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Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).ORCID iD: 0000-0001-5265-8590
Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
Department of Clinical Sciences Lund, Child and Adolescent Psychiatry , Lund University , Lund , Sweden; Department of Psychiatry and Neurochemistry , Gillberg Neuropsychiatry Centre, University of Gothenburg , Gothenburg , Sweden.
Department of Psychology , Lund University , Lund , Sweden; Department of Clinical and Experimental Medicine , Barnafrid - National Competence Centre in Child Abuse, Linköping University , Linköping , Sweden.
2018 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 31-38Article in journal (Refereed)
Abstract [en]

Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

Place, publisher, year, edition, pages
Taylor & Francis, 2018. Vol. 72, no 1, p. 31-38
Keywords [en]
Parental mental illness, children, child-focused intervention, interagency collaboration, psychiatric services
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-15159DOI: 10.1080/08039488.2017.1377287ISI: 000417846400005PubMedID: 28933586Scopus ID: 2-s2.0-85029677558Local ID: 25837OAI: oai:DiVA.org:mau-15159DiVA, id: diva2:1418680
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-06-18Bibliographically approved
In thesis
1. Families with parental mental illness: supporting children in psychiatric and social services
Open this publication in new window or tab >>Families with parental mental illness: supporting children in psychiatric and social services
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Children living with a parent with a mental illness can face difficulties. Parentalmental illness may influence the parents’ ability to cope with family life, where theparents’ awareness of their illness plays an important role. Family interventionsprovided by psychiatric and children’s social care services can be a way to supportthese children, making them feel less burdened, and improving the relationshipswithin the family. The aim of this thesis was to illuminate how children infamilies with a parent with a mental illness are supported in psychiatric and socialservices, especially by means of family interventions, and how families experiencethe support. Study I explored how professionals in adult psychiatric outpatient servicesdeal with children and families when a parent has a mental illness. The findingsshowed that professionals balanced between establishing, and maintaining,a relationship with the patient and fulfilling the legal obligations towards thepatient’s children. Asking the patient about their children could be experiencedas intrusive, and involving the patient’s family in the treatment could be seen asa dilemma, in relation to the patient. Efforts were made to enhance the familyperspective, and when the patient’s family and children joined the treatment thisrequired flexibility from the professional. Study II examined how professionals in children’s social care services experienceworking with children and families when a parent has a mental illness. The socialworkers’ objective was to identify the needs of the children. No specific attentionwas paid to families with parental mental illness; they were supported in thesame way as other families. When the parental mental illness became difficult tohandle both for the parent and the social worker, the latter had to set the child’sneeds aside in order to support the parent. Interagency collaboration seemed likea successful way to support these families, but difficult to achieve. Study III investigated if patients in psychiatric services that are also parentsof underage children, are provided with child-focused interventions or involvedin interagency collaboration between psychiatric and social services and childand adolescent psychiatry. The findings showed that only 12.9% of the patientsregistered as parents in Psykiatri Skåne had registered children under the ageof 18 years. One fourth of these patients had been provided with child-focusedinterventions in psychiatric service, and 13% of them were involved in interagencycollaboration. If a patient received child-focused interventions from the psychiatricservices, the likelihood of being involved in interagency collaboration was fivetimes greater as compared to patients receiving no child-focused intervention.Study IV explored how parents and their underage children who were supportedwith family interventions experienced these interventions. The results showedthat parents experiencing mental illness were eager to find support in explainingto and talking with their children about their mental illness, although the supportfrom the psychiatric service varied. Both children and other family membersappreciated being invited to family interventions. After such an intervention, theyexperienced the atmosphere in the family as less strained and found it easier tocommunicate with each other about difficulties. Unfortunately, the participatingpartners felt that they were left without support specifically targeted at them. The thesis showed that there is a gap between how professionals deal withquestions concerning these families and their support, and the parents’ and thefamilies’ needs to receive support in handling the parental mental illness in thefamily. The psychiatric and social services need to expand their approach andwork with the whole family, in order to meet the needs of the child and otherfamily members involved.

Place, publisher, year, edition, pages
Malmö university, Faculty of Health and Society, 2017. p. 81
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 4
Keywords
children of parents with mental illness, professionals, psychiatric service
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:mau:diva-7363 (URN)10.24834/2043/22318 (DOI)22318 (Local ID)9789171047649 (ISBN)9789171047656 (ISBN)22318 (Archive number)22318 (OAI)
Note

Paper III and IV in dissertation as manuscripts, and not included in the fulltext online.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-18Bibliographically approved

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Afzelius, MariaÖstman, Margareta

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