; Gutowski & Goodman,
2020; McInnes,
2014). Alternatively, some mothers perceived that their mental illness was used in order to discredit them in their parenting case, leading to them having less time with their child (Death et al.,
2019; McInnes,
2014). The issues presented in these studies highlight a large body of literature which indicate gendered family violence continues to be a significant issue impacting mothers in the family courts (e.g., Kaspiew et al.,
2015).
For many parents, the demands of family court proceedings negatively impacted their mental illness (Douglas,
2018; Ezzo,
2018; Gutowski & Goodman,
2020; Powell, Mitra, et al.,
2020; Powell, Parish, et al.,
2020). Mothers who had experienced family violence felt that when engaging in parenting cases against their perpetrator, the court had retraumatised them (Gutowski & Goodman,
2020). Two studies highlighted that the impacts of the family court, along with additional risk factors such as family violence and substance abuse, caused parents to take their life (Ezzo,
2018; Websdale,
2020). Although family court involvement was not the only stressor that influenced the loss of life in these studies, another systematic review found that family conflict was among the most reported life events associated with suicidal ideation and behaviour Liu & Miller (
2014). Overall, such studies highlight the additional stress of litigious court involvement on mental illness, particularly for those who have recently experienced family violence.
Although parents with a mental illness faced barriers when engaging with the family court, they also highlighted enablers to ameliorate these disadvantages. Legal representation that was empathetic and informed about mental illness was mentioned by mothers and fathers to be valued (Douglas,
2018; Powell, Parish, et al.,
2020). Parents also found ongoing professional mental health supports gave them strategies in coping with the ongoing stress related to the family law process (Ezzo,
2018; Powell, Parish, et al.,
2020). Additionally, family and friends were highlighted to have been a support through the parenting case, although a lack of support and isolation was also noted (Powell, Mitra, et al.,
2020).
Results on the MMAT highlight a need to recruit culturally diverse samples population (Raub et al.,
2013; Salzer et al.,
2020). This is consistent with a wider phenomenon in research of under-representing the experiences of diverse cultural populations (Hall et al.,
2016). Relatedly, eight papers in this review represented of both mothers and fathers, through case studies, court judgements or questionnaires (Death et al.,
2019; Ezzo,
2018; McInnes,
2014; Powell, Mitra, et al.,
2020; Powell, Parish, et al.,
2020; Raub et al.,
2013; Salzer et al.,
2020; Websdale,
2020; Woodhead et al.,
2015; Zumbach,
2016). Two studies included only female participants as they were exploring a mother’s experience of having family violence perpetrated against her (Douglas,
2018; Gutowski & Goodman,
2020). Two further studies (across three papers) included more female than male participants, despite recruiting for both mothers and fathers (Powell, Mitra, et al.,
2020; Powell, Parish, et al.,
2020; Salzer et al.,
2020). There was no study which specifically explored fathers’ views or experiences of having a mental illness in the family courts. The lack of representation may in part be caused by intersectional stigma, characterised by the convergence of stigmatised identities such as race, gender and sexuality (Turan et al.,
2019). These intersecting identities often result in high levels of systemic and explicit disadvantage and discrimination. Simultaneously, those who experience intersectional stigma are less likely to speak out about their experiences, and as such are less likely to participate in research. It is important to recognise that many important voices are not being explored in this field of research.
Parental mental illness was not the primary phenomena being explored within the included studies, with the exception of Powell, Mitra, et al. (
2020), Powell, Parish, et al. (
2020) and Salzer et al. (
2020). Instead, research questions/aims focused on family violence (Douglas,
2018; Gutowski & Goodman,
2020; Websdale,
2020), CSA allegations (Death et al.,
2019; McInnes,
2014), risk assessment (Ezzo,
2018; Websdale,
2020) and predictors of custody (Raub et al.,
2013; Woodhead et al.,
2015; Zumbach,
2016). The inclusion of mental illness across these studies indicates that it plays a role in a variety of issues. However, the frequency of which mental illness is discussed also suggests that future research should focus explicitly on parental mental illness in the context of the family courts.
The results of the MMAT indicated transparency is needed when representing judgements and court documents (cases) in research analyses. When selecting and discussing cases, the procedure and justification for selecting specific examples is needed, to ensure the context of these cases are apparent to the reader. Explicit search criteria for inclusion of studies and more details regarding the included cases would allow the reader to substantiate and interpret the findings more clearly. This is particularly important given the complexity of factors that have been shown to contribute to a family court case.
Limitations
According to the results of the MMAT, identified studies did not represent diverse populations, which meant that in this review, parents who are culturally and linguistically diverse were not represented. The MMAT also indicated a lack of transparency around how some authors selected court judgements for analyses. This reduced our ability to interpret data within the context in which it was collected. The review was limited by not including grey literature, such as government documents and court judgements which might have provided further policy context for the results.
Many family separation matters will be resolved through mediation prior to going to court (Kaspiew et al.,
2015), however studies in this review were only included if they featured families that had their parenting case heard in the family court. Including the mediation phase in other studies or reviews may offer additional insights into the impacts of mental illness on participation and outcomes of mediation.
Implications for Practice
This study highlighted the experience of many parents who have a mental illness while going through a parenting matter in the family court. These parents face additional challenges which may impact their ability to engage with the court. Services and individuals working with these families need to provide integrated support aimed at addressing the clients’ intersecting needs (such as family violence, homelessness, and a lack of supports). The importance of court professionals’ empathy and sensitivity was highlighted in a number of studies, indicating training around mental illness and the impacts of family violence should be promoted to those working in the family law field.
This review indicated that stigma related to mental illness prohibits many parents from seeking the supports they need. To promote help-seeking for those involved in parenting matters, information around the protective nature of help-seeking for mental illness when involved in the courts should be offered to parents. Additionally, parents might benefit from being informed about what the court takes into consideration as related to mental illness in parenting matters (e.g., adherence to medication, engagement in treatment, and insight about how their mental illness affects their parental capacity).
Implications for Research
This review highlighted the scarcity of research around parents with a mental illness in the family court. Future research is needed to better understand the experiences of these parents and their families. Such research might specifically target the experience of parental mental illness in the courts. It might allow for the intersectional complexities which often exist in the family court and represent the unique experiences of mothers, fathers and children. Research exploring populations which experience intersecting discrimination and disadvantage is needed, including those from diverse cultural backgrounds, first nations peoples, members of the LGBTIQA+ community and those who have a disability. Representing these voices in future research will allow for a more nuanced understanding of how mental illness interacts with intersecting discrimination, which can be used to inform targeted supports and recommendations for practice changes. Intersectional theory is increasingly included in a wide range of research to discuss intersecting identities and systems of power and may provide a relevant framework for future research (Bauer et al.,
2021). Finally, further research may be conducted with court professionals, including lawyers and judiciary to better understand their experiences of parental mental illness. Such studies may provide further understandings of how parental mental illness is perceived in the courts, in addition to identifying court professionals’ learning needs.