In adjudicating child custody, the court weighs multiple factors to determine the best interest of the child. Most state statutes and court decisions in the United States permit judges to consider the factor of parental mental health. To answer how judges consider this factor when adjudicating child custody, 17 judges who oversee child custody determinations participated in semi-structured in depth interviews conducted by the author. By providing judges with an opportunity to discuss their decision-making process in such cases, this paper provides a unique occasion to understand and gain insight into the process by which judges consider this best interest factor. Thus, the study reported here is the first to specifically examine judicial consideration of parental mental health when adjudicating custody. These interviews reveal that for judges, parental mental illness is not an a priori reason to deny custody. Judges make custody decisions based on information from the observations and recommendations of a Guardian ad litem, custody evaluations, and personal observations of the judge, framed by “common sense.” Judges, however, tend to overestimate their understanding of the psychological factors relevant to post-divorce adjustment. At the same time, they do not discharge effectively their gatekeeping role when they consider, without question, the evidence, opinions, and conclusions offered by evaluators. To address these problems, it is recommended that judges overseeing child custody proceedings be required to receive more effective training concerning the relevancy and significance of parental mental health, understanding and applying social science and behavioral research, and evaluating expert recommendations. In addition, the law should afford such judges more latitude to consider remissions of a contesting parent’s psychiatric symptoms. Lastly, both the law and the judges who enforce it should presumptively afford the mentally ill parent an opportunity for rehabilitation before implementing a permanent custody order.
How Does the Presence of Mental Illness Impact a Child Custody Decision?
According to the Marriage Act, a parent’s mental health shall not be considered if it “does not affect his relationship to the child.” 131 That is, if there is no nexus between the mental illness and the best interest of the child, the judge may not consider the diagnosis in deciding child custody. Judges interviewed for this study overwhelmingly stated that they considered the parent’s mental illness only if it was perceived to relate to the child’s best interest.132 “The issues is how does the [ ] [mental illness] affect your parenting, not do you have a mental health diagnosis.” 133 Another judge noted, “if there is a mental health issue. . . what can you do to make sure that the best interest of the child or children are not harmed. . . [I]t is certainly not a trump card for the other side.” 134 One judge stressed, “I don’t care about the diagnosis. I care whether the party can function if they had custody of the child.” 135 Another judge responded by saying, “[H]ow has the parent dealt with their condition? . . . [A]re they able to handle it and still look after the best interest of the child?
Judicial Determination of Child Custody When a Parent is Mentally Ill: A Little Bit of Law, A Little Bit of Pop Psychology, and A Little Bit of Common Sense
Report of the American Psychological Association Presidential Task Force On Violence And The Family
Treatment of Depression and Anxiety from High Conflict Divorce and Child Custody Battles Using Antidepressants and Benzodiazepines Is Risky
Divorce is one of the most stressful experiences most people endure, right up there with a death in the family, job loss and extended unemployment, or a medical catastrophe such as cancer. When you add to the mix a child custody battle with a Personality Disordered Abuseras your adversary, you will likely experience years of false allegations, be kicked out of your home, see your kids and family suffer the abuse of parental alienation, experience frequent misconduct by the courts, see your reputation ruined by defamation, suffer job loss and chronic underemployment or unemployment, and many other damages. During such a hellish experience, it is only natural to be depressed, anxious, and suffer chronic sleep problems. The continual stress results in what may initially appear as psychological problems but which inevitably result in physiological damage to one’s health.
Many suffering from this nightmare will seek medical help from their general practitioner or psychiatrist. At some level they know the stress-related symptoms they are experiencing are not “all in their heads” as some may claim. Sometimes medical practitioners do help, other times they begin another series of upsets to their patient’s health. That’s because the mainstream therapies used by many doctors often include too quickly prescribing common antidepressants and anxiolytic medications that have a plethora of adverse effects on health. Fortunately, there are alternatives that can often help without the need for these medications or can help to reduce the prescription medication dosages required and thereby help avert some of the worst of the side effects.
