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Muir C, Kedzior SGE, Barrett S, McGovern R, Kaner E, Wolfe I, Forman JR. Co-design workshops with families experiencing multiple and interacting adversities including parental mental health, substance use, domestic violence, and poverty: intervention principles and insights from mothers, fathers, and young people. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:67. [PMID: 38926798 PMCID: PMC11202333 DOI: 10.1186/s40900-024-00584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles based on reflections from mothers, fathers, and young people who experience multiple and interacting adversities. These principles will show how family members perceive an intervention may bring about positive change and highlight key insights into design and delivery. METHODS A series of six co-design workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-design activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. RESULTS The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. CONCLUSIONS The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families' needs, environments, and circumstances. There should be particular focus on the child's as well as the mothers' and fathers' needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed.
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Affiliation(s)
- Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Sophie G E Kedzior
- Department of Women and Children's Health, King's College London, London, UK
| | - Simon Barrett
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ingrid Wolfe
- Department of Women and Children's Health, King's College London, London, UK
| | - Julia R Forman
- Department of Women and Children's Health, King's College London, London, UK
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Stracke M, Dobener LM, Christiansen H. Children of parents with a mental illness - stigma questionnaire: validation and revision. Front Psychiatry 2024; 15:1376627. [PMID: 38952634 PMCID: PMC11215172 DOI: 10.3389/fpsyt.2024.1376627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/13/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed. Methods N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2). Results CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales ("Experienced SBA," "Affiliate SBA," "Shame," and "Anticipated SBA") and two additional screening scales ("Healthcare" and "Social support"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78). Discussion The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.
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Affiliation(s)
- Markus Stracke
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
- German Center for Mental Health, Philipps University Marburg, Marburg, Germany
| | - Lisa-Marie Dobener
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
- German Center for Mental Health, Philipps University Marburg, Marburg, Germany
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Lohrasbi F, Maghsoudi J, Alavi M, Akbar M. Care Bermuda, families of the patients with chronic mental disorders in Iran surrounded by psychosocial problems and needs: a qualitative study. Ann Med Surg (Lond) 2024; 86:3357-3366. [PMID: 38846850 PMCID: PMC11152856 DOI: 10.1097/ms9.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/28/2023] [Indexed: 06/09/2024] Open
Abstract
Background A mental disorder is characterized by a clinically significant impairment of cognition, emotion regulation, or behavior. As a result of the shift in care from medical centers and hospitals to home care, we now see a change in the treatment of patients with chronic mental disorders. Consequently, families have become the main support system in the progressive care of these patients, leading to psychological and social problems. The current qualitative study investigated the social and psychological health needs and problems of family caregivers of patients with chronic mental disorders in Iran's cultural and social context. Methods This was a content analysis qualitative study. The study was conducted in three psychiatric hospitals in Farabi, Noor, Modares. Purposive sampling was done and continued until data saturation. Semi-structured, face-to-face, and individual interviews were conducted with 49 participants (15 family caregivers of patients with CMD and 34 members of the mental health care team). Data analysis was done using the conventional content analysis method. Results Eight hundred seventy-five primary codes were obtained, which were classified into 10 subcategories and 3 main categories of 'health challenges of caregiver', 'confused concept of care' and "the need for a coherent support system. Conclusion In Iranian society, after the patient is discharged from the hospital or care center, family members will change their role to the most important caregivers of these patients. The psychological and social health of these caregivers is destroyed because of the problems they have in providing care for their patients and their needs, which are not met.
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Affiliation(s)
- Fateme Lohrasbi
- Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences
| | - Jahangir Maghsoudi
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Akbar
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Yin M, Li Z, Li X. Family influence on stigma internalisation in people with severe mental illness: A grounded theory study. Int J Ment Health Nurs 2024. [PMID: 38767116 DOI: 10.1111/inm.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024]
Abstract
The internalisation of stigma has adverse effects on the recovery and quality of life of people with severe mental illnesses. Studies have shown that life experiences in one's close environment are highly relevant in explaining the onset and development of self-stigma. Families play a critical role in the daily care of people with severe mental illness and have a profound impact on patient recovery. This qualitative study explored the influence of family on stigma internalisation among people with severe mental illness in the context of Chinese culture. A grounded theory design was used. Semi-structured interviews were conducted with 20 patients with severe mental illness and 10 family members, and observations were carried out among five of the families. The data analysis followed three steps (open, axial and selective coding) and involved the use of a constant comparative method and memo writing. The COREQ reporting checklist was used to report the results. Our findings revealed that families can facilitate and impede stigma internalisation in people with severe mental illness via negative or positive daily interactions. A theoretical framework was developed to present the potential effects of the identified family factors on stigma internalisation. Three major family factors influencing patients' internalised stigma were identified, namely, "beliefs of family members" at the individual level, "responses within the family" at the intrafamilial level and "differentiated family environment" at the level of the whole family system, in which "biased beliefs of family members" could bring about "negative responses within the family" and further result in patients' internalised stigma. Our findings suggested that mental health stigma internalised by ill people should be viewed within the broad context of the family. Family-based programs aimed at improving positive interactions and support within the family need to be developed and launched, with particular attention given to interventions for affiliate stigma, coping with stigma and families' negative responses towards people with severe mental illness to prevent the internalisation of stigma by patients.
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Affiliation(s)
- Min Yin
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Zheng Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Xiaoxue Li
- School of Nursing, Peking Union Medical College, Beijing, China
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Shestiperov A, Grinstein-Cohen O, Lindell D, Irani E, Kagan I. Lived experiences: Growing up with a seriously mentally ill parent. J Nurs Scholarsh 2024; 56:357-370. [PMID: 38168092 DOI: 10.1111/jnu.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. DESIGN This study used an interpretive phenomenological design. METHODS Participants were invited to voluntarily participate in the study through a call posted on social media. Semi-structured interviews were conducted with 30 adults (age range, 20-55 years) who grew up with a parent with serious mental illness. The interviews were recorded and transcribed, and inductive thematic analysis was used to identify main and overarching themes. RESULTS The overarching theme of transition from childhood survival to adulthood survival emerged and included four main themes: (1) a traumatic childhood, (2) perceived control, (3) resilience and general self-efficacy, and (4) adult quality of life. A traumatic childhood consisted of experiences of neglect and abuse, while participants used perceived control to achieve personal growth, self-care, and care of others. Resilience and general self-efficacy emerged during the transition to adulthood and helped participants further their social status and strengthen family bonds. Lastly, adult quality of life was described as being disturbed by feelings of loneliness and being burdensome, stemming from an inherent tendency to rely solely on themselves, leading to trust issues and mental health complications. Therefore, these adults found it difficult to reach out and get help or treatment for their concerns, as they initially did not want to appear dysfunctional or in need. CONCLUSION This study has illuminated the lived experiences of a specific, vulnerable population that has not been intentionally explored until now. To delve into these experiences, we employed a distinctive qualitative approach, merging the interpretive phenomenological perspective with an inductive thematic analysis. This allowed for rich insight with a relatively large group of participants and enabled an in-depth exploration within this methodological framework. Consequently, this study constitutes a notable contribution to the extant body of knowledge, exploring the intricacies of personal growth and its impact on participants' quality of life. It uncovers the essence of resilience and general self-efficacy, revealing how these elements intertwine with the negative results observed. However, the study findings emphasize the need for healthcare professionals, including nurses and other caregivers, to be mindful of the long-lasting effects of the adverse experiences of children of patients with serious mental illness. Prioritizing active clinical assessment and implementing tailored interventions to address such children's specific needs and difficulties across different developmental stages is imperative. Such comprehensive and targeted approaches are crucial in providing appropriate support and promoting the well-being of these individuals. CLINICAL RELEVANCE Enhanced clinical attention in holistic psychiatric care is crucial for individuals and their relatives, especially children. Comprehensive assessments of children and adults raised by seriously mentally ill parents can enable tailored and preventive interventions, positively impacting overall quality of life.
