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Yates S, Gladstone B, Foster K, Silvén Hagström A, Reupert A, O'Dea L, Cuff R, McGaw V, Hine R. Epistemic injustice in experiences of young people with parents with mental health challenges. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:702-721. [PMID: 37994180 DOI: 10.1111/1467-9566.13730] [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] [Received: 06/06/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023]
Abstract
Amongst the impacts of growing up with a parent with mental health challenges is the experience of stigma-by-association, in which children and young people experience impacts of stigmatisation due to their parent's devalued identity. This article seeks to expand our understanding of this issue through an abductive analysis of qualitative data collected through a codesign process with young people. Results indicate that young people's experiences of stigmatisation can be effectively understood as experiences of epistemic injustice. Participants expressed that their experiences comprised 'more than' stigma, and their responses suggest the centrality to their experiences of being diminished and dismissed in respect of their capacity to provide accurate accounts of their experiences of marginalisation and distress. Importantly, this diminishment stems not only from their status as children, and as children of parents with mental health challenges but operates through a range of stigmatised identities and devalued statuses, including their own mental health status, sexual minoritisation, disability and social class. Forms of epistemic injustice thus play out across the social and institutional settings they engage with. The psychological and social impacts of this injustice are explored, and the implications for our understanding of stigma around family mental health discussed.
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Affiliation(s)
- Scott Yates
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kim Foster
- National School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | | | - Andrea Reupert
- School of Educational Psychology and Counselling, Monash University, Clayton, Victoria, Australia
| | - Lotti O'Dea
- Satellite Foundation, Melbourne, Victoria, Australia
| | - Rose Cuff
- Satellite Foundation, Melbourne, Victoria, Australia
| | - Violette McGaw
- Trauma Recovery Program, Toowong Private Hospital, Brisbane, Queensland, Australia
| | - Rochelle Hine
- Monash Rural Health, Monash University, Clayton, Victoria, Australia
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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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Van Schoors M, Van Lierde E, Steeman K, Verhofstadt LL, Lemmens GMD. Protective factors enhancing resilience in children of parents with a mental illness: a systematic review. Front Psychol 2023; 14:1243784. [PMID: 38192397 PMCID: PMC10773682 DOI: 10.3389/fpsyg.2023.1243784] [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: 06/21/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024] Open
Abstract
Objectives A systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature. Method Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting. Discussion Research on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.
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Affiliation(s)
| | | | | | - Lesley L. Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gilbert M. D. Lemmens
- Department of Head and Skin – Psychiatry, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
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Tuck M, Wittkowski A, Allott R, Gregg L. What about the children? Adult mental health practitioners' experiences and views of family-focused practice in Early Intervention Services. Psychol Psychother 2023; 96:697-715. [PMID: 37017306 DOI: 10.1111/papt.12464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND There is a significant risk of negative outcomes for families when a parent experiences serious mental illness. Family-focused practice (FFP) emphasises the "whole family" as the unit of care and has been found to improve outcomes for service users and their families. Despite its benefits, FFP is not routinely implemented in UK adult mental health services. This study explores adult mental health practitioners' experiences and views of FFP within Early Intervention Psychosis Services in the UK. METHODS Sixteen adult mental health practitioners employed in three Early Intervention Psychosis teams in the Northwest of England were interviewed. Interview data were analysed using thematic analysis. RESULTS Five core themes were generated: (1) A limited understanding of FFP, (2) Our practitioners, (3) Our approach, (4) Our families and (5) Our services. Practitioners' understanding of FFP was limited and typically excluded dependent children. Practitioners' age, professional and personal experience, and preconceptions of families influenced delivery, and in turn, the engagement approach they adopted impacted families' responsiveness. The diversity and dynamics of service user families such as age, socioeconomic status, culture and stigma impacted FFP. An operational context characterised by insufficient resources reduced FFP; however, organisational structures such as leadership, clinical supervision and multi-disciplinary teams facilitated FFP. CONCLUSIONS FFP is not yet embedded within Early Intervention Services. Practice recommendations include agreeing on a formal definition of FFP and its scope; the development of FFP policy; clarity in relation to staff responsibilities and identities; the adoption of a collaborative approach which encourages service user choice and for time to be ring-fenced to prioritise FFP. Future research should ascertain service user and family views on the facilitators and barriers to engaging with FFP in Early Intervention Services.
