Supporting children who have a parent with a mental illness in Tyrol: A situational analysis for informing co-development and implementation of practice changes (original) (raw)
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Frontiers in Psychiatry, 2019
- scoping, 4) co-development, 5) implementation, 6) evaluating the practice approaches, and 7) knowledge dissemination. "Scoping" will involve exploring the existing evidence, practice, and current state of identification and collaborative care in Tyrol, Austria. "Co-development" involves the co-design of practice approaches to identify and support children in partnership with key stakeholders and service providers working in Tyrol. The "implementation" of practice approaches will be based on the results of the co-development phase and will involve working with organizations to develop support strategies that draw on known organizational drivers from the field of implementation science to support the rollout of the practice approaches. In "Evaluation" we will follow principles of a realist approach; this includes developing program theories and logic models for the practice approaches. Those will set out the outcomes hypothesized to achieve and the processes that are expected to lead to those changes. This will refer to changes in children, parents, and practitioners. We expect that the main focus will be on measuring child quality of life and mental health outcomes, and outcomes that are on the path to those (such as social support needs, resilience, mental health literacy, stigma, and help-seeking behavior) as well as costs. The "child voice" WP focuses on children's perceptions and needs as the importance of "assent" and support of children to develop their own "voice" in health care is increasingly recognized within child health research. The "dissemination" step focuses on reaching a broad public audience of different stakeholders, researchers, and families involved. Discussion: The research project aims to directly improve identification and support of vulnerable children across selected regions in Tyrol, Austria, and by doing so, improve the health and well-being of future generations, through breaking the cycle of intergenerational transfer of adverse childhood experiences.
BMJ open, 2012
According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiatry of the University Hospital of Northern Norway. The project is designed to evaluate the process of changes in clinical practice due to the implementation of two interventions. The interventions to be implemented are a standardised Family Assessment Form and the intervention called Child Talks. The family assessment form is an intervention to identify children of mentally ill parents and their needs. The intervention Child Talks is a health-promoting and preventive intervention where the mental health workers talk with the family about the situation of the children and their needs. There are two groups of participants in this study: (1) mental health workers in the clinic (N...
Working Together for Change for Children of Parents With Mental Illness and Their Families
2009
This narrative weaves the author s twenty-three-year social work journey with her involvement in research, projects, publications, and policy development in Australia concerning children of parents with mental illness and their families—a group described previously as "invisible. " The author acknowledges the part that advocates worldwide have played in achieving significant increases in knowledge and understanding, as well as commitment from governments, to fund state and national initiatives in Australia. (Case studies are based on actual events, with names changed and identifying information removed.)
Support for children and families living with a family member with mental illness
2016
The prevalence of mental illness means that many children and adults may be affected at some point in their lives, which, in turn, means that many people may live with a family member who has a mental illness. This case study investigated the support available to, and accessed by, children and families living with a family member with mental illness, in the context of related mental health and family support policies. The thesis was informed by theories of social support, stigma, and recognition, within an ecosystems framework. This exploratory study aimed to understand the lived experience of parents, carers, and family members concerning the sources of the support they received, and their perceptions of factors that facilitated or impeded access to support. The perceptions of family workers were also investigated. Data was gathered from four sources: documents setting out policies concerning mental health and family support; in-depth interviews with family members; focus groups with family workers; and responses by parents and carers to standardised questionnaires. The qualitative nature of the study involved prolonged engagement with parent and carer participants, with two interviews being conducted with them over time. Analysis of the mental health policies and family support policies at the federal and state (New South Wales) levels highlighted the shift to economic rationalist approaches which have placed increasing responsibility on those who live with someone with mental illness. Analysis also highlighted the complex bureaucracy that families and practitioners needed to negotiate. Analysis of interviews showed that participants turned first to their family for support, with family workers and other professionals also perceived as supportive. Participants who were mothers wanted to be seen, and strived to seen, as 'good' parents but worried about the child protection service taking their children. Family workers focused on strengths within families, and were perceived to be significant in the support they provided. xx This study contributes to an increased understanding of the influences of mental health and family support