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Affiliation(s)
- Alexander Shestiperov
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
- Merhavim-Mental Health Center, Beer-Yaakov, Israel
| | - Orli Grinstein-Cohen
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
| | - Deborah Lindell
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Ilya Kagan
- Ashkelon Academic College, Ashkelon, Israel
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Allchin B, Isobel S. Re-imagining the vulnerability and risk framing of parents with mental illness and their children. Front Public Health 2024; 12:1373603. [PMID: 38751592 PMCID: PMC11094306 DOI: 10.3389/fpubh.2024.1373603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
To elicit compassion and communicate urgency to policy makers and governments, researchers and program developers have promoted a narrative of vulnerability and risk to frame the experience of families when parents have been diagnosed with mental illness. Developed within a western medicalised socio-cultural context, this frame has provided a focus on the need for prevention and early intervention in service responses while also unintentionally 'othering' these families and individualizing the 'problem'. This frame has had some unintended consequences of seeing these families through a deficit-saturated lens that misses strengths and separates family members' outcomes from each other. This paper raises questions about the continued fit of this frame and suggests a need to reimagine a new one.
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Affiliation(s)
- Becca Allchin
- Mental Health Program, Eastern Health, Melbourne, VIC, Australia
- School of Rural Health, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC, Australia
| | - Sophie Isobel
- University of Sydney, Faculty of Medicine and Health, Camperdown NSW, Australia
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Hine R, Gladstone B, Reupert A, O’Dea L, Cuff R, Yates S, Silvén Hagström A, McGaw V, Foster K. StigmaBeat: Collaborating With Rural Young People to Co-Design Films Aimed at Reducing Mental Health Stigma. QUALITATIVE HEALTH RESEARCH 2024; 34:491-506. [PMID: 38029299 PMCID: PMC11080393 DOI: 10.1177/10497323231211454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Little is known about the experience and impact of intersectional stigma experienced by rural young people (15-25 years) who have a parent with mental health challenges. The StigmaBeat project employed a co-design approach to create short films to identify and challenge mental health stigma from the perspective of young people who have experienced this phenomenon. The aim of this paper is to describe the co-design methodological approach used in StigmaBeat, as an example of a novel participatory project. We describe one way that co-design can be employed by researchers in collaboration with marginalised young people to produce films aimed at reducing mental health stigma in the community. Through describing the processes undertaken in this project, the opportunities, challenges, and tensions of combining community development methods with research methods will be explored. Co-design with young people is a dynamic and engaging method of collaborative research practice capable of harnessing lived experience expertise to intervene in social issues and redesign or redevelop health services and policies. The participatory approach involved trusting and implementing the suggestions of young people in designing and developing the films and involved creating the physical and social environment to enable this, including embedding creativity, a critical element to the project's methodological success. Intensive time and resource investment are needed to engage a population that is often marginalised in relation to stigma discourse.
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Affiliation(s)
- Rochelle Hine
- Monash Rural Health, Monash University, Warragul, VIC, Australia
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Andrea Reupert
- School of Educational Psychology and Counselling, Monash University, Warragul, VIC, Australia
| | - Lotti O’Dea
- Independent Consultant, Naarm/Collingwood, VIC, Australia
| | - Rose Cuff
- Satellite Foundation, Naarm/Collingwood, VIC, Australia
| | - Scott Yates
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | | | | | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, VIC, Australia
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Weimand B, Johansson A, Sjöström N, Waern M, Ewertzon M. A Vicious Circle of Hope and Despair: Stigma Experienced by Relatives of Persons with Severe Mental Illness. Issues Ment Health Nurs 2024; 45:409-416. [PMID: 38364206 DOI: 10.1080/01612840.2024.2308551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Not only people suffering from severe mental illness (SMI) but also their family members experience stigma. Relatives are met with negative attitudes from healthcare professionals, which adds to the problem. This Swedish study employed a qualitative inductive explorative design in the analysis of written free-text responses from 65 persons who completed a questionnaire for relatives of persons with SMI. The overarching theme, "A vicious circle of hope and despair", was elaborated by four categories which formed a vicious circle: "Wanting openness, understanding and acknowledgement"; "Facing a lack of understanding from others"; "Seeking understanding from mental healthcare professionals but experiencing the opposite"; and "Keeping family experiences private." If this vicious circle of family stigma is to be broken, measures are needed for both relatives and health care professionals.
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Affiliation(s)
- Bente Weimand
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway
- Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Anita Johansson
- Research and Development Centre, Skaraborg hospital, Skövde, Sweden
| | - Nils Sjöström
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Mats Ewertzon
- Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden
- Swedish Family Care Competence Centre, Kalmar, Sweden
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Nevard I, Brooks H, Gellatly J, Bee P. Modelling social networks for children of parents with severe and enduring mental illness: an evidence based modification to the network episode model. BMC Psychol 2024; 12:162. [PMID: 38500222 PMCID: PMC10949563 DOI: 10.1186/s40359-024-01647-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
The Network Episode Model (NEM) is a well utilised model conceptualising how social networks, valuable resources which can positively impact wellbeing and functional outcomes, are responsive to the needs of people with physical and mental health difficulties. Children of parents with severe and enduring mental illness (COPMI) are impacted by these illnesses through the intersecting roles of kin relation, informal carer, and dependent. However, it is not clear that social networks effectively respond in kind to the child's episodic need.We draw upon qualitative data to propose a new multi-factorial conceptual model (COPMI-NEM), triangulating parental mental illness, child's developmental stage and social ties to theorise how social networks do respond and adapt to children's needs.The model illustrates how networks are typically flexible and responsive to visible age-related needs, but less reactive to more obscured needs. Successful network navigation and negotiation of support relies on multiple factors including the child's ability to successfully activate social ties and the availability of formal networks. We propose a new theoretically and empirically informed NEM model also available for testing, refinement and validation in other young carer populations exposed to episodic parental health needs. Findings from this study could be used to generate network informed interventions for this and comparable populations.
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Affiliation(s)
- Imogen Nevard
- Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, 6.333 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Helen Brooks
- Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, 6.333 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Judith Gellatly
- Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, 6.333 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Penny Bee
- Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, 6.333 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
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Du N, Wang Y, Huang YT. Parental Depression and Self-Stigma Among Chinese Young People Living With Depression: A Qualitative Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241232351. [PMID: 38462846 DOI: 10.1177/10497323241232351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Self-stigma is detrimental to psychosocial well-being and the recovery journey among people living with depression. However, there has been limited research exploring the experience of stigma internalization when depression runs in families. This study aims to address this gap by (1) characterizing the manifestations of self-stigma among individuals living with depression whose parent(s) also have depression and (2) exploring the potential mechanisms underlying the impact of parental depression on self-stigma. Essential principles of the constructivist grounded theory approach were adopted to collect data through in-depth interviews with 27 participants aged 15-30, living in Mainland China. Many participants perceived depression running in their family as an endless disaster and an incurable illness. These beliefs further led to stigmatizing emotions (such as suppression, anger, and guilt) and behaviors (such as concealment and social withdrawal). Participants also highlighted ambivalent intergenerational relationships, tense family atmospheres, lower parental emotional involvement and support, and a lack of family flexibility due to parental depression. Furthermore, parental depression impacted participants' self-stigma by interfering with family relationships, family functioning, and parenting styles. It also shaped their perceptions of family, illness attribution, and public stigma. Additionally, parental depression had an impact on participants' social functioning, self-esteem, and personality, making them more susceptible to self-stigma. This study emphasizes the crucial role that the family plays in the internalization of stigma among individuals living with depression. It suggests that family dynamics, rather than family structure or economic backgrounds alone, shape this process.