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Affiliation(s)
- Molly Tuck
- School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Rory Allott
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lynsey Gregg
- School of Health Sciences, University of Manchester, Manchester, UK
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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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Granrud MD, Sandsdalen T, Anderzén-Carlsson A, Steffenak AKM. Public health nurses’ experiences working with children who are next of kin: a qualitative study. BMC Health Serv Res 2022; 22:1427. [PMCID: PMC9703408 DOI: 10.1186/s12913-022-08841-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
There are a substantial number of children who are the next of kin of parents suffering from illness or substance abuse. These children can experience emotional and behavioral problems and may need support from professionals. In Norway, the specialist health service in hospitals is required to have a designated practitioner in each department to ensure support for and follow up of children who are next of kin; however, this is not regulated by law in the health care in the municipalities. The aim of this study was to explore public health nurse’s experiences working with children who are next of kin.
Methods
Qualitative interviews were conducted with 10 public health nurses working in the child health clinic and the school health service in four municipalities. Data were analysed using content analysis. Reporting of this study is conducted in accordance to COREQ’s checklist.
Results
The analysis resulted in one main theme: ‘Lack of guidelines and routines among public health nurses working with children who are next of kin’. The main theme consisted of four categories: (1) identifying children who are next of kin are incidental; (2) public health nurses must be observant and willing to act; (3) communication is an important tool; and (4) follow up over time is not always provided.
Conclusion
The public health nurses experienced uncertainty concerning how to identify and follow up children who are next of kin but were vigilant and willing to act in the children’s best interest. Doing so necessitated collaboration with other professionals. The need for guidelines around the role and responsibilities for the public health nurse were emphasized. The knowledge provided by the current study offers valuable insight into strengths and limitations in the support of children who are next of kin and can inform stakeholders in organizing sustainable support for this group.
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Njelesani J, Mlambo V, Denekew T, Hunleth J. Inclusion of children with disabilities in qualitative health research: A scoping review. PLoS One 2022; 17:e0273784. [PMID: 36048816 PMCID: PMC9436059 DOI: 10.1371/journal.pone.0273784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 08/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Children with disabilities have the right to participate in health research so their priorities, needs, and experiences are included. Health research based primarily on adult report risks misrepresenting children with disabilities and their needs, and contributes to exclusion and a lack of diversity in the experiences being captured. Prioritizing the participation of children with disabilities enhances the relevance, meaningfulness, and impact of research. Methods A scoping review was conducted to critically examine the participation of children with disabilities in qualitative health research. The electronic databases PubMed, PsychInfo, Embase, and Google Scholar were searched. Inclusion criteria included qualitative health studies conducted with children with disabilities, published between 2007 and 2020, and written in English. Articles were screened by two reviewers and the synthesis of data was performed using numeric and content analysis. Results A total of 62 studies met inclusion criteria. Rationales for including children with disabilities included child-focused, medical model of disability, and disability rights rationales. Participation of children with disabilities in qualitative health research was limited, with the majority of studies conducting research on rather than in partnership with or by children. Findings emphasize that children with disabilities are not participating in the design and implementation of health research. Conclusion Further effort should be made by health researchers to incorporate children with a broad range of impairments drawing on theory and methodology from disability and childhood studies and collaborating with people who have expertise in these areas. Furthermore, an array of multi-method inclusive, accessible, adaptable, and non-ableist methods should be available to enable different ways of expression.
