How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study

Abstract

Adult mental health clinicians face a range of challenges that hinder their use of family‐focused practices when working with consumers who are parents. The purpose of this study was (a) to examine clinicians' experiences when working with parents and (b) identify strategies they found to be effective when working with parents. Eleven Australian mental health clinicians were recruited who regularly worked with consumers who are parents. Semistructured interviews were conducted within a qualitative paradigm and analysed using interpretative phenomenological analysis. Themes were identified which related to (a) managing sensitive parenting conversations, (b) making decisions about child safety in unclear or unpredictable situations, and (c) working with child protection services. Participants had developed strategies for managing the challenges of the first two practice issues and suggested organizational changes that could facilitate collaboration with child protection services. The findings highlight that the challenges of working with parents with mental health issues cannot be addressed with a one‐size‐fits‐all approach. Initiatives to facilitate the effective support of parents and their children need to be informed by contextual factors, including clinical practice.

Mental health nurses' and psychiatrists' views on addressing parenthood issues among service users

“…Similarly, MHPs in an Australian study were found to ease their discomfort using nonjudgemental and supportive approaches, including the disclosure of the MHP's own parenting experiences with the aim to normalize the difficulty of parenting (Tchernegovski et al . ). The focus on the adult client goes along with MHPs' focus on protecting clients against child custody services.…”

“…This is similar to previous findings showing that MHPs reported negative experiences with child protection services but felt unable to overcome these barriers (Tchernegovski et al . ). In fact, individualistic approaches in mental health care are likely to reproduce rigid ‘adult versus children’ views.…”

“…However, interagency barriers cannot be solved by individual MHPs but should be addressed by changes at the organizational and interorganizational levels (Tchernegovski et al . ). There are strong arguments for a paradigm shift from individualistic to family‐focussed or relational recovery approaches (Nicholson & Deveney ; Reupert et al .…”

“…This is similar to earlier findings on MHPs' expectations that the family would see offers of support as intrusive (Hetherington & Baistow ), MHPs' assessments of parenting conversations as very delicate (Tchernegovski et al . ), and MHPs' experiences of a general feeling of discomfort (Dolman et al . ).…”

“…MHPs were found to describe talking about parenting with MHSUs as challenging, and they expressed fears of raising concerns about children's risks (Tchernegovski et al . ). Further, the quality of family relations; the location of the organization; and given resources in terms of time, staffing, and training were identified as potential barriers (or enablers) to FFPs in adult mental health services (Ward et al .…”