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Affiliation(s)
- Nan Du
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yihang Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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Oakes L, Wolfenden L, Drake RJ, Calam R, Gregg L. Health and social care professionals' views and experiences of supporting parents with serious mental illness. Front Psychiatry 2023; 14:1284712. [PMID: 38161725 PMCID: PMC10756684 DOI: 10.3389/fpsyt.2023.1284712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction A significant number of individuals with a serious mental illness (SMI) such as schizophrenia or bipolar disorder are also parents of dependent children. Despite the risk of adverse psychological, behavioral, and social outcomes their needs often go unmet. To better understand the needs of parents with SMI and their children it is necessary to gain insight into the perspectives and experiences of the professionals in adult mental health and children's services who work with them, and who, ultimately, are best placed to meet those needs. Aims To explore the views and experiences of health and social care professionals working with parents with SMI to understand the needs of, and their role supporting, parents with SMI and their children. Methods Semi-structured interviews were conducted with seventeen professionals from six NHS and Local Authority settings in England, UK. Participants were included if they were employed in adult mental health or local authority children's services and had experience of working with parents with SMI. Sampling was purposive, including a wide range of professions in these settings. Interview data were analyzed using template analysis taking a critical realist perspective. Results Three top-level themes were generated: (1) Impact of parental SMI on the child, (2) Accessing support from services, (3) Role of professionals working with parents with SMI. Themes highlight diverse, wide-ranging effects of SMI on the child and a reluctance from parents to seek help due to stigma and fear. Available services are reported to be inaccessible and unacceptable to parents with SMI and practitioners experience conflict when balancing the needs of the parent and child. A whole-family approach facilitated by improved communication between services is advocated. Conclusion Participants believed that parents with SMI experience complex parenting challenges over and above other parents, describing a largely detrimental impact on the child. Support services were deemed inadequate, and participants stressed the need to develop specialist services tailored toward the needs of parents with SMI and their children. Although participants endorsed joined up working across health and social care settings to facilitate a whole family approach, they required greater service knowledge and training in parental SMI.
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Affiliation(s)
- Lucy Oakes
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Lauren Wolfenden
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Richard J. Drake
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Rachel Calam
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Lynsey Gregg
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
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Cudjoe E, Tam CHL, Chiu MYL. Constructing the school paradox in the lives of children living with parental mental illness. Clin Child Psychol Psychiatry 2023; 28:1480-1494. [PMID: 36689762 PMCID: PMC10540478 DOI: 10.1177/13591045231154112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Children living with parental mental illness are referred to as an invisible population because mental health services rarely target them, as the focus is often on the parent who is ill mentally. The same situation occurs even in school where they are unnoticed. This study conducted in Ghana creates awareness about what these children think about their interactions at school in the context of parental mental illness. Data was collected through interviews and diaries with 13 children living with parental mental illness and analysed to attain the essential features through Husserl's transcendental phenomenology. The children find the school as a happy space where they do not have to be worried about the parent's mental illness. Ultimately, though, even at school, most of the children become concerned about the mental wellbeing of the parent due to their loyalty towards them. This results in the school paradox where the children are torn between having their own time at school and being worried about the parent's condition back home, wanting to be there for the parent. The school paradox is an unhealthy cycle that could be addressed with coordinated efforts from mental health professionals, social workers, psychologists and teachers.
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Affiliation(s)
- Ebenezer Cudjoe
- Centre for Childhood Studies, Department of Psychosocial and Psychoanalytic Studies, University of Essex, UK
| | - Cherry HL Tam
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Marcus YL Chiu
- School of Health & Wellbeing, University of Bolton, UK; Centre for Mental Health and Society, Bangor University, Wales, UK
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Harries CI, Smith DM, Gregg L, Allott R, Wittkowski A. Parents who experience psychosis: A qualitative exploration. Psychol Psychother 2023; 96:590-607. [PMID: 36912129 DOI: 10.1111/papt.12458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES Psychosis can present parents with complex parenting challenges and significant adverse outcomes for parents and their children have been reported. However, remarkably little is known about how parenting is experienced by these parents. Therefore, this qualitative study aimed to understand the lived experiences of parents with psychosis, including how parenting support was experienced. DESIGN AND METHODS Using interpretative phenomenological analysis (IPA), eight biological parents (five mothers and three fathers) with psychosis were recruited and interviewed from early intervention in psychosis services in the Northwest of England. RESULTS Three superordinate themes and seven subordinate themes were identified. Theme 1 'Living with the Struggle: Painfully Disconnected' captured a persistent parenting struggle that distanced parents from their children and support due to all-consuming experiences of psychosis, fear and risk-focused service support. Theme 2 'Desired and Vulnerable Position: Comfortably Connected' captured parental experiences of symptom relief through connection with their children, alongside parental need to be integrated with the systems around them. Theme 3 'Exposed: Parenting Under a Spotlight' represented parental experiences of inescapable observation and judgement from the systems around them. CONCLUSIONS Novel insights into the role of misaligned parent and service priorities in parental perceptions of powerlessness, shame and disconnection from their children, valued parenting identities, and system supports are presented. Systemic interventions that target stigma, provide system-wide psychoeducation and promote person-centred, compassionate and meaningful connections between parents and the systems they live within are needed to promote better parenting outcomes.
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Affiliation(s)
- Claire I Harries
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Debbie M Smith
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Rory Allott
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
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14
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Levkovich I, Labes M. Growing up with a sibling with depression: A qualitative study in Israel. PLoS One 2023; 18:e0290999. [PMID: 37651387 PMCID: PMC10470950 DOI: 10.1371/journal.pone.0290999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
Depression has major consequences for the entire family, among them emotional distress, disrupted daily routine and social damage caused by negative stigmas. The aim of this study was to explore the retrospective experiences of young adults who lived with a sibling with depression while they were adolescents. The present study adopted a qualitative-phenomenological approach. The research participants were recruited via purposive sampling on social networks across Israel from May to September 2022. Semi-structured interviews were conducted with 21 participants aged 18-29 who lived with a sibling with depression during their adolescence. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis. Three themes emerged from the qualitative analyses: 1) "I felt like I was living in a minefield": Adolescence while living with a sibling with depression; 2) "One step forward and two steps back": Siblings' coping strategies; 3) "My parents were not there for me when I needed them": Participants' experiences with their parents during their adolescence. The research findings indicate that adolescents who grew up with a sibling affected by depression had to cope with an acute family crisis, whose serious ramifications required emotional and social support. Mental health professionals and counselors working within educational institutions and the broader community should provide support and intervention for adolescents who have siblings struggling with depression. This intervention may take the form of individual or group therapy that aims to foster a sense of belonging and help affected individuals. Creating a supportive environment that meets the needs of the affected siblings is also crucial in addressing this issue effectively.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv’on, Israel
| | - Michal Labes
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv’on, Israel
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Stavnes K, Ruud T, Benth JŠ, Hanssen-Bauer K, Solantaus T, Hilsen M, Skogøy BE, Kallander EK, Kufås E, Weimand BM. Norwegian health personnel's contacts and referrals for children of ill parents: an exploratory cross-sectional multi-centre study. BMC Health Serv Res 2023; 23:649. [PMID: 37330496 DOI: 10.1186/s12913-023-09607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/26/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND In 2010, changes were made to the Norwegian Health Personnel Act. This led to all health personnel being obliged to support the patients' children and families. The aims of this study were to investigate whether health personnel contacted or referred the patients' children to family/friends or public services. We also investigated if there were factors in the family or the services that increased or decreased the degree of contacts and referrals. In addition the patients were asked whether the law had been a help or even a burden. This study was part of a larger multi-site study of children of ill parents conducted in five health trusts in Norway. METHOD We used cross-sectional data from 518 patients and 278 health personnel. The informants completed a questionnaire addressing the law. Data were analyzed by factor analysis and logistic regression. RESULTS The health personnel contacted/referred children to different services, but not to the degree desired by their parents. Only a few contacted family/friends, or the school and/or the public health nurse, those representing the helpers who live closest to the child, and thus well situated to participate in help and preventive efforts. The service most often referred to was the child welfare service. CONCLUSION The results indicate a change in contacts/referrals for children from their parents' health personnel but also reveal remaining needs for support/help for these children. Health personnel should strive to write more referrals and take more contacts than the current study suggests, to secure adequate support for children of ill parents in Norway, as intended in The Health Personnel Act.
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Affiliation(s)
- Kristin Stavnes
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, 8092, Bodø, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway.
