Evolving Options for Supporting Mothers with Mental Illness

Mothers living with mental illness continue to face deep stigma in healthcare and child welfare systems across Canada. Too often, systems focus on perceived risk rather than support, leading to unnecessary child apprehensions and long-term family separation. New research and lived experience, however, point to a different path forward.

In a recent conference session, Amanda Mihalicz, Sessional Lecturer in the Faculty of Social Work at the University of Regina and a social worker with the Saskatchewan Health Authority, shared findings from her graduate research on maternal experiences of women living with schizophrenia. Her work centres the voices of mothers themselves and challenges long-standing assumptions about parenting and mental illness.

“Women with mental illness highly value their role as mothers,” Mihalicz said. “Motherhood is central to their identity, yet they are often treated as incapable before they are ever given adequate support.”

High Rates of Custody Loss and Systemic Bias

Research consistently shows that mothers diagnosed with schizophrenia lose custody of their children at alarmingly high rates, often within the first few years of a child’s life. Estimates suggest between 50 and 80 percent of these women experience child apprehension, frequently without access to sustained parenting supports.

Mihalicz explained that much of the existing research has focused on deficits and risk, rather than lived experience and strengths. “There has been a strong focus on what could go wrong,” she said, “but far less attention on what mothers say they need in order to parent safely and successfully.”

Her qualitative study involved nine women diagnosed with schizophrenia or schizoaffective disorder, some of whom continued parenting while others had lost custody of their children. Despite different outcomes, all participants described motherhood as deeply meaningful.

“Seven participants spoke about pride in becoming a mother,” Mihalicz said. “For many, it was one of the most important experiences of their lives.”

Medication, Pregnancy, and Complex Decision-Making

Pregnancy and family planning emerged as a central theme. Participants described the difficult balance between managing symptoms and concerns about medication use during pregnancy. Some women discontinued medication out of fear of fetal harm, while others worried about relapse and postpartum psychosis.

“These decisions are incredibly complex,” Mihalicz said. “Close monitoring and proactive conversations need to happen before pregnancy, not after crisis occurs.”

Yet many participants reported that healthcare providers never raised the topic of sexuality or family planning with them. Mihalicz noted that some providers view women with schizophrenia as asexual or incapable of parenting, a bias that limits informed decision-making and increases risk.

The Role of Support Systems in Family Preservation

One of the strongest findings from the study was the importance of family and community support. Mothers who retained custody consistently pointed to spouses, parents, or extended family as critical to stability.

“That support system was everything,” one participant shared. “If I didn’t have my parents, I would have fallen through the cracks.”

Employment and volunteer opportunities also played an important role. Participants described how meaningful work increased confidence, routine, and self-worth. “When people put some faith in me,” one mother said, “I could develop my talents and grow.”

Therapeutic Alliance as a Protective Factor

Across all interviews, positive relationships with care providers emerged as a key factor in stability and recovery. Mothers valued providers who listened, took time to understand their experiences, and treated them as partners in care.

“The most helpful professionals were the ones who sat down and really listened,” one participant said. “Not just ‘take your pills and go to bed,’ but people who cared enough to understand.”

Mihalicz emphasized that strong therapeutic alliances improve medication adherence, reduce hospitalizations, and increase engagement with services. These relationships also lower the likelihood of child apprehension by encouraging mothers to seek help early.

Stigma, Trauma, and Missed Opportunities

Every participant described experiencing stigma related to their diagnosis, including discrimination from partners, employers, and sometimes healthcare providers. Several mothers stopped disclosing their diagnosis altogether after repeated negative experiences.

“Stigma keeps women from seeking care,” Mihalicz said. “That delay increases risk for both mother and child.”

The study also highlighted high rates of childhood trauma and substance use among participants, reinforcing the need for trauma-informed and integrated care. Mihalicz noted that poverty and lack of housing often posed greater risks to child development than the diagnosis itself.

Rethinking Child Welfare Responses

Mihalicz called for a shift away from automatic child removal toward family preservation models that prioritize support, safety planning, and kinship care whenever possible.

“Child protection should be a last resort, not the first response,” she said. “With the right supports in place, many mothers with mental illness can and do parent effectively.”

She urged healthcare providers, social workers, and policymakers to challenge gendered assumptions and work collaboratively with mothers rather than positioning them as risks to manage.

Listening to Mothers First

The session closed with a reminder that meaningful change starts by listening. Many participants told Mihalicz they had never been asked about their experiences as mothers before the study.

“One woman said, ‘It’s not who we are,’” Mihalicz shared. “She wanted people to understand that mental illness does not define her ability to love or parent her child.”

As conversations around perinatal mental health continue to grow in Canada, Mihalicz’s research adds an essential perspective. Supporting mothers with mental illness requires more than risk assessment. It requires trust, coordinated care, and the willingness to see mothers as capable, deserving, and human.

Media? Apply to join us.

Are you a journalist or member of a large media outlet?

To request media accreditation, please contact us directly at info@sparkconferences.com with your name, outlet, and coverage focus. All applications will be reviewed, and confirmation will be sent via email.

Media accreditation includes:

• Complimentary access to attend sessions (in-person or virtual)
• Opportunities to interview speakers and panelists

Join Our Mailing List

Receive news on relevant upcoming conferences and Early Bird deals.