A qualitative exploration of stakeholders’ perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent

Abstract

BackgroundWhile many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent.MethodsFor this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis.ResultsParticipants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers.ConclusionIn short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.

“Finding light in the darkness”: exploring comedy as an intervention for eating disorder recovery

“…Furthermore, some participants also reported elements of clinical recovery, such as weight gain and improvements in quality of life. Thus, these findings replicate the growing evidence that PR and clinical recovery can be mutually facilitatory (Dubreucq et al , 2023). In this respect, the stand-up comedy course was designed to complement, not replace, traditional therapies and clinical approaches.…”

‘Finding a Relationship’ Conversations Between Mental Health and Social Care Staff, and Service Users

“…[17] -Everything you do has to be mostly approved or encouraged by them, so even if you have no personal barriers, without management support, it is not something that can be done. -more training in this regard [41] -they are very daughting so would i feel staff would like support arund this [33] -It could appear as though single staff members are flirting if this conversation was not done effectively [56] Lack of policy -Relationship goals not being part of routine assessment [P46] -starting up relationship problems in a therapeutic session [P2] -I understand their importance but residents do want someone in their life romantically and I want residents to feel happy it would be helpful if there were more clear guidelines on how we can support a client with this [37] Lack of time and resources -Even though this is important, it is difficult to address these issues in the time slot given to me to see the service user. I also do not have access to resources or skills to be able to help someone like that.…”

“…[52] Skills building (indirect) -By working on the individual to build skills mentioned above that‚Äôs as far as we should go [13] -Maybe some skills support around going on dates e.g conversationa dn social interaction [33] -Support with social skills, ensuring the person is being treated for symptoms that may affect confidence etc, or functioning, addressing sexual side effects or symptoms as well. Improving self-esteem, [48] Needing more knowledge in this area -more knowledge around this [27] -I don't know, and probably should [30] -Training [40] -No [41] -Unsure [56] Organisational change -improving policies and access to material to meet needs [54] Should not be part of MHP role -I do not think it should be part of my role [9] Step 2: Creating overarching themes for each of seven qualitative questions.…”

“…[17] - I understand their importance but residents do want someone in their life romantically and I want residents to feel happy it would be helpful if there were more clear guidelines on how we can support a client with this [37] - Everything you do has to be mostly approved or encouraged by them, so even if you have no personal barriers, without management support, it is not something that can be done. [7] Staff need training - more training in this regard [41] - they are very daughting so would i feel staff would like support arund this [33] Staff may get it wrong - It could appear as though single staff members are flirting if this conversation was not done effectively [56] Important issue - it is very important that this topic is spoken about, this is huge in peoples lives [30] - It seems a shame because romantic relationships are so important and could be the changing factor in someone’s loneliness, suicidality and wellbeing. [31] - This is a very important area, and I welcome a better understanding of how to navigate these issues and offer a more holistic approach to clients [48] Client needs to be stable before engaging in relationship - Need to focus on own mental health and wellbeing and care of a baby.…”

Toward recovery-oriented perinatal healthcare: A participatory qualitative exploration of persons with lived experience and health providers’ views and experiences

“…Competing priorities between PLEs and HPs are also observed in the literature about recovery in SMI [20] and concerned in particular women with SMI, for example, anticipated challenges during the peripartum in PLEs versus risk management in HPs. This aligns with recent qualitative research comparing the experience of (future) parents with SMI and MHPs [21].…”