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
| | - Tytti Solantaus
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marit Hilsen
- Regional Centre for Child and Adolescent Mental Health, RBUP Øst Og Sør, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Bjørg Eva Skogøy
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, 8092, Bodø, Norway
- Nordland Research Institute, Postboks 1490, 8049, Bodø, Norway
| | | | - Elin Kufås
- Vestre Viken Hospital Trust, Drammen, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Reupert A, Freeman N, Hine R, Lea S, Nandakumar N, O'Grady C, Patlamazoglou L, Pettenuzzo L, Foster K. Evaluating programs for young people with a family member with mental health challenges: protocol for a mixed methods, longitudinal, collaborative evaluation. BMC Psychol 2023; 11:67. [PMID: 36899413 PMCID: PMC10000348 DOI: 10.1186/s40359-023-01104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Young people with a sibling or parent who experiences mental health challenges have their own support needs. Most programs designed for this population lack a strong evidence base, and the involvement of young people in the development and evaluation of programs designed to support them is unclear or lacking. METHODS This paper describes a protocol for a mixed methods, longitudinal, collaborative evaluation of a suite of programs delivered by The Satellite Foundation, a not-for-profit organisation for young people (5-25 years) who have a family member with mental health challenges. Young people's lived experience and knowledge will guide the research approach. Institutional ethics approval has been obtained. Over a three year period, approximately 150 young people will be surveyed online on various wellbeing outcome measures, prior to, six and twelve months following program participation with data analysed using multi-level modelling. Groups of young people will be interviewed after participating in different Satellite programs each year. An additional group of young people will be interviewed individually over time. Transcripts will be analysed using thematic analysis. Young people's creative artworks on their experiences will be included as part of the evaluation data. DISCUSSION This novel, collaborative evaluation will provide vital evidence on young people's experiences and outcomes during their time with Satellite. Findings will be used to inform future program development and policy. The approach used here may guide other researchers engaging in collaborative evaluations with community organisations.
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Affiliation(s)
- Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, 3800, Clayton, Australia.
| | - Nerelie Freeman
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, 3800, Clayton, Australia
| | - Rochelle Hine
- Monash Rural Health, Monash University, 3820, Warragul, Australia
| | - Sophie Lea
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, 3800, Clayton, Australia
| | - Nivedita Nandakumar
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, 3800, Clayton, Australia
| | | | - Lefteris Patlamazoglou
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, 3800, Clayton, Australia
| | - Laura Pettenuzzo
- The Satellite Foundation, 22 Easey St, 3066, Collingwood, Australia
| | - Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
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Stephens A, Allardyce J, Weavers B, Lennon J, Jones RB, Powell V, Eyre O, Potter R, Price VE, Osborn D, Thapar A, Collishaw S, Thapar A, Heron J, Rice F. Developing and validating a prediction model of adolescent major depressive disorder in the offspring of depressed parents. J Child Psychol Psychiatry 2023; 64:367-375. [PMID: 36096685 PMCID: PMC10087673 DOI: 10.1111/jcpp.13704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Parental depression is common and is a major risk factor for depression in adolescents. Early identification of adolescents at elevated risk of developing major depressive disorder (MDD) in this group could improve early access to preventive interventions. METHODS Using longitudinal data from 337 adolescents at high familial risk of depression, we developed a risk prediction model for adolescent MDD. The model was externally validated in an independent cohort of 1,384 adolescents at high familial risk. We assessed predictors at baseline and MDD at follow-up (a median of 2-3 years later). We compared the risk prediction model to a simple comparison model based on screening for depressive symptoms. Decision curve analysis was used to identify which model-predicted risk score thresholds were associated with the greatest clinical benefit. RESULTS The MDD risk prediction model discriminated between those adolescents who did and did not develop MDD in the development (C-statistic = .783, IQR (interquartile range) = .779, .778) and the validation samples (C-statistic = .722, IQR = -.694, .741). Calibration in the validation sample was good to excellent (calibration intercept = .011, C-slope = .851). The MDD risk prediction model was superior to the simple comparison model where discrimination was no better than chance (C-statistic = .544, IQR = .536, .572). Decision curve analysis found that the highest clinical utility was at the lowest risk score thresholds (0.01-0.05). CONCLUSIONS The developed risk prediction model successfully discriminated adolescents who developed MDD from those who did not. In practice, this model could be further developed with user involvement into a tool to target individuals for low-intensity, selective preventive intervention.
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Affiliation(s)
- Alice Stephens
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Judith Allardyce
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Bryony Weavers
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Jessica Lennon
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Rhys Bevan Jones
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Victoria Powell
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Olga Eyre
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Robert Potter
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Valentina Escott Price
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - David Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Anita Thapar
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Ajay Thapar
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, UK
| | - Frances Rice
- Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Chen W, Wang X, Zhou T, Wen L, Yang X, Chen B, Zhang T, Zhang C, Hua J, Tang Q, Hong X, Liu W, Du C, Xie C, Ma H, Yu X, Guan L. Childhood experiences and needs of offspring living with paternal and maternal severe mental illness: A retrospective study in China. Asian J Psychiatr 2023; 81:103449. [PMID: 36641966 DOI: 10.1016/j.ajp.2023.103449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Parental mental illness is considered one of the strongest risk factors for the development of children. This study aimed to describe the adverse childhood experiences and needs of offspring living with parental severe mental illness (SMI) in China and to compare the differences in needs between offspring living with maternal SMI and those living with paternal SMI. METHOD Overall, 381 participants, including 76 living with paternal SMI, 104 living with maternal SMI, and 201 living without parental mental illness, were enrolled. Data were collected using questionnaires from five sites in China. Differences among the three groups were compared using analysis of variance and chi-square test. Factors were extracted using exploratory factor analysis, and differences in factor scores between the paternal and maternal SMI groups were compared using the rank sum test. RESULTS The percentages of poverty, family care, and housework were significantly higher in the paternal SMI group and maternal SMI group, compared with the control group, and those of school dropout and relationship with friends were significantly higher in the maternal SMI group (p < 0.0167). The need for stigma reduction in the maternal SMI group was significantly higher than that in the paternal SMI group (p = 0.015). CONCLUSION Our findings highlight the importance of considering the impact of maternal and paternal SMI on child development. There is an urgent need to develop a national program to assist families with mentally ill parents to provide services for children living with parental SMI.
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Affiliation(s)
- Weiran Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xun Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Liping Wen
- The Fifth People's Hospital of Zigong, Zigong, China
| | - Xianmei Yang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | | | - Tao Zhang
- Taiyuan Psychiatric Hospital, Shanxi Mental Health Center, Taiyuan, China
| | | | - Juan Hua
- Yantan Mental Health Center, Zigong, China
| | - Qi Tang
- Jiangyou Psychiatric Hospital, Jiangyou, China
| | - Xu Hong
- Xiamen Xianyue Hospital, Xiamen, China
| | - Wenhui Liu
- Taiyuan Psychiatric Hospital, Shanxi Mental Health Center, Taiyuan, China
| | - Chunyu Du
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chenmei Xie
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lili Guan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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19
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Budden T, Hafizuddin A, Dimmock JA, Law KH, Furzer BJ, Jackson B. Support needs and experiences of young people living in families with mental illness. J Adolesc 2023. [PMID: 36808749 DOI: 10.1002/jad.12153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Children and adolescents living in families affected by mental illness are at elevated risk of developing mental health problems. A range of interventions have been designed to help these young people; however, the effectiveness of these programs is, in some cases, mixed. Our aim was to understand in detail the support needs and experiences of a group of Australian children and adolescents living in families with mental illness. METHODS Our study is a qualitative in nature. In 2020-2021, we interviewed 25 Australian young people (Mage = 13.60, SD = 2.26, 20 females and 5 males) living with family members affected by mental illness to understand their (the young people's) experiences, and to identify the types of support that these young people considered important or effective. We conducted reflexive thematic analyses of interview data, underpinned by interpretivist assumptions. RESULTS We identified seven themes within two higher-order categories reflecting our aims to understand (1) lived experiences within families affected by mental illness (i.e., increased responsibilities, missing out, and stigmatization), and (2) support experiences, needs, and preferences (i.e., respite, shared experiences with like-minded others, education, and flexibility). CONCLUSIONS Our findings hold substantial practical value by informing services, interventions, and conversations that better support young people living in families affected by mental illness.