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Affiliation(s)
- Janet Njelesani
- Department of Occupational Therapy, New York University, New York, NY, United States of America
- * E-mail:
| | - Vongai Mlambo
- Stanford University School of Medicine, Stanford, CA, United States of America
| | | | - Jean Hunleth
- Division of Public Health Sciences. Washington University in St. Louis, St. Louis, MO, United States of America
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Cudjoe E, Tam CHL, Effah D, Amegashie EF, Tweneboah AO. Living with parental mental illness is like a roller coaster: Reflections on children's lifeworld in the family setting. J Clin Nurs 2022. [PMID: 35733326 DOI: 10.1111/jocn.16417] [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: 04/12/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore what it is like for children in the family setting to live with parental mental illness. BACKGROUND There are reported risks of negative social and behavioural outcomes among children living with parental mental illness such as poor school performance, isolation and poor mental health. There is yet more to know about how children's interactions with significant members of the family shape their experiences. DESIGN A phenomenological design following Husserl's concepts of lifeworld and inter-subjectivity was adapted for the study. METHOD Twenty-one children (ages 10-17) who lived with a parent with mental illness were interviewed. The data were analysed to attain the essential features of the phenomenon. The study followed the COREQ checklist for qualitative studies. FINDINGS The essence of the phenomenon 'living with parental mental illness' in the family setting comprises strain, sadness and some happy moments. Living with parental mental illness can produce unpredictable life situations for children as relationships and interactions in the family setting can be chaotic and confusing. The ups and downs define their lifeworld as a roller coaster. Strenuous family environment, sibling interaction, navigating separate living arrangements and there are good days were specific themes that clarified the children's lives as a roller coaster. CONCLUSION A concept called the 'parent paradox' is coined to reflect how children are torn between what their living situation looks like comparing the parent with mental illness and the other without mental illness. The paradox is founded on children's loyalty towards their parents. RELEVANCE TO CLINICAL PRACTICE To break the unhealthy cycle created by the parent paradox, mental health nurses should ensure that children are well informed about the parent's mental condition including information about treatment procedures and recovery. Child's psychological distress may be reduced when they are informed.
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Affiliation(s)
- Ebenezer Cudjoe
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Cherry Hau Lin Tam
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Deborah Effah
- Kokompe Health Nurse. Black Belt Ghana Foundation, Takoradi, Ghana
| | - Elorm Faith Amegashie
- Community Psychiatric Unit, Effia Nkwanta Regional Hospital, Sekondi-Takoradi, Ghana
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Hunleth JM, Spray JS, Meehan C, Lang CW, Njelesani J. What is the state of children's participation in qualitative research on health interventions?: a scoping study. BMC Pediatr 2022; 22:328. [PMID: 35659206 PMCID: PMC9166159 DOI: 10.1186/s12887-022-03391-2] [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: 08/04/2020] [Accepted: 05/30/2022] [Indexed: 12/21/2022] Open
Abstract
Background Children are the focus of numerous health interventions throughout the world, yet the extent of children’s meaningful participation in research that informs the adaptation, implementation, and evaluation of health interventions is not known. We examine the type, extent, and meaningfulness of children’s participation in research in qualitative health intervention research. Method A scoping study was conducted of qualitative published research with children (ages 6–11 years) carried out as part of health intervention research. Following Arksey and O’Malley’s scoping study methodology and aligned with the PRISMA-ScR guidelines on the reporting of scoping reviews, the authors searched, charted, collated, and summarized the data, and used descriptive and content analysis techniques. Ovid MEDLINE was searched from 1 January 2007 to 2 July 2018 using the keywords children, health intervention, participation, and qualitative research. Study selection and data extraction were carried out by two reviewers independently. Results Of 14,799 articles screened, 114 met inclusion criteria and were included. The study identified trends in when children were engaged in research (e.g., post-implementation rather than pre-implementation), in topical (e.g., focus on lifestyle interventions to prevent adult disease) and geographical (e.g., high-income countries) focuses, and in qualitative methods used (e.g., focus group). While 78 studies demonstrated meaningful engagement of children according to our criteria, there were substantial reporting gaps and there was an emphasis on older age (rather than experience) as a marker of capability and expertise. Conclusions Despite evidence of children’s meaningful participation, topical, geographical, and methodological gaps were identified, as was the need to strengthen researchers’ skills in interpreting and representing children’s perspectives and experiences. Based on these findings, the authors present a summary reflective guide to support researchers toward more meaningful child participation in intervention research. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03391-2.
