This article outlines the development of practice standards for the adult mental health workforce for addressing the needs of families where a parent has a mental illness (FaPMI). The practice standards recommended here were formulated using a modified cooperative inquiry process with a group of senior clinical leaders in adult mental health services in Australia, following consultation with the available literature and policy documents. The aim of the project was to generate, align, and operationalize family-inclusive practice standards within the core activities of the adult mental health workforce and integrate into the continuum of care and recovery for service users who are parents of dependent children. As part of a modified Delphi method, the standards were also ranked by the senior clinical leaders to determine what they believe to be essential and recommended practices for the adult mental health workforce they manage. We argue that developing practice standards that provide practical and realistic expectations of the adult mental health service workforce enable services and workers to better adapt practice to respond to FaPMI.

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There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.

Parenting with mental illness is not uncommon and is often associated with a range of challenges for parents, children, and the family unit. Family-focussed practice involves the provision of services to the wider family system, including children. While family-focussed practice is important to consumers and their families, adult mental health practitioners do not routinely discuss parenting or children with their clients, nor work closely with the whole family. In the present study, we aimed to examine the characteristics of practitioners from Australian adult mental health services associated with family-focussed practices. Characteristics included sex, years of experience, location, and previous training in child and family-focussed practice. A total of 307 adult mental health practitioners from Victoria, Australia, responded to the Family Focused Mental Health Practice Questionnaire and a series of demographic items. The results indicated that particular practitioner characteristics predicted the delivery of family-focussed practice. Practitioner experience, sex, working in a rural location, and previous family- or child-related training were found to be important in the provision of family-focussed practice. More experienced, female, rurally-located, and well-trained practitioners undertake most family-focussed practice. These results suggest that training in family-focussed practice needs to be promoted, with considerations made for differing needs according to the characteristics of the adult mental health practitioner.

Summary This study explores the concept of family resilience where a parent has a mental illness. Eleven Australian adults who have grown up in a household with a parent who had a diagnosed mental illness participated in an in-depth interview. The interviews focused on the ways in which these families responded to challenges in everyday life, particularly related to parental mental illness. Findings Families developed resilience through processes such as shared humour or regular family rituals and routines. In some cases, open communication about mental illness enabled families to better cope when parents were unwell and to build a greater sense of family connectedness. However, data suggest that parental mental illness potentially creates stress and confusion for families and there are multiple social and cultural barriers that make it difficult for families to acknowledge and speak openly about mental illness. For participants, resilience tended to be about maintaining a balance between stress/distress and optimism and strength within their family. Applications The article highlights the importance of family context when describing resilience, and identifies specific clinical implications for working with families affected by parental mental illness.