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Allchin B, Albermann K, Blake-Holmes K, Gatsou L, Hine R, van Doesum K, Nicholson J. Sustaining efforts to improve family well-being with parents with mental ill health and substance (mis)use. Front Psychiatry 2024; 15:1376409. [PMID: 38596628 PMCID: PMC11003303 DOI: 10.3389/fpsyt.2024.1376409] [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: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Research conducted over the past 30 years has developed an extensive body of knowledge on families where parents experience mental ill health and/or substance (mis)use, and interventions that are effective in improving their outcomes. A more recent focus has also explored the importance and nuance of implementation. This perspective article reflects on the concept and practice of sustainability within this body of work and considers underlying assumptions in the field about the goal and direction of interventions that make clarity about sustainability difficult. We identify challenges for understanding sustainability, relating to how and who defines it, what is measured and the impact of context. We conclude by considering how we might be better able to plan and design for sustainability within this field.
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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
| | - Kurt Albermann
- Social Pediatric Center, Cantonal Hospital, Winterthur, Switzerland
| | - Kate Blake-Holmes
- School of Social Work, Faculty of Social Sciences, University of East Anglia, Norwich, United Kingdom
| | - Lina Gatsou
- Institute of Health, Health Policy and Social Care Research, De Montfort University, Leicester, United Kingdom
- Child and Adolescent Mental Health Services, Leicestershire Partnership NHS (National Health Service) Trust, Leicester, United Kingdom
| | - Rochelle Hine
- Monash Rural Health, Monash University, Warragul, VIC, Australia
| | - Karin van Doesum
- Department of Clinical Psychology, Radboud University Nijmegen, Nijmegen, Netherlands
- Community Mental Health Service, Department Impluz Prevention, Dimence-groep, Deventer, Netherlands
| | - Joanne Nicholson
- The Heller School, Institute for Behavioral Health, Brandeis University, Waltham, MA, United States
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Wiegand-Grefe S. Unterstützung für Kinder und Jugendliche mit psychisch erkrankten Eltern im „Children of mentally ill parents –network“. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-021-00565-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ZusammenfassungKinder psychisch kranker Eltern sind als Risikogruppe für die Entwicklung eigener Auffälligkeiten bekannt. Gleichwohl weisen viele Unterstützungsangebote einen befristeten Projektcharakter auf, und es ist noch keine familienorientierte Regelversorgung für Kinder und Jugendliche mit psychisch erkrankten Eltern in Deutschland etabliert. Am Beispiel des Verbunds „Children of mentally ill parents – network“ (CHIMPS-NET) wird dargestellt, wie sich neue Versorgungsformen mit den Möglichkeiten des Innovationsfonds des Gemeinsamen Bundesausschusses (GB-A) in die Versorgung implementieren lassen. Das systematische Implementierungsmodell des Verbunds, basierend auf Arbeiten aus Australien und Norwegen, wird vorgestellt. Nach der Implementierung und bei erfolgreicher Evaluation ist eine Übernahme der bedarfsorientierten, familienorientierten Versorgungsformen des Verbunds in die regelhafte Versorgung geplant.
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Laser C, Modarressi A, Skogøy BE, Reupert A, Daubmann A, Höller A, Zapf A, Pawils S, Taubner S, Winter S, Maybery D, Wiegand-Grefe S. Clinical Implementation and Evaluation of Three Implementation Interventions for a Family-Oriented Care for Children of Mentally Ill Parents (ci-chimps): Study Protocol for a Randomized Controlled Multicenter Trial. Front Psychiatry 2022; 13:823186. [PMID: 35295776 PMCID: PMC8919324 DOI: 10.3389/fpsyt.2022.823186] [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: 11/26/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Germany, approximately three million children under the age of eighteen have a mentally ill parent. These children are at an increased risk of developing a mental illness themselves (1) as well as a physical illness (2). While research has identified numerous evidence-based family-oriented interventions, little is known about how to implement such interventions effectively and efficiently in clinical practice in Germany. This implementation study (ci-chimps) evaluates three clinical implementation projects with three different implementation interventions for the optimal implementation of the tailored family-oriented preventive and therapeutic interventions in the CHIMPS-NET (children of mentally ill parents-research network) with an implementation model for children of mentally ill parents. METHODS A two-group randomized controlled multicenter trial will examine changes in family-oriented practice and aspects of implementation at baseline as well as at 12- and 24-months follow-up. The CHIMPS-Network consists of 20 clinical centers. The centers in the intervention group receive the support of all of the three implementation interventions: (1) optimal pathways to care, (2) education and a training program for professionals, and (3) systematic screening for children. The centers in the control group do not receive this specific implementation support. DISCUSSION While we know that children of mentally ill parents are an important target group to be addressed by preventive and therapeutic interventions, there is often a lack of structured implementation of family-oriented interventions in clinical practice in Germany. Using a randomized controlled multicenter trial design with a large and wide-ranging sample (clinics for adult psychiatry and clinics for child and adolescent psychiatry, university clinics and clinics at the real health care) will provide a robust understanding of implementing family-oriented changes in German clinical practice. TRIAL REGISTRATION The CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27, the Clinical Trials registration is in review process.
