Needs, expectations and consequences for the child growing up in a family with a parent with mental illness

Parental mental illness is considered one of the strongest risk-factors for development of offspring psychopathology. The lack of pan-European guidelines for empowering children of parents with mental illness led to EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The first task in this project, was to analyse needs, expectations and consequences for children, with respect to living with a parent with mental illness. The aim this paper is to report results of these analyses. The qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland (N=96). There were 3 types of focus groups: (1) professionals (doctors, nurses, psychologists, social workers), (2) adult children and partners of a person with mental illness, (3) parents who have experienced mental illness during their parenthood. Framework analysis method was used. Results of the study highlighted that the main consequences for children of parental mental illness were role reversal, emotional and behavioural problems, lack of parent’s attention and stigma. The main needs of these children were emotional support, security and multidisciplinary help. Implications for practice are: (1) professionals working with parents with mental illness should be aware of the specific consequences for the children; (2) to empower children they should focus on them, but not excluding parents from the parental roles; (3) the multi-agency collaboration is necessary; (4) schools should provide counselling and teach staff and students about mental health problems to reduce stigm

“The validation is not enough”:Australian mothers’ views and perceptions of mental health support from psychologists in private practice

Objective: Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and “treatment as usual” may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Method: Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Results: Three overarching themes were identified in relation to (i) participants’ need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. Conclusions: These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts.</p

Experiences of family members when a parent is hospitalized for their mental illness: a qualitative systematic review

Abstract Background A considerable proportion of people attending mental health services are parents with dependent children. Parental mental illness can be challenging for all family members including the parent’s children and partner. The hospitalization of the parent and subsequent separation from dependent children may be a particularly challenging time for all family members. The aim of this paper was to review qualitative studies of family members’ experiences when parents, who have dependent children, were hospitalized for their mental illness. The experiences of parents themselves, their children aged 0–18 (including retrospective accounts of adults describing their childhoods), and other family members are included. Methods This systematic review followed Cochrane Collaboration and PRISMA guidelines. A search was performed with keywords relating to parents, mental illness, psychiatric treatment, inpatient units, family members and experiences. Databases included CINAHL Plus, PsycINFO, ProQuest, MEDLINE, PubMed and Scopus. Quality assessment was undertaken using an expanded version of the Critical Appraisal Skills Programme. Thematic synthesis was conducted on the included papers. Results Eight papers were identified. The quality assessment was rated as high in some papers, in terms of the clarity of research aims, justification of the methodology employed, recruitment strategy and consideration of ethics. In others, the study design, inclusion criteria and reporting of participant demographics were unclear. Family experiences of pressure and additional responsibilities associated with the parent receiving inpatient treatment were identified along with the family’s need for psychoeducational information, and guidance when visiting the parent in hospital. Children expressed various emotions and the need to connect with others. The final theme related to adverse impacts on the parent–child bond when the parent was hospitalized. Conclusion The limited research in this area indicates that the needs of families are not being met when a parent is hospitalized for their mental illness. There is a considerable need for adequate models of care, family-focused training for staff, and psychoeducational resources for families. Additional research in this area is essential to understand the experiences of different family members during this vulnerable time

Adult mental health clinicians’ perspectives of parents with a mental illness and their children: single and dual focus approaches

Abstract Background When clinicians in the adult mental health sector work with clients who are parents with dependent children, it is critical they are able to acknowledge and respond to the needs of the parents and their children. However, little is known about clinicians’ personal perspectives and reactions towards these parents and children or if/how they balance the needs of both. Methods Semi structured interviews were conducted with eleven clinicians from adult mental health services in Australia. Interviews focused on clinicians’ experiences when working with parents who have mental illness. Transcripts were analysed within an Interpretative Phenomenological Analysis framework to examine participants’ perspectives and personal reactions to parents and children. Results There was considerable divergence in participants’ reactions towards parents and children and the focus of their perspectives when working with parental mental illness. Feelings of sympathy and responsibility made it difficult for some participants to maintain a dual focus on parents and children and contributed to some adopting practices that focused on the needs of parents (n = 3) or children (n = 1) exclusively. Other participants (n = 7) described strategies and supports that allowed them to manage these feelings and sustain a dual focus that incorporated the experiences and needs of both parents and children. Conclusions It is difficult for some mental health clinicians to maintain a dual focus that incorporates the needs and experiences of parents and their children. However, findings suggest that the challenges of a dual focus may be mitigated through adequate workplace support and a strengths-based practice framework that emphasises parental empowerment

Investigating the Impact of Isolation During COVID-19 on Family Functioning – An Australian Snapshot

This study explored possible changes in family functioning from the perspective of parents during the COVID-19 pandemic. Thirty-four parents/guardians of children under 18 years completed a semi-structured interview, average length 47 min. Interviews focussed on changes in different aspects of family functioning including family roles, routines, and rules; parenting practices; communication and relationships; and strengths, challenges, and tensions. Data were analysed using reflexive thematic analysis applied in an idiographic and inductive manner to reduce the loss of individual experiences and perspectives. Four superordinate themes were identified: shifting family roles and boundaries throughout the pandemic; impacts on routines and relationships; opportunities and resourcing; and, experiences of support and unity. Gender differences were evident across some themes, particularly changing roles, workload and work-home boundaries. Challenges and tensions were frequently highlighted, particularly by “vulnerable” family groups such as those with children with disabilities. Parents also described a renewed sense of family and community that underpinned adaptive coping responses. The results highlight the importance of family connectedness in times of need