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Affiliation(s)
- Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Ahmad Hafizuddin
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - James A Dimmock
- Department of Psychology, College of Healthcare Services, James Cook University, Townsville, Australia
| | - Kwok Hong Law
- Department of Psychology, College of Healthcare Services, James Cook University, Townsville, Australia
| | - Bonnie J Furzer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia.,Telethon Kids Institute, Perth, Australia
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20
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Schonewille NN, van den Eijnden MJM, Jonkman NH, van Kempen AAMW, van Pampus MG, Goedhart FG, van den Heuvel OA, Broekman BFP. Experiences with Family Planning amongst Persons with Mental Health Problems: A Nationwide Patient Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3070. [PMID: 36833766 PMCID: PMC9966993 DOI: 10.3390/ijerph20043070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
High rates of unintended pregnancies in patients with mental health problems reflect the unmet need for tailored family planning. This study aims to explore aspects of family planning that are especially challenging for patients experiencing health problems by obtaining the perspective of (former) patients and those with close relationships with the (former) patients. In August 2021, members of a Dutch national mental health panel, consisting of (former) patients and close ones, were invited to respond to a 34-question online survey that included questions on four domains: reproductive history, decision making, parenting, and sexuality. This study has revealed the severe and adverse impact of mental health problems across all of the four domains of reproductive health and family planning, which the questions specifically targeted. Based on these results, we recommend discussing family planning with all patients experiencing or at risk for mental health problems and their partners. These discussions should address a desire to have children, (involuntary) childlessness, uncertainties about parenting and sexuality, while remaining considerate of experienced taboos.
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Affiliation(s)
- Noralie N. Schonewille
- Department of Psychiatry and Medical Psychology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | | | - Nini H. Jonkman
- Department of Research and Epidemiology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
| | - Anne A. M. W. van Kempen
- Department of Neonatology and Pediatrics, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
| | - Maria G. van Pampus
- Department of Gynecology and Obstetrics, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
| | - Francisca G. Goedhart
- Team Knowledge, Innovation and Research, MIND, Stationsplein 125, 3818 LE Amersfoort, The Netherlands
| | - Odile A. van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Department of Anatomy & Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention Program, 1081 HV Amsterdam, The Netherlands
| | - Birit F. P. Broekman
- Department of Psychiatry and Medical Psychology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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21
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Bell MF, Glauert R, Roos LL, Wall-Wieler E. Examining the relationship between maternal mental health-related hospital admissions and childhood developmental vulnerability at school entry in Canada and Australia. BJPsych Open 2023; 9:e29. [PMID: 36715086 PMCID: PMC9970171 DOI: 10.1192/bjo.2022.642] [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] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND It is well established that maternal mental illness is associated with an increased risk of poor development for children. However, inconsistencies in findings regarding the nature of the difficulties children experience may be explained by methodological or geographical differences. AIMS We used a common methodological approach to compare developmental vulnerability for children whose mothers did and did not have a psychiatric hospital admission between conception and school entry in Manitoba, Canada, and Western Australia, Australia. We aimed to determine if there are common patterns to the type and timing of developmental difficulties across the two settings. METHOD Participants included children who were assessed with the Early Development Instrument in Manitoba, Canada (n = 69 785), and Western Australia, Australia (n = 19 529). We examined any maternal psychiatric hospital admission (obtained from administrative data) between conception and child's school entry, as well as at specific time points (pregnancy and each year until school entry). RESULTS Log-binomial regressions modelled the risk of children of mothers with psychiatric hospital admissions being developmentally vulnerable. In both Manitoba and Western Australia, an increased risk of developmental vulnerability on all domains was found. Children had an increased risk of developmental vulnerability regardless of their age at the time their mother was admitted to hospital. CONCLUSIONS This cross-national comparison provides further evidence of an increased risk of developmental vulnerability for children whose mothers experience severe mental health difficulties. Provision of preventative services during early childhood to children whose mothers experience mental ill health may help to mitigate developmental difficulties at school entry.
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Affiliation(s)
- Megan F Bell
- School of Population and Global Health, University of Western Australia, Western Australia; School of Psychological Science, University of Western Australia, Western Australia; and Telethon Kids Institute, University of Western Australia, Western Australia
| | - Rebecca Glauert
- School of Population and Global Health, University of Western Australia, Western Australia; and Telethon Kids Institute, University of Western Australia, Western Australia
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Canada
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22
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Dean L, Buechner H, Moffett B, Maritze M, Dalton LJ, Hanna JR, Rapa E, Stein A, Tollman S, Kahn K. Obstacles and facilitators to communicating with children about their parents' mental illness: a qualitative study in a sub-district of Mpumalanga, South Africa. BMC Psychiatry 2023; 23:78. [PMID: 36707793 PMCID: PMC9883085 DOI: 10.1186/s12888-023-04569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/25/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Given that common mental disorders are one of the leading causes of disease burden worldwide, it is likely that many children are growing up with a parent or other adult within their family who has anxiety or depression. Parents with a mental illness may not consider it appropriate to discuss their illness with their child, and consequently an absence of communication may lead to stigmatization, shame, misunderstanding their parents' symptoms, and even blaming themselves. There is a scarcity of research exploring the experiences and perceptions of healthcare professionals about communication with children of parents with mental illness in low-resource and African contexts. METHODS A qualitative study using semi-structured interviews with healthcare professionals (n = 15) was conducted within the Bushbuckridge sub-district of Mpumalanga Province, South Africa. Data were analysed using Thematic Analysis. RESULTS Four themes were identified relating to the obstacles around communication with children. These included: (1) finding an appropriate language to describe mental illness, as well as the prevailing cultural explanations of mental illness (2) the stigma associated with mental illness (3) the perceived role of children in society and (4) mental health services and staff skills. Two themes that addressed facilitators of communication about parental mental illness were identified: (1) the potential to increase mental health awareness amongst the broader community through social media, the internet, and general psychoeducation (2) healthcare professionals' concerns for the wellbeing and future mental health of patients' children, as well as their hopes for increased mental health awareness amongst future generations. CONCLUSIONS This study provides insight into healthcare professionals' attitudes and perceptions about talking to patients and families within their community about mental illness. The results provide recommendations about possible ways to promote sharing information about a parent's mental illness with children at an individual and community level. Future research should focus on the collaborative creation of culturally sensitive psychoeducational resources and evidence-based guidelines. This must be supported by systemic and organisational change in order for professionals to successfully facilitate conversations with patients who are parents, and their children.
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Affiliation(s)
- Lucy Dean
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Hadassah Buechner
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Bianca Moffett
- grid.11951.3d0000 0004 1937 1135MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Meriam Maritze
- grid.11951.3d0000 0004 1937 1135MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Louise J. Dalton
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Jeffrey R. Hanna
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.4777.30000 0004 0374 7521School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Elizabeth Rapa
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Alan Stein
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.11951.3d0000 0004 1937 1135MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- grid.11951.3d0000 0004 1937 1135MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- grid.11951.3d0000 0004 1937 1135MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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23
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Reupert A, Tchernegovski P, Chen L, Huddle M. Experiences of family members when a parent is hospitalized for their mental illness: a qualitative systematic review. BMC Psychiatry 2023; 23:56. [PMID: 36670415 PMCID: PMC9862559 DOI: 10.1186/s12888-023-04530-4] [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: 03/09/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A considerable proportion of people attending mental health services are parents with dependent children. Parental mental illness can be challenging for all family members including the parent's children and partner. The hospitalization of the parent and subsequent separation from dependent children may be a particularly challenging time for all family members. The aim of this paper was to review qualitative studies of family members' experiences when parents, who have dependent children, were hospitalized for their mental illness. The experiences of parents themselves, their children aged 0-18 (including retrospective accounts of adults describing their childhoods), and other family members are included. METHODS This systematic review followed Cochrane Collaboration and PRISMA guidelines. A search was performed with keywords relating to parents, mental illness, psychiatric treatment, inpatient units, family members and experiences. Databases included CINAHL Plus, PsycINFO, ProQuest, MEDLINE, PubMed and Scopus. Quality assessment was undertaken using an expanded version of the Critical Appraisal Skills Programme. Thematic synthesis was conducted on the included papers. RESULTS Eight papers were identified. The quality assessment was rated as high in some papers, in terms of the clarity of research aims, justification of the methodology employed, recruitment strategy and consideration of ethics. In others, the study design, inclusion criteria and reporting of participant demographics were unclear. Family experiences of pressure and additional responsibilities associated with the parent receiving inpatient treatment were identified along with the family's need for psychoeducational information, and guidance when visiting the parent in hospital. Children expressed various emotions and the need to connect with others. The final theme related to adverse impacts on the parent-child bond when the parent was hospitalized. CONCLUSION The limited research in this area indicates that the needs of families are not being met when a parent is hospitalized for their mental illness. There is a considerable need for adequate models of care, family-focused training for staff, and psychoeducational resources for families. Additional research in this area is essential to understand the experiences of different family members during this vulnerable time.