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Affiliation(s)
- Jean M Hunleth
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, St. Louis, MO, 63110, USA.
| | - Julie S Spray
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, St. Louis, MO, 63110, USA.,National University of Ireland, Galway, Ireland
| | - Corey Meehan
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, St. Louis, MO, 63110, USA.,University of Colorado School of Medicine, Denver, CO, USA
| | - Colleen Walsh Lang
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, St. Louis, MO, 63110, USA.,Department of Anthropology, Washington University in St. Louis, St. Louis, MO, USA.,Loma Linda University Health, Loma Linda, CA, USA
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11
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Steffenak AKM, Anderzén-Carlsson A, Opheim E, Sandsdalen T. Community-based support for children who are next-of-kin for a parent experiencing illness or disability - a scoping review. BMC Health Serv Res 2021; 21:1250. [PMID: 34798870 PMCID: PMC8603592 DOI: 10.1186/s12913-021-07270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.
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Affiliation(s)
| | - Agneta Anderzén-Carlsson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elin Opheim
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
| | - Tuva Sandsdalen
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
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Grové C. Co-developing a Mental Health and Wellbeing Chatbot With and for Young People. Front Psychiatry 2021; 11:606041. [PMID: 33597898 PMCID: PMC7882508 DOI: 10.3389/fpsyt.2020.606041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022] Open
Abstract
There are many young people who experience mental health and wellbeing challenges. A potential negative mental health trigger for some youth is a struggle to cope with stress at school, feelings of depression and anxiety and availability of adequate help for these stressors. In response to youth needs a mental health and wellbeing Chatbot has been co-developed with youth, technology partners and expert stakeholders. An element of the Chatbot is powered by artificial intelligence and rules based AI using natural language processing. It is created to communicate evidence based resources, wellbeing support, educational mental health information and adaptive coping strategies. This paper will discuss how the Chatbot has been developed, highlighting its participatory, co-design process with youth who are the key stakeholders to benefit from this digital tool. Research from interviews and surveys informed the creation of the Chabots personality and its character design. Examples of the conversation design and content development are provided. The paper finishes with how, if at all, digital tools such as Chatbot applications could support the mental health of young people in secondary schools or health care settings in conjunction with the wellbeing or health care team, concluding with lessons learned and cautions.
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Affiliation(s)
- Christine Grové
- Educational Psychology and Inclusive Education Academic Community, Monash University, Melbourne, VIC, Australia
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Riebschleger J, Costello S, Cavanaugh DL, Grové C. Mental Health Literacy of Youth That Have a Family Member With a Mental Illness: Outcomes From a New Program and Scale. Front Psychiatry 2019; 10:2. [PMID: 30778305 PMCID: PMC6369184 DOI: 10.3389/fpsyt.2019.00002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/02/2019] [Indexed: 11/13/2022] Open
Abstract
A program evaluation examined mental health literacy levels and coping outcomes for youth (ages 10-16), before and at the end of their participation in a manualized, school-based mental health literacy program called Youth Education and Support (YES). Most of the youth reportedly had a parent or other family member with a mental health disorder such as depression, anxiety, and/or substance abuse. The mental health literacy levels of program participants from pre to post were evaluated with the developing Knowledge of Mental Illness and Recovery (K-MIR) scale. This scale was validated using item-response theory, demonstrating good psychometric properties. Youth answered two coping questions about their use of positive coping during the program and coping skills compared from pre to post intervention. Findings revealed that youth levels of mental health literacy increased significantly from pre to post program participation. Over 90% of the youth reported an improved use of positive coping strategies from pre to post intervention. The program appeared to deliver enhanced levels of literacy and coping for this sample of youth. The scale appeared to be appropriate to measure youth mental health literacy. Recommendations for practice, policy, and research are offered.