Psychotherapy Is Not A Cure
When you visit your doctor or psychiatrist and explain how you can’t sleep and are depressed and anxious from the horrors of the family law system, first of all you should realize that most of these medical practitioners don’t really understand you or your situation. Unless one has been through the nightmare of the family law courts or has seen the destruction they inflict upon a close family member or friend, it’s hard to have any real understanding of this miserable reality.
Some medical providers may brush off your request for medication, pointing out that your stress is temporary and will go away in a few months and advise you to see a psychologist or therapist. While good psychologists and therapists can certainly provide some help, what they can do is often not enough as the manifestations of the family law crisis often include physiological illness brought on by chronic stress.
Many psychotherapists simply aren’t much use in such difficult situations. First of all, for a chance of good results you must find one who has some experience with the family law system and forms of child abuse including parental alienation. If you pick a therapist who has never set foot in a family court room and seen how dysfunctional the system is, you are far less likely to get competent treatment or helpful advice.
Many psychotherapists have zero experience in family law battles. They may be experts at substance abuse, marital arguments, or helping people suffering job loss but know nothing about extreme divorce and child custody battles. Even those who do have some experience often lack a full appreciation of how abusive, arbitrary, and destructive the family law courts are to their victims and how it frequently takes nothing but an unproven false allegation to put a good parent who has broken no laws and abused nobody into a no-contact or expensive supervised visitation situation that is itself a form of emotional abuse.
Naive therapists may be operating under the mistaken impression that you can’t be kicked out of your home and have all your property and assets taken from you without a chance to present your side of the story or at least some evidence of wrongdoing. But in today’s family law courts, it is not unusual for that to happen. One lie is all it takes to ruin months or years of the lives of the falsely accused parent and his or her children. A second lie is often all it takes to amplify the damage tenfold. The general public fails to understand this, and so do most therapists.
A really excellent therapist for you should also be expertly familiar with personality disorders and sociopathic abuse patterns. Some therapists run away from personality disorder cases as fast as they can. They know how dangerous these people can be to them personally. Others are totally ignorant of how destructive personality disorders can be to the misfortunate ones who married and/or had children with a person suffering one of the DSM-IV Axis II Cluster B personality disorders including Borderline, Narcissistic, Histrionic, and Antisocial personality disorders. Ideally, you want a therapist who knows a lot about personality disorders and is brave enough to help you face off with one of these people. “Brave” applies here because it is common for the Personality Disordered Abuser to seek to defame and even file complaints seeking to revoke the license of a therapist who dares to challenge their abusive behaviors or help their victims.
Unfortunately, finding a suitable therapist is often very difficult to do. For many people, joining a high conflict divorce or parental alienation support group or web discussion forum and asking for referrals from the people there may be one of the few realistic means they have to find a therapist who might be of some help.
If you are fortunate enough to find a good therapist familiar with family court abuse, you are likely to get some useful support and advice that may help you weather the long storm. But even when you have found a good therapist and are starting to build some rapport, the odds are strong that by then you will be suffering physiological symptoms of extreme stress that even an excellent therapist cannot resolve. Lots of talk therapy isn’t enough on its own to turn around severe depression, anxiety, or sleep disorders. Realizing this, you’ll probably go back to your doctor again looking for medical help.
Psychiatric Medicines Are Not Panaceas or Candy
After hearing that you’ve got a psychotherapist and are still suffering, even conservative doctors are going to whip out the prescription pad if they haven’t already. They are likely to quickly prescribe an antidepressant, an anxiolytic, and possibly a sleep medication from their list of favorites. Every doctor has favorite meds, ones they have used for years or new ones they want to try because they got a box full of samples or a fancy $100 surf ‘n turf dinner, golf outing, or a week long tropical vacation in the dead of winter from a big pharma rep pushing a lucrative new pill. So what you will be prescribed may often have little or nothing to do with what will actually work.
Many of the commonly used psychiatric medicines are potentially far more dangerous that eating a large bag of candy may be to a diabetic. And they are about as likely to “cure” depression or anxiety as that same bag full of candy would be to help a patient lose ten pounds of weight in a week.
Below are some observations about commonly used psychiatric medications that you’re likely to be prescribed if you visit your doctor for family law related health problems.