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Affiliation(s)
- Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC, 3800, Australia.
| | - Phillip Tchernegovski
- grid.1002.30000 0004 1936 7857School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC 3800 Australia
| | - Lingling Chen
- grid.1002.30000 0004 1936 7857School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC 3800 Australia
| | - Maddison Huddle
- grid.1002.30000 0004 1936 7857School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC 3800 Australia
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24
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Leclair MC, Charette Y, Seto M, Nicholls TL, Roy L, Dufour M, Crocker AG. Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway. BMC Health Serv Res 2022; 22:1495. [PMID: 36476220 PMCID: PMC9730649 DOI: 10.1186/s12913-022-08848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the present study is to identify individual and contextual barriers and facilitators of access to mental health services during the period preceding an offense leading to a verdict of NCRMD. METHODS The sample includes 753 people found NCRMD in Québec, Canada. All episodes of mental health hospitalizations and service use before the index offense were identified using provincial administrative health data, for an average period of 4.5 years. Access was conceptualized as a function of the possibility of seeking, reaching and receiving appropriate health care services, based on Lévesque and colleagues patient-centred model of access to care. Generalized linear models were computed to identify the individual and contextual predictors of: (1) seeking mental healthcare (at least one contact with any type of services for mental health reasons); (2) reaching psychiatric care (at least one contact with a psychiatrist); (3) receiving psychiatric care, operationalized as (3a) continuity and (3b) intensity. Factors associated with volume of emergency mental health services were examined as exploratory analysis. RESULTS Geographical considerations were highly important in determining who reached, and who received specialized mental health care - above and beyond individual factors related to need. Those who lived outside of major urban centres were 2.6 times as likely to reach psychiatric services as those who lived in major urban centres, and made greater use of emergency mental health services by 2.1 times. Living with family decreased the odds of seeking mental healthcare by half and the intensity of psychiatric care received, even when adjusting for level of need. CONCLUSIONS Findings support efforts to engage with the family of service users and highlights the importance of providing resources to make family-centred services sustainable for health practitioners. Health policies should also focus on the implementation of outreach programs, such as Forensic Assertive Community Treatment teams as part of prevention initiatives.
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Affiliation(s)
- Marichelle C. Leclair
- grid.14848.310000 0001 2292 3357Department of Psychology & School of Public Health, Université de Montréal, Montréal, Canada ,Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada
| | - Yanick Charette
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.23856.3a0000 0004 1936 8390School of Social Work and Criminology, Université Laval, Québec City, Canada
| | - Michael Seto
- Forensic Research Unit, Royal Ottawa Health Care Group, Ottawa, Canada
| | - Tonia L. Nicholls
- grid.498716.50000 0000 8794 2105Department of Psychiatry, University of British Columbia & British Columbia (BC) Mental Health & Substance Use Services, Vancouver, Canada
| | - Laurence Roy
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.14709.3b0000 0004 1936 8649School of Occupational Therapy, McGill University, Montréal, Canada
| | - Mathieu Dufour
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada
| | - Anne G. Crocker
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology & School of Criminology, Université de Montréal, Montréal, Canada
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25
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Stavnes K, Ruud T, Benth JŠ, Hanssen-Bauer K, Weimand BM, Solantaus T, Hilsen M, Skogøy BE, Kallander EK, Kufås E, Peck GC, Birkeland B, Hagen KA. Norwegian health personnel's compliance with new legislation on children of ill parents: an exploratory cross-sectional multicentre study. BMC Health Serv Res 2022; 22:1171. [PMID: 36123688 PMCID: PMC9484080 DOI: 10.1186/s12913-022-08268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background In 2010 the Norwegian Parliament introduced amendments to the Health Personnel Act requiring all health personnel to inform and offer help to their patients’ children and families. We evaluated whether health personnel adhered to their obligations outlined in the Act and investigated whether family and health services characteristics were associated with the degree of compliance with the legislation. Our study was part of a larger Norwegian multi-site study conducted in five health trusts across Norway, assessing the situation for families living with parental illness. Method A cross-sectional study using quantitative data obtained from 518 patients 246 children and 278 health personnel was performed. All informants completed a questionnaire, including an instrument corresponding to the obligations in the legislation. Descriptive analyses, factor analysis and logistic regression analysis were used. Results The legislation was only partially implemented in the clinics of the health trusts. Compared to estimates prior to the introduction of the new legislation, the situation had improved somewhat, but much work remains to be done to fulfil the obligations decreed by law. The more time-consuming the obligations were, the less often they were met. The substance abuse and mental health services followed up on their obligations to a greater extent than did the physical health services. Conversely, children of physically ill parents were better informed by their families than were children of parents with mental health and substance abuse disorders. When asked the same questions, reports from health personnel were more positive compared to those of children and patients regarding the legislation’s fulfillment. Conclusion Data suggest that there has been a change in the support offered to children of ill parents. Additional work is required, however, for the Health Personnel Act to function as fully intended.
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Affiliation(s)
- Kristin Stavnes
- Nordland Hospital Trust, 8092, Bodø, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway. .,The Regional Centre for Eating Disorders (RESSP) at Nordland Hospital, Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway.
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Centre for Mental Health and Substance Abuse, University of South-Eastern Norway, Drammen, Norway
| | - Tytti Solantaus
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marit Hilsen
- Regional Centre for Child and Adolescent Mental Health, RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway
| | - Bjørg Eva Skogøy
- Nordland Hospital Trust, 8092, Bodø, Norway.,Nordland Research Institute, Postboks 1490, 8049, Bodø, Norway
| | | | - Elin Kufås
- Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Bente Birkeland
- Sørlandet Hospital Trust, Kristiansand, Norway.,Faculty for Health and Sports Science, Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | - Kristine Amlund Hagen
- Norwegian Centre for Child Behavioral Development, Postboks 7053 Majorstuen, 0306, Oslo, Norway
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Wang X, Chen W, Wen L, Yang X, Chen B, Zhang T, Zhang C, Du C, Hua J, Tang Q, Hong X, Liu W, Xie C, Ma H, Yu X, Chen D, Guan L. Adverse childhood experiences in offspring living with parental mental illness: a controlled study from China. J Ment Health 2022; 32:541-550. [PMID: 35775503 DOI: 10.1080/09638237.2022.2091765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) affect children's development, and their harm to health is pervasive throughout the life course. AIMS To identify ACEs and their risk factors in Chinese household with or without parental mental illness. METHODS A controlled study was conducted among 181 young adults with parental mental illness (positive group) and 201 demographically matched individuals without parental mental illness (negative group). Univariate and multivariate analyses were performed to study the correlation between ACEs and their risk factors. RESULTS The positive group suffered emotional abuse, domestic violence, bullying, and cumulative ACEs more frequently than the negative group. In the positive group, living in rural areas and having a low household economic status during childhood were identified as risk factors for cumulative ACEs, whereas a higher education level of the mother was a protective factor for cumulative ACEs in univariate analyses. Low household economic status remained an independent risk factor for cumulative ACEs in the positive group in multivariate analyses. CONCLUSIONS Children living with parental mental illness are more vulnerable to ACEs, and our findings highlight the importance of socioeconomic factors in increasing the risk of ACEs. To alleviate the deleterious impact of parental mental illness on offspring, multidimensional supports are needed.
