A survey of programs for parents with mental illness and their families: Identifying common elements to build the evidence base (original) (raw)
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The Journal of Behavioral Health Services & Research, 2007
The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their children.
Advances in Mental Health, 2019
Objectives: This paper outlines the findings from the first stage of a research programme called PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and Children). This programme aims to identify, help implement and evaluate family-focused interventions for families where a parent has a mental illness, and promote a 'think family' service delivery agenda in the Republic of Ireland (RoI). Methods: An initial scoping study was undertaken to: (1) assess the nature and extent of family-focused practice (FFP) in adult (N = 114) and child (N = 69) mental health services in the RoI; (2) review the international literature; and (3) undertake site/service visits to assess readiness for, and inform the implementation of, FFP. Results: A national Expression of Interest (EoI) call led to 37 written submissions (20% response rate) plus six further requests for involvement from interested community services. Fifteen sites/ services (35%) were included in the research following critical appraisal and consultation. FFP across services/sites was smallscale or non-existent. Following a literature review and other strategic/resource considerations, all sites were invited to deliver the Family Talk (FT) intervention; 12 agreed to do so; three sites will deliver other programmes. A series of activities was undertaken by the research team to support early implementation. Discussion: This first phase of the research provides a critical starting point for promoting, and assessing the development of, FFP in mental health services in the RoI. Some useful generalisable lessons are also identified in terms of building capacity and beginning to change practice in this field.
A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective
Frontiers in Psychiatry, 2021
Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise "gap," very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings. Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework. Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change). Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a "think family" infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.
Frontiers in Psychiatry
Background: Children of mentally ill parents have a three to seven times higher risk of developing mental disorders compared to the general population. For this high-risk group, specialized prevention and intervention programs have already been developed. However, there has been insufficient sytematic evaluation to date. Moreover, effectiveness and the cost-effectiveness data of the respective programs until today is very scarce and at the same time constitutes the pre-condition for the program's implementation into regular health care.Methods: The study consists of a two-group randomized controlled multicenter trial conducted at seven study sites throughout Germany and Switzerland. Participants are families with mentally ill parents and their children aged from 3 to 19 years. The intervention comprises 6 to 8 semi-structured sessions over a period of about 6 months. Topics discussed in the intervention include parental mental illness, coping, family relations and social support...
Intervention Programs for Children of Parents with a Mental Illness: A Critical Review
International Journal of Mental Health Promotion, 2006
Keywords: children; parental mental illness; intervention ipants would greatly enhance assessment of the benefit of interventions over time. Greater inter-sectoral collaboration is also required in order to determine which areas should be the main focus for this population group in order to improve their overall long-term well-being.