A systems approach to enhance global efforts to implement family-focused mental health interventions

Abstract

This paper acknowledges progress over the last 20 years in addressing intergenerational risks to the mental health of children whose parents experience mental illness (COPMI-Children of Parents with a Mental Illness and FaPMI-Families Where a Parent Has a Mental Illness) and emphasises ongoing challenges to implement evidence informed family focused interventions. Challenges include variability in practice at individual, regional, and cross-national service system levels and the gap between implementation science and practice. This article begins to address this gap with descriptions of key systems approaches and implementation strategies from around the world to illustrate variability and common themes. A multifaceted, integrated systems approach is proposed as a way forward. Learnings and experience from initiatives, expertise and evidence targeting other vulnerable groups and successful change implementation will enhance existing (COPMI/FaPMI) efforts to facilitate systems change and improve the lives and futures of these children and families around the world.

Mental Health Professionals’ Perspectives of Family-focused Practice across Child and Adult Mental Health Settings: A Qualitative Synthesis

“…These views allude to professionals lacking a sense of shared expectations and outcomes and perhaps raises the question as to why professionals should invest in FFP. It is evident that the ongoing challenges to implement family-focused care have been widely acknowledged with a need for greater empirical evidence, policy and legislative support, leadership, and capacity (Falkov et al, 2016). This integrated approach is therefore likely to better inform stakeholders of the value of investing in the implementation of FFP.…”

Thinking families: A study of the characteristics of the workforce that delivers family‐focussed practice

“…Despite the promotion of family-focussed practice within mental health services in government policy across several countries, including Australia, Finland, Norway, Ireland, and Canada (Falkov et al 2015;Nicholson et al 2015), promoting the care of families where a parent has a mental illness remains a significant challenge for adult mental health services (Goodyear et al 2015a). Part of the issue is that while the benefits of family-focussed practice in mental health are well established (Goodyear et al 2015a;Hosman et al 2009;Reupert & Maybery 2007), significant translation to practice barriers exist in the adoption of evidence-based family interventions to different sectors (Dixon et al 2001;Goodyear et al 2015b;Kavanagh et al 1993;Lauritzen et al 2014Lauritzen et al , 2015.…”

Supporting children who have a parent with a mental illness in Tyrol: a situational analysis for informing co-development and implementation of practice changes

“…Interviewees represent all relevant sectors: healthcare (8), social care (6), educational (2) and the informal care sector (1) and within healthcare adult mental health (4) and child /adolescent mental health (1), as well as inpatient (2) and outpatient services (3). Secondly, we approached interviewees within service planning (2) and from the different types of service providing organisations (13). Among the latter, interviewees were identified as either actively working with families, parents or children.…”

“…These children have an increased likelikhood to experience additional adversities due to their family circumstances, which for some, may lead to negative long-term difficulties, in addition to substantial lifelong impacts for individuals, governments and the wider community [4,[7][8][9][10][11][12]. These childen often remain invisible to the community or professional services, with many barriers to early identification, especially in the (adult) mental health and social care settings [13][14][15]. Consequently, children's needs often remain unmet, and they may not have the opportunity to access support.…”