Care for the Caregiver:
Why Maternal Mental Health Matters for Children and Families
It is 3:17 a.m., and a mother sits awake while her baby sleeps.
Exhausted and anxious, she worries she is doing something wrong. Transportation and childcare make appointments difficult, yet when asked how she is doing, she says, “Fine.”
She is not fine. She needs support.
Instead of coordinated care for her mental health, her child, and their relationship, she encounters disconnected services. One provider focuses on her symptoms, another on the baby, and another on safety at home. A need for support can quickly become a family crisis.
This fictional scenario reflects challenges families may face when mental health, child welfare, and family-serving systems are not coordinated.
Maternal Mental Health Is a Family Issue
Maternal mental health conditions are common and treatable, affecting approximately 1 in 5 mothers during pregnancy or the first year postpartum, according to the Policy Center for Maternal Mental Health.
Access remains a challenge: 84% of the U.S. perinatal population lives in a Maternal Mental Health Shortage Area.
For families involved with child welfare, support may also need to address trauma, separation, loss, changing caregiving relationships, and permanency. An adoption competent lens helps professionals respond to these interconnected experiences.
When Mental Health and Child Welfare Intersect
Serious maternal mental illness is associated with child welfare involvement, but the relationship also reflects barriers such as limited treatment access, poverty, housing instability, inadequate social support, discrimination, and gaps in family-centered services.
A study of 4,827 Medicaid-eligible mothers found that those with serious mental illness were nearly three times as likely to experience child welfare involvement or have children placed in out-of-home care, even after accounting for other factors (Verbiest et al., 2026). The finding underscores the need to look beyond diagnosis to the circumstances affecting the whole family. Adoption competency is especially relevant during separation, placement, reunification, adoption, guardianship, or kinship care.
Where Adoption Competency Fits
Adoption competent mental health care prepares professionals to understand how trauma, separation, loss, attachment, identity, belonging, and changing caregiving relationships affect children, youth, and families impacted by child welfare. Consider a mother receiving mental health treatment while her young child is temporarily living with relatives or in foster care. Her treatment cannot be fully separated from grief, uncertainty, guilt, fear, and relationship changes connected to that separation. Likewise, the child’s behaviors and emotional responses cannot be understood solely as symptoms to manage without considering what the child has experienced.
An adoption competent professional is better prepared to see beyond behavior to the story beneath it. Rather than asking only, “What symptoms are we treating?” adoption competent care encourages professionals to consider what parents and children have experienced, what strengths and relationships can support healing, and how treatment can support the parent-child relationship and permanency goals.
Moving Upstream Before Families Reach Crisis
Supporting families earlier requires systems to make it easier for parents and children to access coordinated, family-centered care. Child welfare and behavioral health systems can support families by:
- Expanding access to mental health care: Connect parents and caregivers to timely, appropriate services before needs escalate.
- Building stronger referral pathways: Create clear connections among behavioral health, child welfare, early intervention, and other family-serving providers.
- Strengthening adoption competency: Prepare professionals to recognize and respond to trauma, separation, grief, attachment, and identity.
- Supporting parent-child relationships: Incorporate relationship-based and family-centered approaches into treatment and services.
- Coordinating care and engaging families: Share responsibility across systems and include parents and caregivers in decisions about treatment, safety, well-being, and permanency.
Stronger Parents. Stronger Relationships. Stronger Families.
Return to the mother sitting awake at 3:17 a.m. and imagine a different path.
Someone recognizes that she is struggling and connects her with appropriate mental health care. Her provider understands that supporting her also means understanding her role as a parent. If child welfare becomes involved, professionals communicate rather than operate in silos.
Most importantly, she does not have to navigate all of it alone.
The National Center for Adoption Competent Mental Health Services helps child welfare and behavioral health systems strengthen workforce knowledge, cross-system collaboration, and access to adoption competent care through no-cost training, technical assistance, and resources.
When we support maternal mental health through an adoption competent lens, we do more than address individual needs. We strengthen relationships, promote healing, and help families thrive together.
Reference
Verbiest, S., Klein-Cox, A., Grewal-Kök, Y., Goodell, C., & Anderson, C. (April 2026). Maternal Health and Child Welfare: A Long-Overdue Conversation. Social Work, Volume 71, Issue 2. Pages 188–190. Retrieved from: https://doi.org/10.1093/sw/swag010.