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Affiliation(s)
- Xun Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, PR China.,Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Weiran Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Liping Wen
- Zigong Fifth People's Hospital, Zigong, PR China
| | - Xianmei Yang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, PR China
| | | | - Tao Zhang
- Taiyuan Psychiatric Hospital, Shanxi Mental Health Center, Taiyuan, PR China
| | - Changchun Zhang
- Beijing Fangshan District Psychiatric Hospital, Beijing, PR China
| | - Chunyu Du
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Juan Hua
- Zigong Yantan District Mental Health Center, Zigong, PR China
| | - Qi Tang
- Psychiatric Hospital of Jiangyou, Jiangyou, PR China
| | - Xu Hong
- Xiamen City Xianyue Hospital, Xiamen, PR China
| | - Wenhui Liu
- Taiyuan Psychiatric Hospital, Shanxi Mental Health Center, Taiyuan, PR China
| | - Chenmei Xie
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Hong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, PR China
| | - Lili Guan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, PR China
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27
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Chaturvedi S, Susmitha R, Nayak D, Digal G, Singh T. Stigma and Discrimination: the Twain Impact on Mental Health During COVID-19 Pandemic. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC9007618 DOI: 10.1007/s43076-022-00179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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28
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Vives-Espelta J, Burjalés-Martí MD, Ferré-Grau C. Nurses' views and practices on parental mental illness: An integrative review. Int J Ment Health Nurs 2022; 31:8-24. [PMID: 34623021 DOI: 10.1111/inm.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/27/2022]
Abstract
When a parent has a mental health problem, family members can be affected by it. Nursing professionals can provide care for the whole family, including children. Nurses can support the parental role of parents with mental illness. This integrative review aimed at the following: To identify and to synthesize the views and practices of nurses on parental mental illness (PMI). An integrative review methodology was employed, following PRISMA guidelines. Theoretical and empirical literature was included. Twenty-three articles were obtained to be analysed, using the Whittemore and Knafl approach. A lack of knowledge about nurses' views and practices on PMI was found. Especially, in some demographic areas such as Mediterranean countries and Central and South America. Different issues which influence how nurses perceive PMI were identified: subjective meaning of family concept, personal experience of being parent, and perceptions of mental illness, among others. The main findings on nurses' practices were as follows: guidelines to implement family-focused practices, knowledge, and skills; therapeutic relationship; and teamwork and interagency communication; among others. These issues are intimately related. They could act as enablers or barriers to support parental role of parents with mental illness. Adequate guidelines and policies are necessary to support parents with mental illness and their families. There is a need to include knowledge about PMI and family-focused approach in nursing education curricula. Training could include reflection on nurses' experiences and personal values to become aware of how these can affect their interventions and practices.
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Affiliation(s)
- Judit Vives-Espelta
- Member of the Research Group of Advance Nursing SGR 1030, Nursing and Health Programme, Nursing Department, Faculty of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Maria-Dolors Burjalés-Martí
- Member of the Research Group of Advance Nursing SGR 1030, Nursing Department, Faculty of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Carme Ferré-Grau
- Coordinator of the Research Group of Advance Nursing SGR 1030, Nursing Department, Faculty of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
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29
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Villatte A, Piché G, Benjamin S. Perceived Support and Sense of Social Belonging in Young Adults Who Have a Parent With a Mental Illness. Front Psychiatry 2022; 12:793344. [PMID: 35095606 PMCID: PMC8792737 DOI: 10.3389/fpsyt.2021.793344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/21/2021] [Indexed: 12/14/2022] Open
Abstract
This participatory action research explores the perceived social support of youth whose parents have a mental illness during their transition to adulthood. Social support is an important protection factor during this developmental period, but few studies have explored how these young adults perceive their social support. Nor has any study assessed whether participation in a group-based participatory action research project could improve these youth's sense of support. Purpose: (1) identify which aspects of social support these youth spontaneously address when talking about their experiences in Photovoice workshops; (2) explore how participants view these types of workshops as a good way to improve their sense of social support and belonging. Methodology: Ten young adults (nine women and one man) between the ages of 18 and 25 who have at least one parent with a mental illness participated in Photovoice meetings in 2019. These group meetings aimed to explore and share their experiences as young adults whose parents have a mental illness. The testimonies were combined with data obtained from the abbreviated version of the Social Provisions Scale and the Scale of Social Belonging. Results: The quantitative results suggest that participants consider their social support levels to be high, but their qualitative statements highlight low level or absence of parental support in terms of emotional, informative or instrumental levels. They see themselves as an important source of support for their parent and discuss the importance of having other supports figures (romantic partner, employer, friends, sibling, etc.). Conversely, they have difficulty asking for help for various reasons (including fear of stigma). They consider that their participation in this Photovoice project allowed them to feel heard, supported and to develop a sense of belonging to a group. Discussion: To conclude, clinical issues to be considered for psychosocial intervention with young adults of parents with a mental illness are discussed.
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Affiliation(s)
- Aude Villatte
- Laboratory LaPProche, Department of psychoeducation and psychology, Universite du Quebec en Outaouais, Saint-Jerome, QC, Canada
- Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Quebec, QC, Canada
- Réseau de recherche en santé des populations du Québec (RRSPQ), Montreal, QC, Canada
- Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Quebec, QC, Canada
| | - Geneviève Piché
- Laboratory LaPProche, Department of psychoeducation and psychology, Universite du Quebec en Outaouais, Saint-Jerome, QC, Canada
- Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Quebec, QC, Canada
- Réseau de recherche en santé des populations du Québec (RRSPQ), Montreal, QC, Canada
- Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Quebec, QC, Canada
| | - Sylvie Benjamin
- Laboratory LaPProche, Department of psychoeducation and psychology, Universite du Quebec en Outaouais, Saint-Jerome, QC, Canada
- Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Quebec, QC, Canada
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30
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Román-Sánchez D, Paramio-Cuevas JC, Paloma-Castro O, Palazón-Fernández JL, Lepiani-Díaz I, de la Fuente Rodríguez JM, López-Millán MR. Empathy, Burnout, and Attitudes towards Mental Illness among Spanish Mental Health Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:692. [PMID: 35055513 PMCID: PMC8776222 DOI: 10.3390/ijerph19020692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/17/2022]
Abstract
Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.
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Affiliation(s)
- Daniel Román-Sánchez
- Nursing Faculty “Salus Infirmorum”, University of Cadiz, 11001 Cadiz, Spain; (D.R.-S.); (J.C.P.-C.); (J.L.P.-F.); (I.L.-D.); (J.M.d.l.F.R.)
| | - Juan Carlos Paramio-Cuevas
- Nursing Faculty “Salus Infirmorum”, University of Cadiz, 11001 Cadiz, Spain; (D.R.-S.); (J.C.P.-C.); (J.L.P.-F.); (I.L.-D.); (J.M.d.l.F.R.)
| | | | - José Luis Palazón-Fernández
- Nursing Faculty “Salus Infirmorum”, University of Cadiz, 11001 Cadiz, Spain; (D.R.-S.); (J.C.P.-C.); (J.L.P.-F.); (I.L.-D.); (J.M.d.l.F.R.)
| | - Isabel Lepiani-Díaz
- Nursing Faculty “Salus Infirmorum”, University of Cadiz, 11001 Cadiz, Spain; (D.R.-S.); (J.C.P.-C.); (J.L.P.-F.); (I.L.-D.); (J.M.d.l.F.R.)
| | - José Manuel de la Fuente Rodríguez
- Nursing Faculty “Salus Infirmorum”, University of Cadiz, 11001 Cadiz, Spain; (D.R.-S.); (J.C.P.-C.); (J.L.P.-F.); (I.L.-D.); (J.M.d.l.F.R.)
