Ill and substance-abusing parents: how can the general practitioner help their children? A qualitative study

Abstract

BackgroundSevere illness among parents may interfere with their parenting. Children having ill or substance-abusing parents are at risk of own health problems and psychosocial difficulties. The health care system should identify families in need of help and provide the help needed. For ill parents, it can be difficult to seek help and advices for their parenting. The aim of this study was to identify important factors for the general practitioner (GP) to bear in mind during encounters with ill and substance-abusing parents, to enable the GP to provide appropriate support for the children.MethodA qualitative approach was chosen and the data material was semi-structured individual interviews with 12 parents with mental illness, substance abuse or severe somatic illness. The participants were recruited through GPs in Norway, and the interviews were performed in 2014. We used systematic text condensation for analysis.ResultsIt was important for the participants that the GP was oriented about their family and children’s situation. They wanted to be regarded as competent parents in ordinary families; however, they were aware that their illness affected their parenting. They expressed a need for advice about how to inform the children of their illness and talk to them about their challenges, and, if necessary, utilize helpers who could inform the children and talk to them directly. There were often many agencies involved, and it was important that the helpers cooperated and shared information. In addition, the parents were in need of information about support services.ConclusionIll parents in this study conveyed a double message to their helpers. They wanted to be considered as responsible and well-intended parents who wished the best for their children. At the same time they needed support in parenting. The GP should take the time to listen to the parents’ first spontaneous description about an ordinary daily life (while realising that it may not necessarily be an accurate report), then explore their worries and needs of support.

Growing up with parental substance use disorder: The struggle with complex emotions, regulation of contact, and lack of professional support

“…Children's mixed emotions towards their parents with SUD are well documented (Backett-Milburn et al, 2008;Gullbrå, Smith-Sivertsen, Rortveit, Anderssen, & Hafting, 2016;Werner & Malterud, 2016a;Wilson et al, 2012). These children often have strong emotional tensions concerning their parents and feel both betrayed and loved at the same time (Backett-Milburn et al, 2008).…”

“…Despite this knowledge, there seems to be a lack of understanding of the necessity of including the whole family when parents suffer from SUD (Alexanderson & Näsman, 2017;Gullbrå et al, 2016;Selbekk & Sagvaag, 2016). Parents with SUD often receive welfare support or treatment, but family members do not get the same attention.…”

Making life work for both themselves and their parents alone- how children aged 11–16 view themselves in relation to their chronically ill parents in a primary health care setting

“…In PHC in Norway, research has shown that parents with mental illness, substance abuse or severe somatic illnesses want to be regarded as competent parents in ordinary families. At the same time, these parents are aware that their illnesses affect their parenting, and they wish to receive advice about how to inform the children of their illnesses (Gullbra, Smith-Sivertsen, Rortveit, Anderssen, & Hafting, 2016). Doctors in the Norwegian PHC (GP's) considered themselves to be in a good position to help children and made a great effort to support many of them.…”

Overcoming Clinician and Parent Ambivalence: General Practitioners' Support of Children of Parents With Physical or Mental Illness and/or Substance Abuse

“…Approximately 20–30% of children 0–18 years at some point in time experience a parent with physical or mental illness and/or substance abuse (1–4). While the prevalence of children living with parents with illness and/or substance abuse varies, as the definitions of these parental problems are often not the same, the negative effects that this situation can have on the children are clear.…”

“…Therefore, we conducted the research project Burdened Children as Next of Kin and the General Practitioner. The results of four sub-studies have been published (10, 30–32).…”