What help may be available for a family where a parent or carer suffers mental ill-health?
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Help and support may be available from adult social care services, early help services, from children’s services under a child in need framework, and for any young carer.
Adult social care services
Adult social care services may provide care and support for someone with an illness or disability. This may be a physical or a mental condition.
The law about adult social care services in England is set out in The Care Act 2014.
Section 9(1) of The Care Act 2014 says if a local council thinks someone needs care and support they must do a needs assessment. This aims to find out if the adult has care and support needs. And if they do work out those needs are. This is usually carried out by a social worker from the council’s adult services department.
At the same time there should be an assessment of any adult carer if they may have care and support needs (see section 10, Care Act 2014).
How assessment should be done and what it should look at
Local adult services departments will have their own assessment protocols that they follow. These will guide them in the way they approach and carry out their work. But they must also follow nationally set eligibility criteria. These criteria set a minimum level of need that all local councils must meet.
There are three questions the assessment must answer. The questions aim to work out if someone meets this minimum level of need (see regulation 2(1)):
- Does the person have care and support needs as a result of a physical or mental condition?
- Are they unable to achieve two or more desired goals or eligibility outcomes as a result of their care and support needs?
- Is there, or likely to be, a significant impact on their wellbeing.
The eligibility criteria
The eligibility outcomes are listed in regulation 2(2) of The Care and Support (Eligibility Criteria) Regulations 2015. They include being able to:
- Manage meals and eating
- Manage personal hygiene
- Cope with going to the toilet
- Carry out caring responsibility for any child in their care
- Keep the home clean and safe
- See and be in contact with family and friends
- Take part in work, volunteering, education or training
- Access and use local services.
Someone will be classed as unable to achieve an activity if:
- They need help to do it
- When they try to do it it’s painful, or makes them feel distressed or anxious
- If the activity is dangerous to them or to others
- It takes a much longer time than it should.
The outcome of assessment
If the assessment finds that someone has eligible needs, the local council has a duty to meet those needs. A care plan will be drawn up (see section 24(1) and section 25 Care Act 2014). And then a means test will be done. This looks at what financial resources the person has. The means test will decide if the council should contribute to the costs of the care and support.
Examples of the type of help that adult social care may provide (following assessment) include:
respite care, help with travel, and adaptations to the home. Help may be provided by the council directly or in the form of direct payments. Direct payments allow the disabled adult to arrange and pay for their own care and support.
Where none of the needs a parent or carer has meet the eligibility criteria then the local council must still provide them with written advice and information about:
- What can be done to meet or reduce their needs
- What can be done to prevent or delay them developing a need for care and support in the future (see section 13(5) The Care Act 2014).
- Ask if there are any children in the family
- Consider whether any child needs help or is at risk of harm.
Important note: Parents and carers needing information and advice about adult social care law and services should seek advice from a specialist organisation. This is sometimes called ‘community care law’. See the Disability and the Mental health sections of our Useful links page for some relevant organisations.
Contact details for local council adult social care departments can be found by entering your postcode or town into this search tool on the NHS website.
Government statutory guidance called Working Together 2018 says practitioners working with families should be alert to families who may need early help services. The guidance says children whose families are affected by mental ill-health may need this type of help Working Together 2018, page 14 at paragraph 6).
Early help aims for agencies to work together to provide support as soon as problems emerge. This is because tackling a problem early can stop things getting worse. Education (schools, nurseries), housing, and health services are all examples of agencies. Early Help can be given to a family with a child up to age 18. So, the child may be a baby, toddler, at primary school or a teenager.
Social workers are not involved in early help assessments or providing early help services. But sometimes, they ask early help services to provide assistance to children and families they are working with.
See our Early help page for more information about early help services.
Child in need
There is a general legal duty on children’s services departments to work to keep children safe, well cared for and, at home unless this would place them at risk. To help achieve this, children’s services must provide a range and level of services in their local area to help children ‘in need’ and their families (section 17(1) Children Act 1989).
A ‘child in need’ is a child who needs extra support or services to help them achieve or maintain ‘a reasonable standard of health or development’ (see section 17(10) Children Act 1989). A disabled child will be classed as a ‘child in need’.
If children’s services think a child or family may need extra support, they should carry out a ‘child in need’ assessment. This aims to work out if the child is in need or not. And to find out what support and services the child and family need. Local children’s services departments have their own measures for deciding which children are ‘in need’ enough to get services.
See our Child in need page for important information about how to request a child in need assessment and what is involved.
If a parent is already involved with adult social care services, it may be helpful for any assessment work to be jointly carried out jointly. That means, with both adult and children’s services involved.
Support for young carers
Sometimes where a parent or carer is suffering affected by mental ill-health, their child takes on a caring role. This may be practical or emotional care. It may be for the parent/carer or for brothers and sisters. Where this is happening, or may be about to happen, children’s services should do a young carers assessment.
The law defines a young carer as a young person under the age of 18 years who:
- Provides care to another person, or
- Intends to provide care for another person, and
- Is not providing that care as part of their paid employment or formal ‘voluntary work’.
This definition of a young carer comes from section 17ZA of the Children Act 1989.
Children’s services have a legal duty to try and identify young people in their local area in this situation. But a young person or parent can request an assessment themselves.
The aim of a young carer assessment is to work out if it is appropriate for the child to be doing their caring role. And to see what support the child and family need. The assessment should look at the whole family situation. The work should involve children’s services:
- Explaining how the assessment will be done and what it will be involve
- Looking at what kind of caring the young person is doing. And how much caring
- Looking at whether help is available from other family members
- Looking at what help the young person may need from children’s services as a child in need
- Identifying what help may be provided by adult social services for the adult.