Anxiolytics are medications that are intended to oppose anxiety. Most of the common ones act upon the GABA receptors in the brain. GABA is a neurotransmitter with a purpose of calming down the brain. Many of these medications work pretty well at first, until you get used to using them. Then they often require higher and higher dosages as a physiological dependency (basically an addiction) develops. As the dependency grows, you may see your anxiety go from having trouble sleeping to having panic attacks between doses.
The most widely used class of anxiolytics is benzodiazepines including Xanax (alprazolam), Valium (diazepam), Restoril (temazepam), Klonopin (clonazepam), and many others. Most of these drugs are approved forshort term use, but frequently patients are told to keep taking them for months or years and this is where much of the problem with these medications originates.
These meds are usually not bad choices for most people if they are used for only a few days or up to a week or two or a month at the outside. Another reasonable usage pattern is infrequent use (ideally much less than once per week) during high stress situations such as panic attacks. Using them much beyond these limited scopes and the risks go up dramatically. This is why a well-informed doctor will be very careful about writing prescriptions for these medications for limited quantities as they should be keeping a tight watch on your usage of such drugs. But many doctors fail to do this, often due to ignorance but sometimes due to cost containment pressures trying to limit “unnecessary” appointments at which they expect you’ll just be asking for a refill.
When you find one of these medications does help you calm down as you probably will at first, the doctor is tempted to keep you on it. And the longer you are on it, the more you will depend upon it. Because the doctors writing the prescriptions for these meds are virtually never the same ones who are helping hundreds of thousands of addicted people get off of them, they often fail to appreciate the risks these medications present. When a patient is severely addicted to these meds, it is not unusual for the patient to go “doctor shopping” to find yet another doctor to write another prescription as even many of those who originally wrote the first several prescriptions will at some point question why you are needing several times the amount of medication.
Even if you don’t end up addicted to these medications, they are still likely to hurt you. Common side effects from this class of medications resemble those of alcohol as many of them function as depressants of the central nervous system and cause cognitive impairments, short-term memory problems, slurred speech, clumsiness, slow reflexes, drowsiness, and other sorts of troubles you’d expect to see after a few alcoholic drinks. Worsened depression and liver and kidney damage are among the more moderately severe side effects. In extreme cases, these drugs can kill you via triggering respiratory arrest (cessation of breathing) particularly when combined with painkillers that are also often prescribed to people with severe stress related pain symptoms.
Benzodiazepines also generally mess around with your sleep architecture by reducing the amount of deep sleep and/or REM sleep, leaving you with more light sleep that is not as restorative. So while they may help you fall asleep when you are anxious, the sleep you will get will probably not be as restful as what you need. The more you use them to fall asleep, the worse your insomnia is likely to become without them. Long-term use also tends to worsen depression. These are three more good reasons why benzodiazepines should not be used on a daily basis even if you do manage to avoid addiction.
To give you an idea how destructive benzodiazepines can be, Australia banned temazepam in 2004 due to widespread abuse, prescription forgery, and theft from pharmacies. Sweden has reportedly banned the drug due to similar experience. In the United Kingdom, BBC TV broadcast a documentary titled “Temazepam Wars” involving drug related abuse and crime in Paisley, Scotland. In the US and Canada, the problems have not been as severe but clearly there is potential for disaster for anybody using these kinds of medications for long.
Temazepam’s effects are particularly addictive compared to other benzodiazepines. One aspect of this is its intermediate period of activity. Typically this drug is prescribed to help you sleep, so it often remains highly active for several hours to half a day and then the effects start to wane. When it is used every day to aid failing to sleep, what happens is that the patient often develops an interdose withdrawal in which anxiety becomes much worse than usual after the drug wears off. And this then tempts the patient to take another in the daytime or to take some other anxiolytic, often another benzodiazepine. To reduce the chances of this problem, you probably need multiple times the active drug period for your brain chemistry to return to normal between uses. But in somebody with chronic anxiety who is popping these pills daily who is on the way to becoming an addict, there is never enough time for brain chemistry to renormalize.