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Affiliation(s)
- Joanne Riebschleger
- School of Social Work MSU, Michigan State University, East Lansing, MI, United States
| | - Shane Costello
- Faculty of Education - Monash, Monash University, Melbourne, VIC, Australia
| | - Daniel L Cavanaugh
- School of Social Work MSU, Michigan State University, East Lansing, MI, United States
| | - Christine Grové
- Faculty of Education - Monash, Monash University, Melbourne, VIC, Australia
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14
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Davison J, Scott J. Should we intervene at stage 0? A qualitative study of attitudes of asymptomatic youth at increased risk of developing bipolar disorders and parents with established disease. Early Interv Psychiatry 2018; 12:1112-1119. [PMID: 28188672 DOI: 10.1111/eip.12421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/08/2016] [Accepted: 11/13/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Studies of potential interventions for asymptomatic individuals at risk of severe mental disorders (ie, clinical stage 0) have focused on genetic counselling or the views of adults with established disease. No study has interviewed youth at risk of bipolar disorders (BD). METHODS Qualitative analysis of interviews with asymptomatic adolescent offspring of adults with BD (OSBD = 7) and unrelated parents with bipolar disorders (PBD = 6) to examine manifest and latent themes in the dialogue. RESULTS Core themes in both groups were ignorance regarding the magnitude of risk of BD onset in offspring and greater concerns for the health of other family members than for oneself. Parents expressed anxieties in coping with the uncertainty about whether their children would inherit BD and their desire to reduce this risk was partly driven by guilt and their sense of responsibility; PBD favoured the introduction of specialized clinical OSBD services. In contrast, the priority for OSBD was advice on coping with a parent with BD; OSBD favoured access to generic non-clinical peer group support, which they perceived as less stigmatizing than specialist services. CONCLUSION The study highlights that youth at risk of BD should be allowed to express their ideas on what interventions they believe are likely to be most beneficial for them, as their views may differ from other advocates who are routinely consulted, such as PBD. A noteworthy finding was that OSBD thought that being included in the clinical dialogue about their parents' BD would decrease rather than increase their stress levels.
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Affiliation(s)
- Jo Davison
- Newcastle Early Intervention in Psychosis Service, NTW NHS Trust, Newcastle, UK
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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15
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Stasiulis E, Gladstone B, Boydell K, O'Brien C, Pope E, Laxer RM. Children with facial morphoea managing everyday life: a qualitative study. Br J Dermatol 2018; 179:353-361. [PMID: 29451694 DOI: 10.1111/bjd.16449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Facial morphoea is a chronic inflammatory skin disorder, typically presenting in childhood and adolescence, which can be disfiguring, and which has been suggested to cause mild-to-moderate impairment in quality of life. OBJECTIVES To explore the everyday experiences of children with facial morphoea by examining the psychosocial impact of living with facial morphoea and how children and their families manage its impact. METHODS We used a qualitative, social constructionist approach involving focus groups, in-depth interviews and drawing activities with 10 children with facial morphoea aged 8-17 years and 13 parents. Interpretive thematic analysis was utilized to examine the data. RESULTS Children and parents reported on the stress of living with facial morphoea, which was related to the lack of knowledge about facial morphoea and the extent to which they perceived themselves as different from others. Self-perceptions were based on the visibility of the lesion, different phases of life transitions and the reactions of others (e.g. intrusive questioning and bullying). Medication routines, and side-effects such as weight gain, added to the stress experienced by the participants. To manage the impact of facial morphoea, children and their parents used strategies to normalize the experience by hiding physical signs of the illness, constructing explanations about what 'it' is, and by connecting with their peers. CONCLUSIONS Understanding what it is like to live with facial morphoea from the perspectives of children and parents is important for devising ways to help children with the disorder achieve a better quality of life. Healthcare providers can help families access resources to manage anxiety, deal with bullying and construct adequate explanations of facial morphoea, in addition to providing opportunities for peer support.
