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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00163

Adult mental health outpatients who have minor children: Prevalence of parents, referrals of their children and patient characteristics

 Torleif Ruud1, 2*,  Darryl Maybery3, Andrea Reupert3, Bente M. Weimand1, 4,  Kim Foster5, 6, Anne Grant7, Bjørg Eva Skogøy8, 9 and  Solveig Ose10
  • 1Akershus University Hospital, Norway
  • 2University of Oslo, Norway
  • 3Monash University, Australia
  • 4Oslo University College, Norway
  • 5Australian Catholic University, Australia
  • 6NorthWestern Mental health, Australia
  • 7Queen's University Belfast, United Kingdom
  • 8Nordland Hospital, Norway
  • 9UiT The Arctic University of Norway, Norway
  • 10SINTEF, Norway


A strong connection exists between parental mental illness and mental health risk for their children. It is important to determine the prevalence and characteristics of parents in mental health treatment and identify referral actions for their children. Previous studies indicate that 12-45 percent of adult mental health service patients are parents with minor children. There is a need for studies with larger sample sizes that investigate the prevalence and characteristics of parents, and factors associated with referral actions for their children.


Data on 23,167 outpatients who are parents with children under 18 years of age were drawn from a national census study across 107 Norwegian adult mental health outpatient clinics in two weeks in April 2013. Clinicians identified various socio-demographic characteristics of patients who were parents and referral actions for their children.


8035 (36 percent) of outpatients had children under 18 years. 31 percent were provided with referrals for their children and 58 percent were reported to have children with no need for referral. Three percent were reported to have children with unmet needs who were not referred. There were missing data on children’s needs and referral actions for 8 percent of parents. Patients who care for minor children were more likely to be refugees, and less likely to be single, male, not own a house/apartment, and have a schizophrenia spectrum illness or substance use disorder. Children were more likely to be referred when their parent was single, with no income from paid work, low education, not owning house/apartment, poor family network, long outpatient treatment, and an individual care plan; and less likely for men with a moderate or less severe mental illness. Children were referred to child protection agencies, child and adolescent mental health services and school psychological/pedagogic services.


The prevalence of outpatients with children is similar to other studies. Referrals were made for children of one of three outpatients with minor children. Needs and referrals of children were unknown for one in ten outpatients. Mental health outpatient clinics must improve procedures to identify parenting status and ascertain and act on children’s needs.

Keywords: Prevalence of parents with mental illness, Children of parents with mental illness, mental health outpatients, Patient characteristics, Needs of care, Referrals

Received: 31 Aug 2018; Accepted: 05 Mar 2019.

Edited by:

Beate Schrank, Karl Landsteiner University of Health Sciences Tulln, Austria

Reviewed by:

Leandro D. Valiengo, University of São Paulo, Brazil
William H. Fisher, Brandeis University, United States  

Copyright: © 2019 Ruud, Maybery, Reupert, Weimand, Foster, Grant, Skogøy and Ose. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Torleif Ruud, Akershus University Hospital, Lillestrøm, 1000, Norway,