Search

There is strong evidence supporting the benefits of family work, for both parents and children, in the treatment of parental mental illness. However, there has been only limited research on the implementation of family work in settings outside the mental health sector, such as family therapy or family counselling services, where mental illness may not be the primary presenting issue for a family. This article reports on a qualitative study that explored the experiences of family therapists working with families affected by parental mental illness. The article focuses on dilemmas clinicians faced integrating discussions about parental mental illness into family sessions. The findings support the need for clinicians to have appropriate training in family work related to mental health issues and also to develop the skill set needed to actively introduce, negotiate and explore the topic of mental illness with families. Practitioners points: Developing knowledge, language and confidence in talking about mental illness may assist clinicians to raise discussions about parental mental illness in family sessions.Training in evidence‐based interventions for working with children of parents with a mental illness may provide a tool for clinicians in family sessions.Clinicians must be attuned to the ‘emotional readiness’ of parents and children to discuss parental mental illness. Developing readiness may take time. [ABSTRACT FROM AUTHOR]

Having a parent with a mental illness can create considerable risks in the mental health and wellbeing of children. While intervention programs have been used effectively to reduce children's psychopathology, particularly those whose parents have a specific diagnosis, little is known about the effectiveness of these early interventions for the wellbeing of children of parents who have a mental illness from a broad range of parents. Here we report on an evaluation of CHAMPS (Children And Mentally ill ParentS), a pilot intervention program offered in two formats (school holiday and after school peer support programs) to children aged 8-12 whose parents have a mental illness. The wellbeing of 69 children was evaluated at the beginning of the programs and four weeks after program completion, on instruments examining self-esteem, coping skills, connections (total, within and outside the family) and relationship problems (total, within and outside the family). Post intervention, there were significant improvements in self-esteem, coping and connections within the family, and reductions in relationship problems. The impact on children's wellbeing differed according to the intensity of the program (consecutive days or weekly program). The results are discussed in the context of providing interventions for children whose parents have a mental illness and the implications for service provision generally. [ABSTRACT FROM AUTHOR]

Amongst the impacts of growing up with a parent with mental health challenges is the experience of stigma‐by‐association, in which children and young people experience impacts of stigmatisation due to their parent's devalued identity. This article seeks to expand our understanding of this issue through an abductive analysis of qualitative data collected through a codesign process with young people. Results indicate that young people's experiences of stigmatisation can be effectively understood as experiences of epistemic injustice. Participants expressed that their experiences comprised 'more than' stigma, and their responses suggest the centrality to their experiences of being diminished and dismissed in respect of their capacity to provide accurate accounts of their experiences of marginalisation and distress. Importantly, this diminishment stems not only from their status as children, and as children of parents with mental health challenges but operates through a range of stigmatised identities and devalued statuses, including their own mental health status, sexual minoritisation, disability and social class. Forms of epistemic injustice thus play out across the social and institutional settings they engage with. The psychological and social impacts of this injustice are explored, and the implications for our understanding of stigma around family mental health discussed. [ABSTRACT FROM AUTHOR]

Little is known about the experience and impact of intersectional stigma experienced by rural young people (15–25 years) who have a parent with mental health challenges. The StigmaBeat project employed a co-design approach to create short films to identify and challenge mental health stigma from the perspective of young people who have experienced this phenomenon. The aim of this paper is to describe the co-design methodological approach used in StigmaBeat, as an example of a novel participatory project. We describe one way that co-design can be employed by researchers in collaboration with marginalised young people to produce films aimed at reducing mental health stigma in the community. Through describing the processes undertaken in this project, the opportunities, challenges, and tensions of combining community development methods with research methods will be explored. Co-design with young people is a dynamic and engaging method of collaborative research practice capable of harnessing lived experience expertise to intervene in social issues and redesign or redevelop health services and policies. The participatory approach involved trusting and implementing the suggestions of young people in designing and developing the films and involved creating the physical and social environment to enable this, including embedding creativity, a critical element to the project's methodological success. Intensive time and resource investment are needed to engage a population that is often marginalised in relation to stigma discourse. [ABSTRACT FROM AUTHOR]

