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Families with parental mental illness: supporting children in psychiatric and social services
Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).ORCID iD: 0000-0001-5265-8590
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Children living with a parent with a mental illness can face difficulties. Parentalmental illness may influence the parents’ ability to cope with family life, where theparents’ awareness of their illness plays an important role. Family interventionsprovided by psychiatric and children’s social care services can be a way to supportthese children, making them feel less burdened, and improving the relationshipswithin the family. The aim of this thesis was to illuminate how children infamilies with a parent with a mental illness are supported in psychiatric and socialservices, especially by means of family interventions, and how families experiencethe support. Study I explored how professionals in adult psychiatric outpatient servicesdeal with children and families when a parent has a mental illness. The findingsshowed that professionals balanced between establishing, and maintaining,a relationship with the patient and fulfilling the legal obligations towards thepatient’s children. Asking the patient about their children could be experiencedas intrusive, and involving the patient’s family in the treatment could be seen asa dilemma, in relation to the patient. Efforts were made to enhance the familyperspective, and when the patient’s family and children joined the treatment thisrequired flexibility from the professional. Study II examined how professionals in children’s social care services experienceworking with children and families when a parent has a mental illness. The socialworkers’ objective was to identify the needs of the children. No specific attentionwas paid to families with parental mental illness; they were supported in thesame way as other families. When the parental mental illness became difficult tohandle both for the parent and the social worker, the latter had to set the child’sneeds aside in order to support the parent. Interagency collaboration seemed likea successful way to support these families, but difficult to achieve. Study III investigated if patients in psychiatric services that are also parentsof underage children, are provided with child-focused interventions or involvedin interagency collaboration between psychiatric and social services and childand adolescent psychiatry. The findings showed that only 12.9% of the patientsregistered as parents in Psykiatri Skåne had registered children under the ageof 18 years. One fourth of these patients had been provided with child-focusedinterventions in psychiatric service, and 13% of them were involved in interagencycollaboration. If a patient received child-focused interventions from the psychiatricservices, the likelihood of being involved in interagency collaboration was fivetimes greater as compared to patients receiving no child-focused intervention.Study IV explored how parents and their underage children who were supportedwith family interventions experienced these interventions. The results showedthat parents experiencing mental illness were eager to find support in explainingto and talking with their children about their mental illness, although the supportfrom the psychiatric service varied. Both children and other family membersappreciated being invited to family interventions. After such an intervention, theyexperienced the atmosphere in the family as less strained and found it easier tocommunicate with each other about difficulties. Unfortunately, the participatingpartners felt that they were left without support specifically targeted at them. The thesis showed that there is a gap between how professionals deal withquestions concerning these families and their support, and the parents’ and thefamilies’ needs to receive support in handling the parental mental illness in thefamily. The psychiatric and social services need to expand their approach andwork with the whole family, in order to meet the needs of the child and otherfamily members involved.

Place, publisher, year, edition, pages
Malmö university, Faculty of Health and Society , 2017. , p. 81
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 4
Keywords [en]
children of parents with mental illness, professionals, psychiatric service
National Category
Nursing Psychiatry
Identifiers
URN: urn:nbn:se:mau:diva-7363DOI: 10.24834/2043/22318Local ID: 22318ISBN: 9789171047649 (print)ISBN: 9789171047656 (electronic)OAI: oai:DiVA.org:mau-7363DiVA, id: diva2:1404278
Note

Paper III and IV in dissertation as manuscripts, and not included in the fulltext online.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-18Bibliographically approved
List of papers
1. How Adult Psychiatry Professional's View Children
Open this publication in new window or tab >>How Adult Psychiatry Professional's View Children
2015 (English)In: Austin Journal of Psychiatry and Behavioral Science, ISSN 2381-9006, Vol. 2, no 2, article id 1041Article in journal (Refereed)
Abstract [en]

