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Harries CI, Smith DM, Gregg L, Wittkowski A. Parenting and Serious Mental Illness (SMI): A Systematic Review and Metasynthesis. Clin Child Fam Psychol Rev 2023; 26:303-342. [PMID: 36807250 PMCID: PMC10123049 DOI: 10.1007/s10567-023-00427-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 02/21/2023]
Abstract
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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Affiliation(s)
- C I Harries
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK
| | - D M Smith
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - L Gregg
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK
| | - A Wittkowski
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK.
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Barbalat G, Plasse J, Gauthier E, Verdoux H, Quiles C, Dubreucq J, Legros-Lafarge E, Jaafari N, Massoubre C, Guillard-Bouhet N, Haesebaert F, Franck N. The central role of self-esteem in the quality of life of patients with mental disorders. Sci Rep 2022; 12:7852. [PMID: 35550549 PMCID: PMC9098638 DOI: 10.1038/s41598-022-11655-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/25/2022] [Indexed: 11/09/2022] Open
Abstract
In psychiatry, recent years have seen a change of focus from a clinician- to a patient-centered perspective that emphasizes quality of life as a treatment target. As a complex construct, quality of life is composed of multiple dimensions that interact with one-another (e.g. physical and psychological well-being, relationships, autonomy, self-esteem). Here, we used data from the REHABase cohort, which includes N = 2180 patients from 15 psychosocial rehabilitation centers in France, to explore networks of quality-of-life dimensions among six psychiatric disorders: schizophrenia, neurodevelopmental, bipolar, depressive, anxiety, and personality disorders. Stronger connections (edges) involved the Self-Esteem dimension, such as Self-Esteem–Physical Well-Being, Self-Esteem–Autonomy, Self-Esteem–Psychological Well-Being, and Self-Esteem–Resilience. Self-esteem was also consistently retrieved as the most central node (the dimension with the most connections within each network). Between-group tests did not reveal any differences regarding network structure, overall connectivity, edge-weights, and nodes’ centrality. Despite presenting with different symptom profiles, various psychiatric disorders may demonstrate similar inter-relationships among quality-of-life dimensions. In particular, self-esteem may have a crucial inter-connecting role in patients’ quality of life. Our findings could support treatment programmes that specifically target self-esteem to improve patients’ quality of life in a cost-effective way.
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Affiliation(s)
- Guillaume Barbalat
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, UMR 5229, CNRS & Claude Bernard Unversity Lyon 1, Université de Lyon, Lyon, France.
| | - Julien Plasse
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, UMR 5229, CNRS & Claude Bernard Unversity Lyon 1, Université de Lyon, Lyon, France
| | - Emmanuel Gauthier
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, UMR 5229, CNRS & Claude Bernard Unversity Lyon 1, Université de Lyon, Lyon, France
| | | | | | - Julien Dubreucq
- Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | | | | | | | | | - Frédéric Haesebaert
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, UMR 5229, CNRS & Claude Bernard Unversity Lyon 1, Université de Lyon, Lyon, France
| | - Nicolas Franck
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, Pôle Centre rive gauche, UMR 5229, CNRS & Claude Bernard Unversity Lyon 1, Université de Lyon, Lyon, France
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Dubreucq M, Lysaker PH, Dubreucq J. A qualitative exploration of stakeholders' perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent. Front Psychiatry 2022; 13:1066309. [PMID: 36713897 PMCID: PMC9874152 DOI: 10.3389/fpsyt.2022.1066309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND While many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent. METHODS For this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis. RESULTS Participants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers. CONCLUSION In short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.
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Affiliation(s)
- Marine Dubreucq
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France.,GCSMS Rehacoor 42, Saint Etienne, France.,INSERM U1290, Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France
| | - Paul H Lysaker
- Roudebush VA Medical Center, Research Department, Indianapolis, IN, United States.,Department of Clinical Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Julien Dubreucq
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France.,Centre de Neurosciences Cognitive, UMR 5229, CNRS, Université Claude Bernard Lyon 1, Lyon, France.,Réseau Handicap Psychique, Grenoble, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Saint Etienne, Saint Etienne, France
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