The experience of parenthood by individuals with severe mental illness has not been well studied. Research on mentally ill parents has focused on their pathology and the potential risk for their children without considering the parents' perspective. This qualitative study used interviews to explore how these parents coped with the dual demands of parenthood and their illness. Participants included individuals whose children are now young adults as well as those with younger children. Themes that emerged were problems with diagnosis and treatment, stigma, chaotic interpersonal relationships, the strain of single parenthood, custody issues, relationship with children, social support, and pride in being a parent. Follow-up interviews focused on the themes of relationship with children, strain of single parenthood, and sources of support. Relationship with children contained three specific topics: discipline, boundary issues, and role reversal. Implications for practice are discussed along with recommendations for future research involving other family members.

Parents who have serious and persistent mental illness are often overlooked in social work and mental health journals. Furthermore, mentally ill parents typically are viewed from a pathology perspective that fails to address their desire to be competent parents. This article reviews the literature on mentally ill parents and addresses conceptual issues in assessment and services. The author critiques methods of assessment and recommends more appropriate and comprehensive assessment protocols. Model programs are discussed with a focus on the development of competent parenting skills combined with social supports for parents who have a serious and persistent mental illness.

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The term "empowerment" has been widely adopted in social work and other areas of contemporary culture, yet its meanings are not clearly agreed upon. This article discusses the various uses of this term in both the social-work and mental-health literature.These conceptualizations are then compared with the results of a small qualitative study, in which practitioners from the Deep South discussed their understandings of the meaning of empowerment. Central to their ideas about empowerment were a set of paradoxes and redundancies with other constructs, especially self-determination. Although the concept of empowerment had heuristic value, it was most relevant for work with individuals, rather than larger social forces. While this is in contrast to the broader use of this term in the theoretical literature, it is consistent with other literature about practitioners' views of this vaguely defined term.

This article argues for health and mental health collaboration between social workers and rural primary care physicians and describes a study of physicians' attitudes toward integrated services. The physicians who expressed interest in a collaborative arrangement differed in practice characteristics, attitudes toward social workers, and endorsement of social work roles. Also, interested physicians treated significantly more patients, had the lowest proportion of patients over age 65, and endorsed as useful a significantly larger number of social work activities. If social workers aspire to collaborative arrangements in rural primary care, they must provide excellent services now, continue to work toward a better understanding of their broad mental health competencies, and be willing to provide services that conform to the expectations and limitations of primary care.