Background: Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices.Methods: In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0-100 point likert scale.Results: Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user.Conclusion: Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts. [ABSTRACT FROM AUTHOR]

Objective Method Results Discussion This study aimed to investigate the benefits and difficulties with providing online peer support services for children with a family member experiencing mental health challenges.Using a qualitative descriptive design, the perspectives were gathered of Australian children and young people with a family member experiencing mental health challenges and had participated in online peer support activities during the COVID-19 restrictions of 2020 and 2021. Five age-differentiated focus groups were held with participants aged between 8 and 24 years (N = 32), and interviews were held with youth peer leaders (N = 3) and program facilitators (N = 6).This paper presents seven themes generated from the qualitative data. The themes captured the benefits of an online setting such as enabling greater accessibility, participation and comfort. Juxtaposed with this, themes also captured challenges such as the unease and risks of participating online, as well as the perspective that in-person activities facilitated stronger and quicker connections.It was concluded that a blended model of online and in-person support services is likely to be valuable for children with a family member experiencing mental health challenges to ensure accessibility and provide the capacity to meet the varied needs of this cohort. [ABSTRACT FROM AUTHOR]

The family-focused mental health intervention, 'Let's Talk About Children,' has positively influenced the lives of families affected by parental mental illness. This paper outlines the use of this brief, strengths-based intervention for parents with gambling and other co-occurring issues from the gamblers' support services sector. Over a six-month period, a training manual and accompanying resources were adapted for the gamblers' support services sector and a targeted training session developed. Nine problem gambling counsellors from three Victorian gambling support services trialled the Let's Talk About Children intervention over a four-month period. Qualitative data were gathered through focus groups, interviews, and practice enquiry groups to determine the impact of the Let's Talk About Children model for gambling support services. The results are presented as 'practice wisdoms and recommendations' reporting on the impact of the trial and to provide some guidance to support others in the implementation of a specific family-focused intervention. This paper reports on the first exploratory trial of Let's Talk About Children for the gambler's support services sector in Australia. [ABSTRACT FROM AUTHOR]

Early interventions for children whose parents have a mental illness, comprising the provision of age-appropriate information about mental health, positive coping strategies, and meaningful social and emotional connections, are identified as preventive interventions for childhood health and wellbeing. The aim of this study was to evaluate the CHAMPS (Children and Mentally Ill Parents) peer support program that is designed to connect, support and educate this cohort of children and their parents/carers. The CHAMPS program was reviewed and co-designed by clinicians, parent participants, peer workers and children in 2017 and 2019. The revised modularised program incorporates peer facilitators and shared lived experience as a way for participants to build understanding of their own experiences and strategies for coping. Children, parent/carers and program facilitators were interviewed for this study. This paper presents findings from interviews conducted with 8- to 12-year-old children (N = 20) who completed CHAMPS; parents/carers (N = 17) and program facilitators (N = 10). Children reported that the program lessened isolation and feelings of self-blame for their parents' struggles; and parents reported benefits from supported communication with their children in explaining their diagnosis and in understanding the needs of their child. It was concluded that early intervention peer support programs for children can have multiple positive impacts on the family, highlighting the importance of psychoeducation and improved family communication, as well as connections to peers for supporting families where parents have a mental illness. [ABSTRACT FROM AUTHOR]