policies on service providers, and on families with children when a family member has a mental illness. It has also documented the lived experiences of mental illness of mothers, grandmothers and a foster carer, demonstrating their reliance on family, and friends, and awareness of their family needs. The study demonstrates the need for local, accessible community-based services with practitioners who can undertake home visits in a flexible and ongoing way that promotes family strengths and confidence. The methodology and findings of this study contribute to the fields of social work, family services, and mental health. Definitions of key terms Adult mental health service: Public mental health service provided for people aged 19-65 years who meet intake criteria. Brighter Futures is funded by the state government of New South Wales and delivered by nongovernment agencies. The program provides targeted support to vulnerable families with children under nine years. Carers in this study refers to people caring for people with a mental illness. Centrelink is part of the Federal Department of Human Services and is responsible for providing access to eligible individuals and families to social, health, and other payments and services, such as family allowances and pensions. Child and adolescent mental health service: Public mental health service provided for children and young people up to the age of 18 years who meet intake criteria. Child and family health nurses provide a primary health service to mothers in the preand perinatal period. In New South Wales, they are employed by Local Health Districts, such as Hunter New England LHD. Child and family health service is a service for children aged two to 12 years with multiple developmental concerns, who have been referred by another professional. The service is provided in community settings by Hunter New England Local Health District. Council of Australian Governments (COAG) comprises the federal government, and the governments of the six states and two mainland territories, and the Australian Local Government Association. COAG meets to debate and coordinate government activities. Commonwealth: The Commonwealth of Australia is a federal constitutional monarchy under a parliamentary democracy. Consumers refers to those who use health and social services. Department of Community Services (DoCS), Family and Community Services is a Government department in New South Wales which has legislative responsibility for the protection of children, which may include children being taken from their parents and or carers where neglect and or abuse has occurred. Prevention and early intervention services are funded for delivery through nongovernment agencies (see Brighter Futures above).
Frontiers in Psychiatry
Background: The main objective of this project is to create a research and intervention model to promote large-scale implementation and evaluations of generic very brief interventions for children of parents with mental disorders (COPMI). Feasible interventions for COPMI aged 0-18 years are highly needed, as this is a large high-risk group in society. Reducing behavioral problems and enhancing wellbeing for families with parents affected by any mental disorder are important preventive initiatives. One key prevention strategy is to reduce the risk and expression of psychopathology in children and to promote wellbeing. The present model protocol offers an intervention for children of parents with mental disorders internationally based on a model already implemented in the Netherlands and Norway. Methods: Participants will be parents receiving treatment in mental health services in participating countries and their minor children aged 6-18 years. Participants should be randomized into an intervention group or control group. Data should be retrieved from electronic patient journals (demographics, DSM 5/ICD-10, SCID, MINI) as well as from assessment measures administered at baseline and follow-up, including the KIDSCREEN-27, Strengths and Difficulties Questionnaire (SDQ), Parents' Evaluations of Developmental Status (PEDS), Parenting Sense of Competence (PSOC), Resilience Scale for Adolescence (READ), Guilt and Shame Questionnaire for Adolescents of Parents with Mental Illness (GSQ-APMI), Mental Health Literacy Scale, and Parent-Child Communication Scale. CLINICAL STUDY PROTOCOL A Model Protocol for Research and Intervention Reedtz et al.
Children of a parent with a mental illness: Perspectives on need
Advances in Mental Health, 2005
Being a child of a parent who has a mental illness involves considerable risk to the child's secure attachment and long-term mental health. Parental mental health concerns place children at a significantly greater risk of lower social, psychological and physical health than children in families not affected by mental illness. In this paper, previous research is extended by examining the needs of these children from the perspectives of children, parents and mental health and welfare professionals. The study involved qualitative and quantitative data collection from focus groups with children and parents, and a comparison of quantitative findings with mental health professionals. Similar responses from the children and parents included problems with major episodes (e.g. parent hospitalisation), issues regarding coping and the importance of sibling support. Parents also identified a number of different issues (e.g. external support) compared with children (e.g. the importance of friendships). A final component of the research undertook a quantitative comparison of seven core 'things that might help' children in the circumstance of their parent being hospitalised. The findings showed differences between parents and mental professionals but most significantly with children. The findings overall are discussed in relation to the needs of children whose parent has a mental illness and recommendations are made regarding policy and service provision.