Written evidence submitted by APPG for Strengthening Couple Relationships and Reducing Parental Conflict (CYP0113)

We are pleased to be able to submit evidence to the Health and Social Care Committee’s enquiry into Children’s Mental Health.

We do so from the perspective that:

         research overwhelmingly demonstrates that exposure to frequent, intense and poorly resolved conflict between parents has a long-lasting and negative effect on children's mental health and development.[1]

         how ‘couples communicate and engage with each other in managing relationship conflicts both affects their ability to engage in effective parenting practices and can influence children’s mental health outcomes in infancy, childhood, and adolescence, with extended impacts on academic/educational attainment, physical health and well-being, employability, and future relationship stability in later life’.1

         1.25 million children in Britain are exposed to interparental conflict;[2] indeed, the most recent data on children’s mental health shows that among 11 to 16 year old girls, 63.8% with a probable mental disorder had seen or heard an argument among adults in the household, compared with 46.8% of those unlikely to have a mental disorder.[3]

The Government has extended its Reducing Parental Conflict Programme by one year, to April 2022. Evidence gathered so far suggest that this programme is highly successful at reducing conflict between parents,[4] an outcome which research indicates will have a powerful impact on children’s mental health as a result. In addition to this, the DWP has funded a number of projects, including face to face and digital interventions, in order to build a broader evidence base of what works in reducing parental conflict through its Challenge Fund.[5]

It is telling, however, that these programmes/funding streams are being delivered by the Department for Work and Pensions, far removed from both the Department of Health and Social Care (which does not see any role for couple therapists in Children’s IAPT services or CAMHS to address parental conflict, despite its impact on child mental health)[6] and the Ministry of Justice (which has recently announced its intention to pilot a new approach to delivering family justice in private law proceedings, beginning with two pathfinder sites in Bournemouth and North Wales).

In relation to “Addressing capacity and training issues in the mental health workforce”, we believe that the Government should undertake a review of the capacity and training of the mental health workforce in order to understand, and address, the need for that workforce to be able to address parental conflict.

In a sample of over 42,000 children being seen across 75 young people’s IAPT services, family relationships was cited by professionals in 52% of cases.[7] This finding suggests that problems within families, and particularly between parents, are likely to be one of the single biggest factors affecting children’s mental health, and yet this does not appear to feature (other than the DWP’s programmes and its training of local authority staff delivered through the Knowledgepool) in discussions and planning around workforce development.

We believe therefore that children's mental health services should be required to ensure that their work includes reducing conflict between parents. Adding couple experts to their multidisciplinary teams would mean that this parental couple work becomes a normal and expected element of these services - a recent pilot project demonstrates the feasibility and effectiveness of such an approach.[8]

However, the workforce where expertise in working with parents in conflict is needed is broader than that of CAMHS and includes:

         Children’s IAPT workforce

         Services being delivered through Family Hubs

         Services being delivered to separating families with a view to ensuring that what are essentially relationship difficulties, rather than legal ones, are addressed outside of the court (in the majority of cases where there are no safeguarding concerns of course).

We believe that early intervention is key. This means ensuring the provision of easily accessible help for parents, young people and children through those in a position to pick up the signs rather than the pieces. This includes those working with families during pregnancy and pre-school years, such as GPs, health visitors and nursery staff, as well as in schools.

In order to address parental conflict seriously, we believe that assessing for parental conflict should be made part of the assessment framework for child and adolescent mental health services, in children, young people and families counselling services, and in schools.

Indeed, with respect to schools, we believe that head-teachers, teachers and teaching assistants should be trained to understand the impact which parental conflict can have on the behaviour, self-esteem and wellbeing of pupils and know where parents can find effective relationship support. We do not believe that there is any particular focus on this currently, and we fear that the failure to train the school workforce in these issues represents a missed opportunity to improve the wellbeing and mental health of children.

With access to the right training and resources, all adults working with children and families have a role to play in identifying early signs that additional support may be needed, and they should feel empowered and equipped to signpost to appropriate resources.

Equally, there should be a commitment to working with those who have direct access to parents to help raise the awareness of the impact of parental behaviour on the mental health and long-term life chances of their children.

Relational capability skills are essential for parents to be able to avoid harmful conflict, whether they are parenting together or separated. There is a wealth of research[9] pointing to the impact of stress on relationships, the impact this has on children and the association between stress, conflict and child outcomes. The evidence clearly points to the value in helping parents to cope with stress as an effective method to reduce harmful conflict and therefore negative outcomes for children.

Investment in early intervention is good social and economic sense. Prevention is better than cure, and to protect the long-term mental health of children, different agencies must work together across the spectrum of services to ensure needs can be met at every stage.

It is interesting to note that the Welsh Government has recently committed to extend its support to families via a range of digital early intervention programmes, to be delivered via local authorities throughout 2021-22., which will include training local authority staff on the use of online resources with local families.

The early identification of difficulties in children resulting from conflict between a pupil’s parents (whether together or separated) has the potential to enable parents to be encouraged and sign-posted towards relationship support delivered face to face through voluntary sector organisations (and including through family hubs) and the NHS (e.g. the provision of Couple Therapy for Depression/Behavioural Couples Therapy in IAPT services), digitally (e.g. through web-based support or through relationship support apps) or through other services which specifically address the needs of separating and separated parents.

March 2021