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Affiliation(s)
- Carolin Laser
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Modarressi
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Bjørg Eva Skogøy
- Nordland Hospital Trust, Nordland Research Institute, Bodø, Norway
| | - Andrea Reupert
- Krongold Clinic, Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandra Höller
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Zapf
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Pawils
- Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Svenja Taubner
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Sibylle Winter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Berlin, Berlin, Germany
| | - Darryl Maybery
- Department of Rural Health, Monash University, Clayton, VIC, Australia
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Allchin B, O'Hanlon B, Weimand BM, Boyer F, Cripps G, Gill L, Paisley B, Pietsch S, Wynne B, Goodyear M. An explanatory model of factors enabling sustainability of let's talk in an adult mental health service: a participatory case study. Int J Ment Health Syst 2020; 14:48. [PMID: 32670399 PMCID: PMC7346490 DOI: 10.1186/s13033-020-00380-9] [Citation(s) in RCA: 6] [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: 01/22/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background While effective interventions have been developed to support families where a parent has a mental illness in Adult Mental Health Services, embedding and sustaining them is challenging resulting in families not having access to support. This study developed an explanatory model of influencers that had enabled sustainability of the Let’s Talk intervention in one service. Methods A participatory case study was used to build an explanatory model of sustainability at the service using theoretical frameworks. Qualitative and quantitative data was collected about practitioner’s practice and the organisation’s implementation process and capacity to support practice. A local research group worked with the researcher using a transforming data approach through description, analysis and interpretation. Results Influencers were grouped into four major categories: (1) External social, political and financial context, (2) Resources, (3) Prior organisational capacity and (4) Sustainability Factors. The last category, Sustainability factors, was divided into three subcategories: (4.1)Practitioner (4.2) Organisation and (4.3) Parent-Client. These categories form part of an explanatory model for the key influencers of continued practitioner practice and organisational capacity to support practice. Conclusions and implications for practice In this case study, the pre-existing organisational context along with practitioner, organisation and parent-client factors operated together to influence sustainability. The results suggest that sustainability is more likely to be supported by both linking Let’s Talk to existing organisational identity, capacity, structures and relationships and by supporting mutual adaptations to improve the fit. Additionally, by understanding that setbacks are common and ongoing adjustments are needed, implementers are able to have realistic expectations of sustainability.
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Affiliation(s)
- Becca Allchin
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC Australia.,Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brendan O'Hanlon
- The Bouverie Centre, La Trobe University, Melbourne, VIC Australia
| | - Bente M Weimand
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Fran Boyer
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Georgia Cripps
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Lisa Gill
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brooke Paisley
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Sian Pietsch
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Brad Wynne
- Eastern Health Mental Health Program, Box Hill, VIC Australia
| | - Melinda Goodyear
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC Australia.,Emerging Minds, Hilton, SA Australia
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Roslan AA, Mohamad SB, Tayyab S. Docking Evaluation of the Interaction Between Green Tea Active Ingredient, l-Theanine and Human Serum Albumin. NATIONAL ACADEMY SCIENCE LETTERS 2020. [DOI: 10.1007/s40009-020-00949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Reupert A, Bartholomew C, Cuff R, Foster K, Matar J, Maybery DJ, Pettenuzzo L. An Online Intervention to Promote Mental Health and Wellbeing for Young Adults Whose Parents Have Mental Illness and/or Substance Use Problems: Theoretical Basis and Intervention Description. Front Psychiatry 2019; 10:59. [PMID: 30828308 PMCID: PMC6384231 DOI: 10.3389/fpsyt.2019.00059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
The transition to adulthood can be a vulnerable period for certain population groups. In particular, young adults aged 18-25 years who have a parent with mental illness and/or substance use problems face increased risks to their mental health compared to same aged peers. Yet these young adults may not have access to age-appropriate, targeted interventions, nor engage with traditional face-to-face health services. To support this vulnerable group, services need to engage with them in environments where they are likely to seek help, such as the Internet. This paper describes the risk mechanisms for this group of young adults, and the theoretical and empirical basis, aims, features and content of a tailored online group intervention; mi.spot (mental illness: supportive, preventative, online, targeted). The participatory approach employed to design the intervention is described. This involved working collaboratively with stakeholders (i.e., young adults, clinicians, researchers and website developers). Implementation considerations and future research priorities for an online approach targeting this group of young adults conclude the paper.
