Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings: An International Interview Study With Program Leaders

Bauer, Annette; Best, Stephanie; Malley, Juliette; Christiansen, Hanna; Goodyear, Melinda; Zechmeister‐Koss, Ingrid; Paul, Jean

doi:10.3389/fpsyt.2021.741225

Cited by 9 publications

(14 citation statements)

References 47 publications

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“…The "It takes a Village" practice model, as outlined in this paper, is built around a participatory process from all areas of the project, including in understanding (1) the contextual needs, what is currently working and not working for children of parents with a mental illness (scoping), ( 2) key elements and a conceptual understanding of best practice for families where a parent has a mental illness (evidence review), (3) practice elements of the approach to develop a model (codesign), and (4) understanding the conditions necessary to implement and trial the practice approaches (implementation design). Alongside this, was the development of an evaluation logic and realist approach framework to design the outcome measures of the evaluation of the village approach (48). From this process, we achieved a high agreement from stakeholders to trial the practice approaches, where relevant, in their organizational setting.…”

Section: Discussionmentioning

confidence: 99%

“…A number of research activities were conducted in preparation of the co-design process aimed at understanding the local context and understanding international best practice. The following data were used and is now published: (a) a situational analysis of Tyrolean societal and service provision context in relation to families (46), (b) an analysis mental health care service uptake (47), (c) a mapping of mental health service usage in Tyrol (47), (d) a synthesis of the knowledge from the literature and international experts about what works, for whom, and in which context (48). These secondary data sources were narratively summarized to give an overview of the results of the scoping phase.…”

Section: Scoping Data Sourcesmentioning

confidence: 99%

“…Interviews with international experts in the implementation of family focused practice for these families found a number of key themes to understand more about the nature of the challenges and also enablers to practice in order to produce desired outcomes for children of parents with a mental illness. As described in (48), core components of programs included a focus on building strengths of parents in their parenting skills and helping children to understand parents' mental illness. The interviews also highlighted the interplay between practitioner, parent, and child outcomes; and the need for sufficient resources, such as training and supervision and organization support for family focused practice [see (48) for more detail].…”

Section: International Best Practicementioning

confidence: 99%

“…As described in (48), core components of programs included a focus on building strengths of parents in their parenting skills and helping children to understand parents' mental illness. The interviews also highlighted the interplay between practitioner, parent, and child outcomes; and the need for sufficient resources, such as training and supervision and organization support for family focused practice [see (48) for more detail].…”

Section: International Best Practicementioning

confidence: 99%

“…Agreement on inclusion/exclusion criteria, study design, options for outcome indicators. [see (48) for more detail of the outcomes] 6 (n = 13) Defining feasibility, commitments and next implementation steps.…”

Section: (N = 16)mentioning

confidence: 99%

See 4 more Smart Citations

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

et al. 2022

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Providing support to parents and their children to help address the cycle of intergenerational impacts of mental illness and reduce the negative consequences for children is a key focus of selective prevention approaches in public mental health. However, a key issue for children of parents with a mental illness is the lack of access to early intervention and prevention support when needed. They are not easily identifiable (until presenting with significant mental health issues of their own) and not easily accessing the necessary support that address the complex interplay of parental mental illness within families. There are significant barriers to the early identification of these children, particularly for mental health care. Furthermore, there is a lack of collaborative care that might enhance identification as well as offer services and support for these families. The “It takes a Village” project seeks to improve mental health outcomes for children through the co-development, implementation and evaluation of an approach to collaborative practice concerned with the identification of families where a parent has a mental illness, and establishing a service model to promote child-focused support networks in Austria. Here we describe the development of service delivery approach for the “It takes a Village” project that aims to improve identification and support of these children within enhancements of the existing service systems and informal supports. The paper describes the use of codesign and other implementation strategies, applied to a research setting, with the aim of impacting the sustainability of workforce reform to achieve lasting social impact. Results highlight the steps involved in translating evidence-based components, local practice wisdom and lived experience into the “It takes a Village” practice model for Tyrol, Austria. We highlight through this paper how regional context-specific solutions are essential in the redesign of care models that meet the complex needs of children of parents with a mental illness. Service system and policy formation with local and experienced stakeholders are also vital to ensure the solutions are implementation-ready, particularly when introducing new practice models that rely on organizational change and new ways of practice with vulnerable families. This also creates a solid foundation for the evaluation of the “It take a Village” approach for children of parents with a mental illness in Austria.

