Many parent carers of children with special educational needs or disability struggle with their mental health. In this study, we want to find out whether mothers of children with special educational needs or disability in England are more likely to have mental health conditions than other mothers, and whether this problem has worsened since the start of the COVID-19 pandemic.
We will be looking at health data to see how many parent carers have mental health conditions such as depression, anxiety and addiction. We will also investigate whether ethnicity, physical health, or complications at their child’s birth mean that they are more likely to need support for their mental health. We will look at how the COVID-19 pandemic has affected mothers’ mental health by comparing data from before and during the pandemic, as well as after the lifting of restrictions in 2022. We will also compare the number of mental health diagnoses mothers have according to which special educational needs or disability their child is diagnosed with.
This research will help us to understand the challenges that parent carers face with mental health conditions. This will mean that more research can be done to find ways to help and support parent carers’ mental health.
Background:
Parent carers of children with special educational needs or disabilities (SEND) in England are likely to have high rates of mental health conditions and an unmet need for support and treatment for their mental health. In addition, parent carers are likely to have been disproportionately affected by the pandemic due to changes in education and support during COVID-19.
Aims:
To examine the prevalence of mental health conditions, specifically depression, anxiety, post-traumatic stress disorder (PTSD), and addiction among mothers of children with SEND in the UK, before and during the COVID-19 pandemic, compared to mothers of children without SEND.
To explore change (increase or decrease) in the number of maternal mental health conditions between adjacent annual time points and from baseline to each subsequent time point.
To compare the prevalence of maternal health disorders across SEND conditions in children. We will also consider the association between premature births or birth complications and maternal mental health.
Methods:
We will use a retrospective cohort design using the Clinical Practice Research Datalink (CPRD). We will investigate whether the prevalence of mental health disorders in mothers is impacted by their ethnicity, socio-economic deprivation, and physical health conditions. Additionally, we will investigate the effect of birth complications (including pre-term birth).
Anticipated outputs and impact:
This project contributes to a larger study which is compiling information about the need and access to mental health services for parent carers, including the impact of the pandemic and regional variation (using the geographical region of GP practice). We plan for this project to lead to further research to develop and test strategies to overcome barriers to accessing evidence-based mental health treatment for parent carers with mental health conditions. The ultimate intention is to benefit the mental health and wellbeing of parent carers and their families.
The outcome will be prevalence of mental health disorders in mothers of children with SEND (cases) and children without SEND (controls). This will be assessed at the patient-level with a binary indicator for presence of a mental health condition.
The following mental health conditions will be considered:
• psychosis (affective and non-affective, including bipolar)
• depressive disorders
• anxiety disorders (including PTSD)
• eating disorder (anorexia and bulimia)
• personality disorder
• substance and alcohol dependence.
We will also include referrals to mental health related secondary care outpatient services or inpatient psychiatric stays as indicating the presence of mental health conditions.
Time period will be defined as follows:
Year 0: 01/07/2018 - baseline
Year 1: 01/07/2019 - change in 1 year without a pandemic
Year 2: 01/07/2020 - as first COVID-19 lockdown ends
Year 3: 01/07/2021 - restrictions lifting
Year 4: 01/07/2022 - no ongoing restrictions
Luke Mounce - Chief Investigator - University of Exeter
Luke Mounce - Corresponding Applicant - University of Exeter
Gretchen Bjornstad - Collaborator - University of Exeter
Sarah Bailey - Collaborator - University of Exeter
Sarah Walker - Collaborator - University of Exeter
Tamsin Newlove-Delgado - Collaborator - University of Exeter
HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation;CPRD Aurum Mother-Baby Link