Parental mental illness: a review of barriers and issues for working with families and children

Abstract

Many consumers of psychiatric services are parents, making these services the opportunistic point for supporting consumers' children. While evidence suggests that assisting such children improves their mental health, there is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This paper summarizes the constraining barriers and issues for the psychiatric workforce according to: (1) policy and management; (2) interagency collaboration; (3) worker attitude,skill and knowledge; (4) the parent-consumer; and (5) the consumer's family, including children. Potential solutions are presented, with a particular focus on the hierarchical nature of these barriers. Recommendations are made, including organizational audits to identify the most pressing barriers that impede family sensitive practice.

Assertive community treatment for parents with serious mental illnesses: A comparison of “parent-sensitive” assertive community treatment teams versus other teams.

“…Thus, despite similar caseload demands, providers from parent-sensitive teams reported spending significantly more time discussing parent-related issues with consumers than other teams. Although reasons for these differences are unclear, prior research suggests several possibilities, including team leaders who emphasize parenting (Maybery & Reupert, 2009), extensive training in family planning and parenting issues (Maybery & Reupert, 2009), effective peer specialists and/or peer support (David et al, 2011), and/or more financial resources to address parenting challenges in treatment (Biebel et al, 2006).…”

“…At the provider-level, providers report a lack of time, resources, training, and knowledge about how to serve parent consumers (David et al, 2011;Maybery & Reupert, 2006). Further, providers sometimes erroneously assume that consumers are not parents (Maybery & Reupert, 2009) and/or hold negative attitudes towards parents living with serious mental illnesses (Boursnell, 2007), so these providers fail to address parenting in treatment.…”

“…Unfortunately, treatment barriers at the policy-level and provider-level often prevent parenting from being incorporated into mental health treatment (Maybery & Reupert, 2006;Maybery & Reupert, 2009). With respect to policy barriers, less than one-fourth of states require providers to formally assess the parental status of consumers and/or offer special services for parent consumers (Biebel, Nicholson, Geller & Fisher, 2006).…”

Translating Knowledge about Parental Mental Illness to the Field of Practice

“…Korhonen and colleagues (2008) [13] documented that mental health nurses do not regard the children of patients as their responsibility. Some workers may also believe that family members may cause or increase the mental illness by laying extra burdens on the patient [14] and therefore hesitate to include a family perspective in their treatment of patients.…”

Children of mentally ill parents: The need for new routines and better implementation strategies

“…Det er imidlertid mange årsaker til at implementering av nye rutiner og tiltak for barn som er pårørende, er krevende. Forskere har blant annet pekt på at det innenfor psykisk helsevern for voksne er tradisjon for at pasientens barn først kommer i fokus når barna har problemer i slik utstrekning at de selv blir henvist til utredning og/eller behandling (Maybery & Reupert, 2009). For å kunne håndtere ulike utfordringer knyttet til endring av klinisk praksis er det viktig å ha en implementeringsstrategi fra starten.…”