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Dobener LM, Stracke M, Viehl K, Christiansen H. Children of Parents With a Mental Illness-Stigma Questionnaire: Development and Piloting. Front Psychiatry 2022; 13:800037. [PMID: 35463495 PMCID: PMC9023877 DOI: 10.3389/fpsyt.2022.800037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Children of parents with a mental illness are a particularly vulnerable group as they have a high risk to develop a mental disorder themselves and those are associated with high stigma. Moreover, just like primary recipients of stigma, they are affected by the social taboo surrounding mental illness: they do not receive enough information, are often left alone with their problems, and are thus considered "invisible children". In previous research, family stigma has only been assessed through general questionnaires for all family members. What has not yet been adequately investigated is how stigma difficulties affect the children of parents with mental illness in particular. To address these limitations, we developed the Children of Parents with Mental Illness-Stigma-Questionnaire (COPMI-SQ), a self-report instrument for young people aged 12-19 years, designed to assess young people's stigma experiences in daily life. Based on a systematic review preceding the questionnaire, we identified relevant stigma dimensions for children of parents with a mental illness that resulted in 93 items that according to theory were assumed to load on four different scales: experienced stigma, anticipated stigma, self-stigma, and structural discrimination. An expert discussion, and a comprehensibility analysis with the target group followed. In this paper, we report on the development process and initial pilot data (N = 32) on the psychometric properties of the COPMI-SQ. Item analyses via an item difficulty index, discriminatory power, as well as internal consistency analysis resulted in a revised instrument reduced to 67 items. We observed very high internal consistencies (between α = 0.868 and α = 0.975) for the subscales. The approach taken to develop the COPMI-SQ followed scientifically accepted principles by ensuring different construction phases and is considered a solid basis for further reliability and validity studies. The study is ongoing and undergoing a further validation investigation; dimensionality and factor structure will also be examined.
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Affiliation(s)
- Lisa-Marie Dobener
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Markus Stracke
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Kathrin Viehl
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
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Dobener LM, Fahrer J, Purtscheller D, Bauer A, Paul JL, Christiansen H. How Do Children of Parents With Mental Illness Experience Stigma? A Systematic Mixed Studies Review. Front Psychiatry 2022; 13:813519. [PMID: 35250666 PMCID: PMC8894251 DOI: 10.3389/fpsyt.2022.813519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/10/2022] [Indexed: 02/03/2023] Open
Abstract
Stigma can have devastating health and wellbeing impacts, not just on people with mental health problems, but on people associated with the stigmatized person. This is called stigma-by-association. Children whose parents have mental health problems are a particularly vulnerable group, and stigma acts as a mechanism, contributing to the transgenerational transmission of mental disorders. The current study is a systematic mixed studies review, synthesizing knowledge about how this group of children experience stigma-by-association. Overall, 32 studies were included, after a systematic search including quantitative, qualitatative, and mixed methods studies. The methodological quality was assessed and qualitative content analysis undertaken. We grouped children's stigma experiences into four dimensions, i.e., experienced stigma, anticipated stigma, internalized stigma, and structural discrimination. Results show that stigma is an important factor in those children's lives, and needs further investigation in qualitative and quantitative research. The current study emphasizes the importance of anti-stigma interventions and campaigns.
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Affiliation(s)
- Lisa-Marie Dobener
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany.,Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
| | - Julia Fahrer
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Daniel Purtscheller
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Annette Bauer
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, United Kingdom
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany.,Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
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Vetri K, Piché G, Villatte A. An Evaluation of the Acceptability, Appropriateness, and Utility of a Bibliotherapy for Children of Parents With a Mental Illness. Front Psychiatry 2022; 13:815873. [PMID: 35492703 PMCID: PMC9046907 DOI: 10.3389/fpsyt.2022.815873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/14/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Children of parents with a mental illness are at higher risk for various psychiatric problems and adaptive difficulties compared to those of parents without mental health problems. Certain preventive psychoeducational interventions target these children to promote their well-being and resilience and prevent the emergence of adaptive difficulties. However, few such interventions have been developed and evaluated specifically for elementary school-aged children of parents with a mental illness. OBJECTIVES This study aims to evaluate an interpersonal psychotherapy-based book targeting children living with a parent with a mental illness. METHODS The study examines children, parents and psychosocial workers' perception of the acceptability, appropriateness and utility of the book. In total, 22 participants answered online open-ended questions after reading the book. RESULTS The book was highly appreciated and positively perceived by the families and psychosocial workers. Results suggest that children, parents and psychosocial workers viewed it as an appropriate and useful tool for supporting children with a parent with a mental illness. The present study reveals that the bibliotherapy appears well adapted to the developmental level of school-age children. DISCUSSION This study presents a book that shows promise for supporting the resilience of elementary school-aged children having a parent with a mental illness. Results highlight the importance of tailoring the content and modalities of interventions to the developmental level, needs and preferences of elementary school-aged children. The relevance of a collaborative method is also discussed, thus providing knowledge regarding this type of approach for the development of interventions targeting children.
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Affiliation(s)
- Kelly Vetri
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
| | - Geneviève Piché
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
| | - Aude Villatte
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
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Gregg L, Calam R, Drake RJ, Wolfenden L. Expressed Emotion and Attributions in Parents With Schizophrenia. Front Psychiatry 2021; 12:799626. [PMID: 34966315 PMCID: PMC8710699 DOI: 10.3389/fpsyt.2021.799626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022] Open
Abstract
We examined expressed emotion (EE) and attributions in parents with schizophrenia and compared them to parents without serious mental illness (SMI) in order to better understand the emotional climate of families in which a parent has schizophrenia. Parenting practices and parental reports of child behavior were also compared between the two groups. The relationship of EE to attributions was examined in each group separately. Relationships between parental mental health, EE, and attributions were explored in the parents with schizophrenia only. The Camberwell Family Interview was used to determine both EE and attributions in 20 parents with schizophrenia and 20 parents without SMI. We found that more parents with schizophrenia were rated as high EE than those without (60 and 35%, respectively) although this was not a statistically significant difference. Parents with schizophrenia demonstrated significantly more hostility and criticism toward their children than those without SMI and made more child-blaming attributions. Blame was associated with increased hostility, less warmth, and fewer positive remarks. Parental warmth was related to greater parenting self-efficacy, less harsh parenting practices, better child behavior, and a more positive parent-child relationship. We conclude that EE and attributions are potential explanatory variables to be considered in the development of preventative and early intervention strategies for families with a parent with schizophrenia or other psychotic disorder. Blame and warmth are modifiable factors that could be targeted within family and parenting interventions.
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Affiliation(s)
- Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Rachel Calam
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Richard J. Drake
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, The University of Manchester, Manchester, United Kingdom
| | - Lauren Wolfenden
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Chen L, Vivekananda K, Guan L, Reupert A. Parenting experiences of Chinese mothers living with a mental illness. BMC Psychiatry 2021; 21:589. [PMID: 34814877 PMCID: PMC8609737 DOI: 10.1186/s12888-021-03581-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the experiences of mothers with mental illness are well researched in Western countries, little is known about the experiences of Chinese mothers. This study aims to explore the experiences of family life and parenting of Chinese mothers, in the context of their mental illness. METHODS Fourteen Chinese mothers with mental illness undertook in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was employed to guide the data analysis. RESULTS Seven themes were identified: motherhood as a central identity, the stigma associated with being a mother with mental illness, participants' perceptions about the impact of mental illness on parenting and their children, experiences of talking to children about mental illness, how having children impacts mothers' illness and recovery, and support obtained and needed. Similar to Western mothers, Chinese mothers experienced stigma and fluctuating mental illness symptoms which impacted on parenting. Unlike mothers based in Western countries, the mothers interviewed in this study highlighted complicated co-caring relationships with parents-in-law and did not raise child custody concerns. CONCLUSIONS Mental health professionals need to have the skills to identify and recognize the mothering role of their clients. Culturally sensitive interventions are required to assist Chinese families where mothers have a mental illness. Future research is required to investigate family experiences of parental mental illness from the perspectives of children, partners, and mental health professionals.
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Affiliation(s)
- Lingling Chen
- Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia.
| | - Kitty Vivekananda
- grid.1002.30000 0004 1936 7857Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC 3800 Australia
| | - Lili Guan
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Andrea Reupert
- grid.1002.30000 0004 1936 7857Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC 3800 Australia
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Lessard-Deschênes C. The quality assessment of studies in integrative reviews: A commentary on Reupert et al. (2021). Int J Ment Health Nurs 2021; 30:1033-1034. [PMID: 34028157 DOI: 10.1111/inm.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
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