In a developing addict, more and more doses are taken to suppress the increased anxiety potential in a worsening cycle. In part 2 of 5 of that “Temazepam Wars” documentary, there’s a profile of Davie Wright who pops around 30 temazepam pills per day along with other prescription drugs. Just looking at him, you can see there’s something really wrong.
If you need any more convincing of the potential danger, go read Professor Ashton’s web pageBenzodiazepine Abuse for more horror stories and details of why these medications are dangerous. Ashton runs a clinic for people trying to recover from addiction to these drugs and is very well informed on the damage they can cause. Their addiction potential has often been cited as being higher than that of heroin. It can literally take multiple years for some patients to complete a withdrawal program to get them off these addicting drugs.
All that said, if you find yourself prescribed with a benzodiazepine drug, be aware they can help if used infrequently and/or for short periods of time when you are prepared to stay at home sleeping or doing something else mentally and physically unchallenging that is not a safety risk. For example, if you get a panic attack when you are served with another stack of court papers filled with lies by your ex, popping a Xanax to calm down is not the worst thing in the world so long as you are doing this infrequently. But if you find yourself doing that day after day, you are likely on your way to an addiction that could be worse than the original anxiety was.
For somebody being abused by a liar and his or her accomplices in family court, a benzodiazepine addiction may be the only real problem your lying ex has to cite for why you may not be a good parent. And of course the courts, in their typical unfairness, will not care that it was the lying ex via malicious abuse and the medical establishment via incompetence that got you addicted. They will blame you. And you and your children will suffer for it.
There are a large number of antidepressants on the market today. Many of the older types such as tricyclics have fallen out of favor as big pharma has pushed newer types on doctors and patients. probably the most popular type these days is the Selective Serotonin Reuptake Inhibitors (SSRI) antidepressant which includes Prozac (fluoxetine), Celexa (citalopram), Paxil (paroxetine), Zoloft (sertraline), Lexapro (escitalopram), and a couple of dozen others.
There are two aspects of these drugs that are the most alarming to me. First is that upon dosage changes, particularly when first taking the drug or when trying to discontinue it, there is a statistically significant elevation in the risk of suicide. The risks are high enough that even the FDA, usually eager to help push dangerous drugs on unsuspecting millions in the name of profits for its drug company partners, actually demanded SSRI manufacturers put “black box” warnings on the drugs to disclose the elevated suicide risk. It’s like you telling your kids that playing ball on the freeway is a sure way to get hurt. You should listen to that warning.
The second biggest alarming observation is that many (possibly most) of these drugs are no more effective than placebo in people suffering mild or moderate depression. They seem to be effective in people with severe depression, but let’s face it, most people don’t start out with severe depression. Perhaps the idea is to let them think they are being helped until they are really sick and are then hooked on the meds.
There are dozens of alarming side effects from SSRIs. The most common include drowsiness, fatigue, weight gain, insomnia, headaches, and elevated anxiety ranging on up to panic attacks. The full list is very long and includes side effects ranging from tinnitus (ringing ears) and having trouble urinating all the way up to death by suicide. These drugs are not a panacea.
Often when a side effect becomes too severe, the doctor will try to switch you to another SSRI or SNRI (Serotonin–Norepinephrine Reuptake Inhibitor) antidepressant. SNRIs are a newer class of drugs that are often prescribed when the depression involves neuropathic pain as SSRIs are poor at treating that symptom.
Newer doesn’t always mean better in drug land. Often it takes decades for the medical establishment to figure out that an FDA approved drug is killing far more people than the too-often fraudulent drug studies said it would. After seeing how horse urine derived synthetic estrogrens were pushed on unsuspecting menopausal women for decades while raising their rates of heart attack, strokes, and blood clots, almost no lie out of the FDA should surprise anyone.
Both benzodiazepines and antidepressants are frequently prescribed for insomnia. There are also newer non-benzodiazepine medications such as Ambien (zolpidem) that are also active on the GABA receptors to calm the brain. They are generally regarded as having similar side effects as benzodiazepines but with less addiction potential. However, they are also regarded as less effective for severe anxiety so they may not be of much help for some people.
