"Sylvia Frumkin" has a baby: a case study for policymakers

"Sylvia Frumkin" was a pseudonym given to a 32-year-old woman with chronic mental illness described by Susan Sheehan in her books Is There No Place on Earth for Me? This paper presents the case of "Gloria Morrison," a patient similar to Ms. Frumkin, who is also a mother. Issues raised by the case in three areas are discussed. Issues for the service delivery system include developing better assessment, prediction, and reduction of the risk that a parent's mental illness may pose to a child's safety and well-being; targeting supportive and educational interventions to relatives and foster parents caring for children of severely mentally ill patients; and tailoring programs and services to the needs of such patients and their children. Clinical treatment issues include offering treatment options through agencies other than the department of social services; developing protocols for the care of severely mentally ill pregnant and postpartum women; focusing on issues of loss; and providing parenting skills training. Issues in the area of family support include increasing providers' awareness of family burden and alleviating conflicts between the family and patient.