Aim: Young adults aged 18–25 whose parents have a mental illness or substance use problem can be vulnerable to multiple difficulties in adulthood. There are, however, few available interventions designed for this group. This study evaluated a 6 week online intervention (mi. spot; mental illness: supported, preventative, online, targeted) specifically designed for this population. The intervention aims to improve mental health and wellbeing. Methods: Forty‐one young people, recruited from the community, participated in a two‐arm parallel randomized controlled trial where participants were randomized to mi. spot (n = 22) or a wait list control group (n = 19). They were assessed at baseline, immediately post intervention and at six weeks post intervention with measures covering depression, anxiety and stress, wellbeing, coping, general self‐efficacy, help seeking and social connectedness. Results: Intervention participants reported significantly improved psychological wellbeing, coping, general self‐efficacy, and a reduction in anxiety. Participants in the control group reported significant improvements in emotional wellbeing and help seeking and a reduction in self‐blame. Conclusion: This pilot controlled trial supported previous findings and shows preliminary evidence that mi.spot is effective for young adults who grew up with parents who have a mental illness or substance use problem. A large‐scale, randomized controlled trial with a diverse group of young people is needed. [ABSTRACT FROM AUTHOR]

This article reports a strengths-based intervention to support parents with mental illness and their children in adult mental health settings: "Let's Talk About Children" (LTC) intervention. A qualitative methodology was adopted with parent participants receiving LTC in adult mental health and family services. The benefits for parents receiving LTC were described through in-depth interviews with 25 parents following the delivery of the program. Interview data identified an impact on parental self-regulation—mainly through a change in a sense of agency as a parent—and skill building, once a clearer picture of their child's everyday life was understood. This study outlines the benefits of talking with parents about the strengths and vulnerabilities of their children during routine mental health treatment. The role for self-determination of parents in preventive interventions for children is an important consideration for mental health recovery, and it also helps to break the cycle of transgenerational mental illness within families. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to qualitatively identify the mechanisms of change as young adults, whose parents have a mental illness and/or substance use issue, navigate their way through a 6-week, moderated online intervention. Methods: Using a qualitative, grounded theory approach, data were collected and triangulated for analysis from participants before, during, and after engaging in the intervention. First, 31 young people's motivations for enrolling in the intervention were identified from one open ended question on an online survey. Second, online chat sessions were analysed to identify those topics the 31 participants engaged in throughout the intervention. Finally, 19 interviews were conducted 2 weeks post-intervention, to ascertain participants' perceptions of the impacts of the intervention and how the intervention promoted changes. Results: The main storyline was that of participants "making sense" of their parents, themselves and other relationships, in collaboration with peers, in a safe online space. This storyline of "making sense" drove their motivation to join the intervention and was the focus of the online chats. After the intervention, some were closer to having "made sense" of their families while others struggled differentiating themselves away from their families. An anonymous, professionally moderated online site afforded participants opportunities to think about who they were and for some, who they wanted to be. Conclusion: Generating an explanatory theory of how vulnerable young people navigate their way through an online intervention provides important information that can be used to inform future services, interventions, and research. [ABSTRACT FROM AUTHOR]

‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘.. the whole family, and how the child fits into the picture’. [ABSTRACT FROM AUTHOR]

Let's Talk About Children is a manualised intervention for parents with a mental illness that aims to impact positively on family dynamics. Previous evaluations focused on parents with an affective disorder. The purpose of this study was to evaluate the intervention for parents with various mental illnesses and explore parents' self-reported views regarding the impact of the intervention. A quasi-experimental approach was employed to compare outcomes for parents who received Let's Talk About Children plus treatment as usual (n = 20) with a wait list control (treatment as usual) group (n = 19), using family functioning and parenting stress questionnaires. Questionnaires were completed 2 weeks prior to receiving the intervention and 4 to 6 weeks after the final session. The wait list parents completed the same questionnaires at two time periods, 6 weeks apart. Semi-structured interviews were conducted after the intervention. Both intervention and control groups showed improvements in parenting and family functioning. Interview data highlighted (1) increased insight, (2) normalising of the illness in the family, (3) family communication changes, (4) the importance of supporting the parenting role and (5) suggestions for additional supports. There are possible issues regarding the influence of psycho-education when giving participants information about the nature of the research. [ABSTRACT FROM AUTHOR]