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Section: Discussionmentioning

confidence: 99%

Section: Scoping Data Sourcesmentioning

confidence: 99%

Section: International Best Practicementioning

confidence: 99%

Section: International Best Practicementioning

confidence: 99%

Section: (N = 16)mentioning

confidence: 99%

See 3 more Smart Citations

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

et al. 2022

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Parenting and Serious Mental Illness (SMI): A Systematic Review and Metasynthesis

Harries

Smith

Gregg

et al. 2023

Clin Child Fam Psychol Rev

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The consequences of Serious Mental Illness (SMI) on parent and child outcomes can be profound. Supporting parents to manage their caregiving roles alongside parental SMI successfully has been recognised as a public health priority. To meet this priority and develop effective and acceptable interventions, it is imperative that parents’ experiences and support needs are understood. This systematic review aimed to synthesise qualitative research that explored parents’ experiences and perceptions of the impact of SMI on their parenting and their corresponding support needs. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Five databases were searched for terms associated with SMI, parenting, and qualitative research. Twenty-nine studies involving 562 parents who experienced SMI met inclusion criteria, and the methodological quality of included studies was appraised using the Critical Appraisal Skills Programme. After findings were synthesised using thematic synthesis, six themes were identified: (1) The constrained parent, (2) parenting difficulties, (3) the strained child, (4) inescapable threat, (5) combatting threat, and (6) wrap-around support needs. Novel insights into the centrality of SMI-related parenting difficulties and threat perceptions across parent, family, healthcare, and wider social systems on strained parent–child and distanced parent–support relationships were highlighted. Systemic practice change initiatives via compassionate and inclusive system-wide support were recommended.

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The role of health economics within health technology assessment: past, present, and future – an Austrian perspective

Zechmeister-Koss,

Götz,

Fabian

et al. 2024

Int J Technol Assess Health Care

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In many countries, the economics domain forms a routine part of health technology assessments (HTA) next to analyzing the comparative effectiveness and safety of a technology. The method applied most often is economic evaluation, such as cost-effectiveness analysis, which is supposed to support the efficient use of resources. In Austria, economic evaluation has played a negligible role in HTA and reimbursement decisions, even though the country faces the same public healthcare sustainability challenges as others. In this commentary, we argue that while health economics will need to play a more active role in HTA-related decision support to deal with those challenges, current approaches in other countries may have to be broadened to fit the Austrian context. We are outlining four arguments to underpin this perspective: First, economic evaluations (in their current form) are of limited benefit for supporting reimbursement decisions of new high-priced technologies. Second, a broader variety of health economic methods is needed to address the scope of technologies. Third, applying health economic methods requires a reflection on their underlying values. Finally, health economics within HTA needs to go beyond microeconomic analysis of interventions. We are suggesting several alternative methods and approaches, encouraging out-of-the-box thinking and experimenting with methods developed in the academic context but rarely applied in routine HTA. Although some of our topics are unique to Austria, others may equally apply to other healthcare systems. With our thoughts, we aim to stimulate discussions for further developing health economics within HTA in Austria and internationally.

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Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings: An International Interview Study With Program Leaders

Cited by 9 publications

References 47 publications

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

Parenting and Serious Mental Illness (SMI): A Systematic Review and Metasynthesis

The role of health economics within health technology assessment: past, present, and future – an Austrian perspective

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