Who To Trust?
Your doctor probably does want to help you, but may be lacking objective knowledge and a full understanding of your symptoms and stress. As a result, it is very common for doctors to prescribe poor choices of psychiatric drugs and then struggle with trying to find a better option as the patient experiences bad side effects or no therapeutic effect at all.
My advice to you is to investigate any medication your doctor may be considering before you start taking it. The Internet is no substitute for competent medical advice, but unfortunately neither is a medical license or FDA approval.
In particular, when you are evaluating possible treatments you owe it to yourself and your kids to consider that the stress from a psycho ex and the abuse you’ll endure in the kangaroo courts is probably going to last many years and quite likely until all your kids are adults. Any treatment that is predicated on short-term use only is bound to be inadequate for such an extreme situation. This is why benzodiazepines are particularly risky. If you can honestly restrict them to infrequent treatment for extreme stress at the level of panic attacks, you probably won’t become an addict. But there’s a steep slippery slope and with one really bad period (another false child sexual abuse allegation, seeing your new partner arrested on the basis of the psycho ex’s false child abuse allegations, etc.) you may end up an addict. One simply cannot safely depend upon using benzodiazepine drugs in a high conflict child custody situation for a decade or longer on a daily basis without severely damaging one’s health no matter how careful one may try to be.
My suggestion is that you first look to alternative medicine using supplements, nutrition, and behavior modification (such as stress mitigation via meditation or exercise) before you start down the road of prescription pharmaceuticals. Be sure to read up on why antidepressants and anxiolytics may not work well and what some inexpensive natural alternatives such as natural anxiolytics and antidepressants and safe hormone boosting in articles such as these:
It’s my belief that defending and improving your sleep is probably the #1 thing you can do to prevent your health from spiraling downward during the long-term stressful years of a nasty divorce or child custody battle. That second article on L-Theanine, pregnenolone, and DHEAgives some supplement suggestions that along with the sleep hormone melatonin andserotonin-boosting foods and supplements containing L-tryptophan may be enough to significantly improve your sleep most nights.
Melatonin is a particularly good sleep aid because it does not alter sleep architecture, unlike most prescription medications that tend to deprive you of the more restorative periods of sleep which are the REM and deep sleep phases. As melatonin is a hormone a healthy body makes every day, supplementing with it can help make up for inadequate melatonin in people who are so stressed out that they cannot sleep. The risks are low compared to pharmaceuticals as studies using even massive dosages of melatonin on a daily basis show no sign of toxicity or addiction.
It is important to get some blood and saliva tests to look at possible hormone and neurotransmitter explanations for your poor psychological state before resorting to pharmaceuticals. In particular, there are a large number of people stuck in family law battles who suffer from adrenal hormone imbalances. High cortisol is probably the most common and tends to badly disrupt sleep and trigger weight gain, but if this is left untreated the adrenal hormones will probably eventually falter and you’ll be left with a potentially even worse situation of low cortisol that can trigger chronic insomnia and pain plus a physiological deficiency at handling stress. No amount of antidepressants, anxiolytics, or sleep medications is going to fix an adrenal hormone problem. Please read more about cortisol imbalances in the context of chronic depression, anxiety, pain, and sleep disorders in the following articles:
You Are Not Alone
Many or most people can benefit from sessions discussing their divorce and child custody battles with a good therapist. Unfortunately it often takes many tries to find one that is competent in helping family court victims and is a good match for a patient in terms of personality, location, schedule, and cost. So while you’re working on finding a good therapist, it may also help to start finding and building support systems and discovering ways to improve your health and mood via other means before you get so worn down that you are sucked into the potentially vicious cycle of prescription psychiatric medications without a long-term plan to avoid dependency on these drugs.
For people new to family court hell, please realize you are not alone. Family courts and wrongful government interference have destroyed the lives of millions in the US and other supposedly “civilized” nations. Educate your parents and siblings on the abusive family courts and they may help emotionally support you in return. Find a support group in your community or online. The people you may meet there can often provide good suggestions on therapists, doctors, and coping mechanisms that have worked for them.
