The Family Talk Programme in Ireland: A Qualitative Analysis of the Experiences of Families With Parental Mental Illness (original) (raw)
Related papers
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.
International Journal of Mental Health Systems
Background: Previous research has shown a link between parental mental illness and adverse development in their offspring. In Norway, it is mandatory for health professionals to identify if patients in adult mental health services have children, and subsequently to provide support for the children. An important tool to detect if families are affected by parental mental illness and to assess if there is a need for further intervention is the Family Assessment Conversation. Family Assessment Conversations is potentially a powerful tool for communication with families affected by parental mental illness because it facilitates early identification of children at risk of various adversities due to the family situation. Additionally the tool may initiate processes that enable children and parents to cope with the situation when a parent becomes seriously ill. Little is however known about how the mental health practitioners use the family assessment form in conversations, and to what extent they record relevant information in the electronic patient journals. Methods: The main aim of the study was to provide information about the existing practice within mental health services for adults in terms of parental mental illness and family assessment conversations. The project is a retrospective journal review. The data base consists of relevant journal data from 734 patients aged 20-60 years admitted. In total, 159 recordings of family assessment conversations were discovered. Results: The main result in this study was that many of the questions in the family assessment form lacked documented responses and assessments from the healthcare professionals. Only 17% of the participants had been assessed with the total family assessment form. Additionally, there was a lack of documentation about whether or not the children had been informed in a large proportion of the assessment forms (31%). A total of 55% say that the child has not been informed. This implies that there is still a long way to go in order to make sure that children of parents with a mental illness are given relevant information and support. Conclusions: The documentation and family assessment frequency is low and reflects the challenges healthcare professionals and patient experience when the child's situation becomes the topic of assessment. There is a need to further investigate the challenges of changing the mental health systems to incorporate the children and families of patients. More research should promote knowledge on what may facilitate family assessment dialogue.
2014
Since the government commissioned the Crossing Bridges programme in 1998 (Falcov, 1998) and through legislation and a number of government policies and initiatives since, there has been emphasis on addressing the needs of families where there are parental mental health problems. Furthermore, there is a fast-growing body of research pointing to the needs of these families. However, service structures, development and provision have lagged behind. Most often parents with mental health difficulties have access to services addressing their individual mental health needs while their needs as parents and the needs of their children remain largely invisible. One such need that has been highlighted repeatedly in the literature is the need for children to have information about and make sense of their parent’s mental health difficulties. Given the lack of services to respond to this need, it is most often left to the parent to make decisions about and respond to their child’s search for unde...
The Patient’s Voice as a Parent in Mental Health Care: A Qualitative Study
International Journal of Environmental Research and Public Health
Objective: This study is an evaluation of patients in mental health care who have undertaken treatment with an integrated family approach. The treatment focuses on the mental disorders of patients, their role as parents, the development of their young children, and family relationships. The treatment was conducted by professionals from an adult and a child mental health service in the Netherlands. The aim of the study was to identify the key elements and processes of this approach in order to develop a theoretical model. Background: Parental mental disorders have an impact on parenting and child development. To stop detrimental cascade effects and prevent parents and children from being caught up in the intergenerational transmission of psychopathology, a family approach in mental health care is needed. Methods: A qualitative design was adopted using thematic analysis. Data were collected through 18 interviews with patients. The themes in the interviews were which outcomes the patie...
A parent’s perspective of the bidirectional impact of mental illness in families
Clinical Nursing Studies, 2018
Objective: Recent research has found over 70% of children attending a mental health service also have a parent with a mental illness. Research on the impact of mental illness in families focuses primarily on how parental mental illness impacts on children. What is not understood is the experience of parents and children where both have a mental illness. The aim of this study was to investigate the experiences of parents where both a child and a parent have a mental illness.Methods: Thirty-seven parents were interviewed using a narrative design to determine their personal and family experiences. Interviews were analyzed using interpretative phenomenological analysis with a number of themes highlighted.Results: Themes particular to this family type were: impact of parental mental illness; specific strategies; bidirectional impacts of mental illness; and intergenerational factors. Also raised were supports parents would have liked. From the narrative of these parents the challenges of ...
Mental Health Matters: a Multi-Family Framework for Mental Health Intervention
Journal of Family …, 2002
This paper reports a collaborative project, developed jointly by a group of community mental health workers in association with a specialist team commissioned to initiate family work throughout a central London mental health provider. The result of this project 'The 'Mental Health ...