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Affiliation(s)
- E Stasiulis
- Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Medical Science, Toronto, ON, Canada
| | - B Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - K Boydell
- Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Black Dog Institute, University of South Wales, Randwick, NSW, Australia
| | - C O'Brien
- Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Rehabilitation Services, The Hospital for Sick Children, Toronto, ON, Canada
| | - E Pope
- Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - R M Laxer
- Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medicine, The Hospital for Sick Children, Toronto, ON, Canada
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16
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Drost LM, van der Krieke L, Iedema-den Boer Z, Sytema S, Schippers GM. Social support in chat sessions for adolescents and young adults living with a family member with mental illness. Int J Ment Health Nurs 2018; 27:683-692. [PMID: 28573828 DOI: 10.1111/inm.12354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/29/2022]
Abstract
Children from families with a mental illness are at risk of developing negative health outcomes. Online interventions are a new way to offer support to these children. The present study utilized a website that had been developed to support Dutch youth who had a family member with a mental illness. The objective was to analyse monitored and unmonitored chatroom conversations among these young people, and specifically to compare supportive messages and self-disclosures of experiences. We electronically imported session transcripts of 34 chatroom conversations into the qualitative analysis software Atlas.ti. A content analysis was performed on 4252 messages from 22 female participants. A correlational analysis was then conducted to identify significant associations between sent and received supportive statements and disclosing statements. We found supporting comments in approximately 34% of the conversations and disclosures of problems in the home in approximately 15-18% of the messages. Participants made approximately twice as many disclosing statements and approximately half as many supportive statements in the monitored sessions compared to the unmonitored sessions. The number of disclosures that were sent was positively correlated with the amount of social support that was received. The number of disclosures sent was negatively correlated with the amount of social support that was sent, but only in the unmonitored sessions. Considering the greater reach of Internet interventions, online chatroom sessions might be provided as complementary to, or as an alternative to, face-to-face groups for supporting youth with a family member who has a mental illness.
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Affiliation(s)
- Louisa M Drost
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Zamira Iedema-den Boer
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sjoerd Sytema
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerard M Schippers
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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17
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Yamamoto R, Keogh B. Children's experiences of living with a parent with mental illness: A systematic review of qualitative studies using thematic analysis. J Psychiatr Ment Health Nurs 2018; 25:131-141. [PMID: 28776896 DOI: 10.1111/jpm.12415] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ABOUT THE SUBJECT?: There are many qualitative studies that explore what it is like for children who live with a parent who has a mental illness. These studies are sometimes criticized because they have small sample sizes which limits their application. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We conducted a systematic review of qualitative papers with an aim to strengthening our understanding of what it is like for children who live with a parent who has a mental illness. We used stringent criteria to make sure that only the voices of children affected by parental mental illness were included in the review. In addition, the paper presents a timely update on previous reviews completed in this area. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings of this review highlight the impact that parental mental illness has on children and the important role that mental health nurses can play in maximizing opportunities for building resilience in affected children. Mental health nurses are in a key position to provide timely and age-appropriate information and support to both parents and children to assist in the development of appropriate coping and support mechanisms. ABSTRACT Introduction This paper brings together what is known about what it is like for children who live with a parent with a mental illness with a view to strengthening our understanding of their experiences. This paper presents an update on previous reviews that were completed in this area and used a systematic approach and stringent inclusion/exclusion criteria to ensure that the voices of children were central in the included papers. A systematic review of this nature could not be located in the literature. Aims This paper presents the findings of a systematic review which explored the experiences of children who were affected by parental mental illness. Methods CINAHL, PubMed, PsychINFO, Pubmesh and EMBASE were searched for qualitative studies which explored children's experiences, and eight studies were included following review and quality appraisal. Pertinent data were extracted, coded and analysed using a thematic approach. Results Four themes emerged from the analytic process which described the children's understanding of mental illness, their relationship with their parents, their coping strategies and their social connections. Implications for Practice Mental health nurses need to recognize the psychosocial needs of children, and to acknowledge, the wider impact mental illness has of the family.