Parenting with mental illness is not uncommon and is often associated with a range of challenges for parents, children, and the family unit. Family-focussed practice involves the provision of services to the wider family system, including children. While family-focussed practice is important to consumers and their families, adult mental health practitioners do not routinely discuss parenting or children with their clients, nor work closely with the whole family. In the present study, we aimed to examine the characteristics of practitioners from Australian adult mental health services associated with family-focussed practices. Characteristics included sex, years of experience, location, and previous training in child and family-focussed practice. A total of 307 adult mental health practitioners from Victoria, Australia, responded to the Family Focused Mental Health Practice Questionnaire and a series of demographic items. The results indicated that particular practitioner characteristics predicted the delivery of family-focussed practice. Practitioner experience, sex, working in a rural location, and previous family- or child-related training were found to be important in the provision of family-focussed practice. More experienced, female, rurally-located, and well-trained practitioners undertake most family-focussed practice. These results suggest that training in family-focussed practice needs to be promoted, with considerations made for differing needs according to the characteristics of the adult mental health practitioner. [ABSTRACT FROM AUTHOR]

Summary This study explores the concept of family resilience where a parent has a mental illness. Eleven Australian adults who have grown up in a household with a parent who had a diagnosed mental illness participated in an in-depth interview. The interviews focused on the ways in which these families responded to challenges in everyday life, particularly related to parental mental illness. Findings Families developed resilience through processes such as shared humour or regular family rituals and routines. In some cases, open communication about mental illness enabled families to better cope when parents were unwell and to build a greater sense of family connectedness. However, data suggest that parental mental illness potentially creates stress and confusion for families and there are multiple social and cultural barriers that make it difficult for families to acknowledge and speak openly about mental illness. For participants, resilience tended to be about maintaining a balance between stress/distress and optimism and strength within their family. Applications The article highlights the importance of family context when describing resilience, and identifies specific clinical implications for working with families affected by parental mental illness. [ABSTRACT FROM AUTHOR]

A collaborative approach to care of parents with a mental illness is essential to address the needs of the whole family. However, a number of constraints within adult mental health and child-focused services prevent a unified approach to the care of families where a parent has a mental illness (FaPMI). This paper reports on a cross-sector workforce development initiative aimed to build skill and knowledge in practitioners to work with FaPMI. The initiative included training in the 'Keeping Families and Children in Mind' e-resource to mental health, child and family services. The resource was combined with face to face training and small group meetings over six weeks, to help develop emerging champions/practice leaders to promote FaPMI-focused practice. A significant decline in the perceived ability to engage in FaPMI-focused practice emerged immediately post-training. The lack of perceived organisational supports was the major barrier to the implementation of FaPMIfocused practice across sectors. However following continued support of practitioners, a significant increase in FaPMI-focused practice across sectors, and a return to pre-survey levels of perceived organizational support, was observed at six-month post-training. The importance of providing additional implementation supports and time to consolidate practice change following training is highlighted. Recommended implementation and training strategies that will improve FaPMI-focused cross-sector approaches to better meet the need of FaPMI are described. [ABSTRACT FROM AUTHOR]

This article outlines the development of practice standards for the adult mental health workforce for addressing the needs of families where a parent has a mental illness (FaPMI). The practice standards recommended here were formulated using a modified cooperative inquiry process with a group of senior clinical leaders in adult mental health services in Australia, following consultation with the available literature and policy documents. The aim of the project was to generate, align, and operationalize family-inclusive practice standards within the core activities of the adult mental health workforce and integrate into the continuum of care and recovery for service users who are parents of dependent children. As part of a modified Delphi method, the standards were also ranked by the senior clinical leaders to determine what they believe to be essential and recommended practices for the adult mental health workforce they manage. We argue that developing practice standards that provide practical and realistic expectations of the adult mental health service workforce enable services and workers to better adapt practice to respond to FaPMI. [ABSTRACT FROM AUTHOR]

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices. [ABSTRACT FROM AUTHOR]