Outcomes of programs serving mothers with psychiatric disabilities and their young children: a multisite case file abstraction study.

OBJECTIVE This multisite study examined outcomes of mothers with mental illnesses receiving integrated clinical, rehabilitation, and parenting services for their preschool-age children. Mothers' outcomes included independent living and employment status, custody loss and reunification, psychiatric hospitalization, and substance abuse. METHOD Retrospective case file abstraction yielded data regarding 104 mothers served over 12-month periods during 1995-1999 at 4 programs located in 3 different states. Multivariable logistic regression (MLR) analysis explored associations between outcomes and predictors from prior research, controlling for study site. RESULTS During their first 12 months of program participation, significant increases were found in the proportions of mothers employed and living independently. Significant decreases were noted in the proportion of mothers abusing substances. Although 10% of the women served lost formal custody during their first year of participation, 22% were reunited with 1 or more children. In MLR analysis, mothers who abused substances were more likely to have experienced childhood sexual abuse and custody loss; those who were psychiatrically hospitalized were more likely to have abused substances, lost custody of 1 or more children, and had more disabling forms of mental illness; and those who lost custody of 1 or more children were more likely to have experienced a psychiatric hospitalization and less likely to be residing with 3 or more children. CONCLUSIONS Programs for mothers with mental illness and their preschool children address service needs in an integrated fashion that appears to improve clinical and rehabilitation outcomes, while preventing custody loss and supporting reunification.