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Affiliation(s)
- Rumi Yamamoto
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
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18
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Riebschleger J, Grové C, Cavanaugh D, Costello S. Mental Health Literacy Content for Children of Parents with a Mental Illness: Thematic Analysis of a Literature Review. Brain Sci 2017; 7:E141. [PMID: 29072587 PMCID: PMC5704148 DOI: 10.3390/brainsci7110141] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022] Open
Abstract
Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children's MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children.
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Affiliation(s)
- Joanne Riebschleger
- School of Social Work, Michigan State University, 655 Auditorium Rd., East Lansing, MI 48824-1118, USA.
| | - Christine Grové
- Faculty of Education, Monash University, 57 Scenic Blvd., Clayton, VIC 3800, Australia.
| | - Daniel Cavanaugh
- School of Social Work, Michigan State University, 655 Auditorium Rd., East Lansing, MI 48824-1118, USA.
| | - Shane Costello
- Faculty of Education, Monash University, 57 Scenic Blvd., Clayton, VIC 3800, Australia.
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19
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Wahl P, Bruland D, Bauer U, Okan O, Lenz A. What are the family needs when a parent has mental health problems? Evidence from a systematic literature review. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2017; 30:54-66. [DOI: 10.1111/jcap.12171] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 04/06/2017] [Accepted: 04/12/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Patricia Wahl
- Institute for Health Research and Social Psychiatry; Catholic University of Applied Sciences North Rhine-Westphalia; Paderborn Germany
| | - Dirk Bruland
- Centre for Prevention and Intervention in Childhood and Adolescence; Bielefeld University; Bielefeld Germany
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence; Bielefeld University; Bielefeld Germany
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence; Bielefeld University; Bielefeld Germany
| | - Albert Lenz
- Institute for Health Research and Social Psychiatry; Catholic University of Applied Sciences North Rhine-Westphalia; Paderborn Germany
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20
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Tabak I, Zabłocka-Żytka L, Ryan P, Poma SZ, Joronen K, Viganò G, Simpson W, Paavilainen E, Scherbaum N, Smith M, Dawson I. Needs, expectations and consequences for children growing up in a family where the parent has a mental illness. Int J Ment Health Nurs 2016; 25:319-29. [PMID: 27278508 DOI: 10.1111/inm.12194] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 08/06/2015] [Accepted: 09/22/2015] [Indexed: 11/30/2022]
Abstract
The lack of pan-European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parent's attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi-agency collaboration is necessary; schools should provide counselling and prevent stigma.
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Affiliation(s)
- Izabela Tabak
- Institute of Applied Psychology, Academy of Special Education.,Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | | | - Peter Ryan
- Department of Mental health, Social work and Interprofessional Learning, Middlesex University, London, England
| | | | - Katja Joronen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Giovanni Viganò
- Synergia - Social Research Institute and Department of Decision Sciences, Bocconi University, Milan, Italy
| | - Wendy Simpson
- School of Medicine, University of Dundee, Dundee, Scotland
| | - Eija Paavilainen
- School of Health Sciences, University of Tampere, Tampere, Finland.,EteläPohjanmaa Hospital District, Seinäjoki, Finland
| | - Norbert Scherbaum
- Department of Addiction Medicine and Addictive Behaviour, LVR Hospital Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - Martin Smith
- Department of Mental health, Social work and Interprofessional Learning, Middlesex University, London, England
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