Abstract Background: Children of parents with a mental illness need support from adult psychiatric services. Efforts have been made to enhance the knowledge of practitioners in this field so that they may work in a more family- oriented manner and to include children in the therapeutic services they provide. Aim: This study investigates how adult psychiatry services works with families and children when a parent has a mental illness. Method: Twenty-four Swedish professional care providers were interviewed individually or in focus groups. Data was analyzed using an inductive content method. Results: Although the professionals knew that their patients had minor children, they still prioritized the individual relationship they had with the parent. Few efforts were made to include both children and families in the treatment offered, and when this happened it was done at the professional’s own discretion. Conclusion: Despite the mandatory Swedish obligation to pay attention to a patient’s children, our study showed that professionals tend to fall short in this regard. Adult psychiatry services needs to strengthen family -oriented work in order to provide support to such children. Keywords: Minor children; Parents with mental illness; Adult psychiatric services; Family therapy

Place, publisher, year, edition, pages
Austin Publishing, 2015
Keywords
Minor children, Parents with mental illness, Adult psychiatric services, Family therapy
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14790 (URN)22057 (Local ID)22057 (Archive number)22057 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2023-08-21Bibliographically approved
2. Children of parents with serious mental illness: the perspective of social workers
Open this publication in new window or tab >>Children of parents with serious mental illness: the perspective of social workers
2017 (English)In: Practice, ISSN 0950-3153, E-ISSN 1742-4909, Vol. 29, no 4, p. 293-310Article in journal (Refereed) Published
Abstract [en]

The aim of this study is to describe the experiences of children’s social workers in Sweden who work with families in which a parent suffers from serious mental illness, and how a child in such a family receives support. Data were collected through individual interviews and focus groups discussions with 13 professionals in 2 minor municipalities in southern Sweden. Interviewees stated that parental serious mental illness was not a main focus for children’s social workers. When parental serious mental illness became a barrier to caring for their children, the children’s social workers sought to collaborate with psychiatric services, but in many cases it did not turn out well. Providing support to the parent was one way of aiding the family, although at the price of setting the child’s perspective aside. Being faced with responsibility for the parent and the child left children’s social workers feeling they were the last outpost for the families. Children’s social workers require greater knowledge of how to handle parental serious mental illness, and more interagency collaboration with psychiatric services is needed to adequately support children of parents with a serious mental illness. Keywords: children of parents with serious mental illness; parental serious mental illness; children’s social workers; psychiatric services

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
children of parents with serious mental illness, parental serious mental illness, children’s social workers, psychiatric services
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14682 (URN)10.1080/09503153.2016.1260705 (DOI)2-s2.0-85000673407 (Scopus ID)21763 (Local ID)21763 (Archive number)21763 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2023-08-21Bibliographically approved
3. Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
Open this publication in new window or tab >>Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
2018 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 31-38Article in journal (Refereed)
Abstract [en]

Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Parental mental illness, children, child-focused intervention, interagency collaboration, psychiatric services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-15159 (URN)10.1080/08039488.2017.1377287 (DOI)000417846400005 ()28933586 (PubMedID)2-s2.0-85029677558 (Scopus ID)25837 (Local ID)25837 (Archive number)25837 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-06-18Bibliographically approved
4. Families living with parental mental illness and their experiences of family interventions
Open this publication in new window or tab >>Families living with parental mental illness and their experiences of family interventions
2018 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 25, no 2, p. 69-77Article in journal (Refereed)
Abstract [en]

Introduction: Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim: This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method: Five families with children aged 10–12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both family and individual interviews were performed. Results: In striving to lead an ordinary life while coping with the parental mental illness, these families sought the support of the psychiatric services, especially in order to inform their children about the mental illness. Despite different family interventions, the family members felt supported and reported that the number of conflicts in the family had decreased. The parents were appreciative of help with child-rearing questions, and the children experienced a calmer family atmosphere. However, the partner of the person with mental illness experienced being left without support. Implications for practice: Our study shows that psychiatric services, and especially mental health nurses, are in a position to more regularly offer family interventions in supporting the children and the healthy partners.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Family, children of parents with mental illness, Family intervention
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14726 (URN)10.1111/jpm.12433 (DOI)000424163500002 ()28906576 (PubMedID)2-s2.0-85041610832 (Scopus ID)23817 (Local ID)23817 (Archive number)23817 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved

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