Finally, do some reading to understand how the government has come to view families as targets to be abused and that you and your children have the misfortune of living in an era in which “family values” literally means how much money the government and its stooges can make off interfering in your lives and that you and your family are viewed with disdain and dislike by the government until you are terrorized into subservience to the government. Ourreview of Baskerville’s “Taken Into Custody” can get you started in the right direction.
I speak as an attorney who practices family law and who has litigated many custody disputes. I also speak as a single parent who has watched two children live through the experience of divorce when they were 8 and 12 and who has lived through the pain of watching a child leave my house because the grass looked greener on the other side. I believe that one of my key roles as your lawyer, is to help you navigate through the emotional turmoil that custody litigation involves.
My background first. I married relatively young the first time – 24. It lasted only a year and there were no children. As I proceeded through the divorce process and was completely disillusioned by the manner in which my attorney kept me in the dark about the progress of my case, I made the decision at age 28 to attend law school as a night student. My education and experience up to this point had been in the field of accounting and business valuation. I am a CPA (license inactive) and was certified as a Senior Member of the American Society of Appraisers specializing in the valuation of closely held businesses. I don’t keep that latter certification current because I choose now to devote my focus to the family law area.
I graduated from law school four years later, at the age of 31, had married in that time, and also had my first child. I was as a new lawyer, a new wife and a new mother. I had my second child, my son, four years later, and was married for 17 years.
I have litigated and conciliated many custody cases. I have seen what I consider to be horrendous decisions by judges who apply their personal biases to these matters with little or no psychological training. I have seen some very good decisions made by judges with caring and logic applied to the painful situation. I have also seen judges who rely solely on recommendations from psychologists who don’t properly evaluate the parents.
There is a body of principles that must be followed by psychologists in performing forensic custody evaluations. It has been my experience that many court-appointed psychologists are not performing their duties. The excuse that I hear most frequently is that the cost will be too high if they apply the procedures that are designed to help evaluate parenting capabilities. Consequently they prepare reports that support their custody recommendation that are nothing more than a personal opinion with no foundation.
I have seen competent and loving parents get a very limited amount of time with their kids because they experienced a period of depression or post-traumatic stress related to their divorce and they didn’t get help.
Instead, they engaged in behavior that gave their spouse cause to argue that they were not competent parents. Once there is a status quo custody arrangement, my experience has been that it is very costly and very difficult to change until the child becomes of high school age so that the court will listen to them.
Don’t try to deny depression or anxiety. Yes, hide it from your spouse, but go get medical and psychological assistance. Talk to your attorney about it, get medication and SEEK COUNSELING. If you have health insurance many plans will cover up to 20 visits per year. Many churches have counseling groups that charge far less than private counselors. And most of the churches have support groups and “Divorce Care” programs that assist you and others through the process.
Many times counseling without medication isn’t enough. Your goal is the stay the healthiest, mentally and physically, so that you can be a good parent to your children. The best place to get medication is from a psychiatrist. They are the most qualified to judge dosage and are familiar with the effects of far more drugs than your PCP. You can get the referral from your PCP. I was medicated with Celexa, without feeling any mental or physical effects. This enabled me to cope with the stresses of the day and to function as both a mother and the breadwinner.
I have built my own law firm and have raised two children without the help- – physically or financially– from their father. In addition, my son has Type I diabetes. After approximately being on my own with this situation for nearly 10 years, I have to question whether I would have been able to keep it together without medication and therapy.
My counselor has become my life advisor and I utilize her services every time I encounter an issue, work or personal, that I need help thinking through. There is a law in Pennsylvania that protects all your communication with a mental health professional. You are the only person who can waive that right and I have seen the courts uphold it. So don’t be afraid to see a professional. Introspection and learning new coping mechanisms are marvelous and give your children a terrific model.
I have also seen parents get limited time because they permitted a custody arrangement to exist that gave them limited time with their child. In many cases the reason for agreeing to less than equal custody is due to the fact that the leaving spouse doesn’t want to require the child to adjust to a change in their lifestyle.