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Affiliation(s)
- Andrea Reupert
- Faculty of Education, Krongold Clinic, Monash University Melbourne, VIC, Australia
| | - Catherine Bartholomew
- Wellways Australia Incorporating Australian HealthCall Group Melbourne, VIC, Australia
| | - Rose Cuff
- The Bouverie Centre Melbourne, VIC, Australia
| | - Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University Melbourne, VIC, Australia.,NorthWestern Mental Health Melbourne, VIC, Australia
| | - Jodie Matar
- Faculty of Education, Krongold Clinic, Monash University Melbourne, VIC, Australia
| | - Darryl J Maybery
- Department of Rural Health, Monash University Clayton, VIC, Australia
| | - Laura Pettenuzzo
- Faculty of Education, Krongold Clinic, Monash University Melbourne, VIC, Australia
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Fritz L, Domin S, Yang J, Thies A, Stolle M, Petermann F, Fricke C. Behandlung psychisch erkrankter Eltern: das Gruppenprogramm SEEK. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0297-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martinsen EH, Weimand BM, Pedersen R, Norvoll R. The silent world of young next of kin in mental healthcare. Nurs Ethics 2017; 26:212-223. [PMID: 29281928 DOI: 10.1177/0969733017694498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Young next of kin to patients with mental health problems are faced with many challenges. It is important to focus on the special needs of children and adolescents as next of kin to ensure their welfare and prevent harm. RESEARCH QUESTIONS: We aimed to investigate young next of kin's need for information and involvement, to examine the ways they cope with situations involving coercion related to the treatment of their relative, and to identify ethical challenges. RESEARCH DESIGN: We conducted a qualitative study based on semi-structured, individual interviews. PARTICIPANTS AND RESEARCH CONTEXT: Seven young next of kin aged 14-22 years participated in the study. The informants were recruited from a regional hospital trust in Norway. ETHICAL CONSIDERATIONS: The study was approved by the National Data Protection Official for Research and based upon informed consent and confidentiality. FINDINGS: The adolescents wanted more information and described a need for increased interaction with their sick relative at the hospital. They struggled to keep their relationship with their relative intact, and they described communication problems in the family. Coercive treatment was perceived in a negative way. DISCUSSION: The study finds that there are ethical challenges at stake for young next of kin and their families other than those that are often emphasized by traditional healthcare, which often focuses on the individual patient's rights. These challenges are related to the young next of kin's needs for interconnectedness and for the preservation of relationships as well as challenges related to family communication and the need for information. CONCLUSION: The study finds a need for more family-oriented perspectives in both mental healthcare practices and healthcare ethics.
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Affiliation(s)
| | | | | | - Reidun Norvoll
- University of Oslo, Norway; Oslo and Akershus University College of Applied Sciences, Norway
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Apter G, Bobin A, Genet MC, Gratier M, Devouche E. Update on Mental Health of Infants and Children of Parents Affected With Mental Health Issues. Curr Psychiatry Rep 2017; 19:72. [PMID: 28831672 DOI: 10.1007/s11920-017-0820-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This paper highlights the most recent publications, in the field of psychiatry, on offspring of patients with psychiatric illnesses such as schizophrenia and bipolar disorder, and then summarizes what we know about the progeny of adults with mood disorders, the most prevalent of parental disorders. Studies examining personality disorders and contextual factors such as stress and trauma are examined with a focus on the crucial question of development and attachment status in children. Findings converge to reveal that offspring of parents (generally mothers) with most major psychiatric disorders present a higher risk for all mental disorders, and a wide range of disorders are also found in children, adolescent, and finally adult offspring of mothers with mood and anxiety disorders. Developmental psychopathology and infant and child psychiatry have focused on early relationship formation through social interaction and attachment patterns as pathways affected by vulnerability or resilience factors. First year of life longitudinal studies following mothers and infants has shown that maternal psychopathology is positively correlated with higher risk of attachment issues. It would seem that pathology appears when adaptation to real-life contexts becomes difficult in association with an accumulation of negative individual characteristics and environmental circumstances. We suggest that in order to move forward psychiatry should embrace a developmental cascade model, which posits a cumulative pathway for the emergence of psychopathology in the developing child. We propose that we have sufficient knowledge today to start implementing multilevel approaches to enhance the health and mental health of the next generation.
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Affiliation(s)
- Gisèle Apter
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France.
| | - Anne Bobin
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France
| | - Marie-Camille Genet
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
| | - Maya Gratier
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France
| | - Emmanuel Devouche
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Paris Descartes University, 71 avenue Edouard Vaillant, 92774, Boulogne-Billancourt Cedex, France
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