Adult mental health service engagement with patients who are parents: Evidence from 15 English mental health trusts

Abstract

Objectives Ascertaining whether mental health service users have children is a clinical requirement in UK health services, and acknowledgement of a patient’s parenting role is necessary to enable engagement with their parenting experience and to facilitate support, both of which are associated with improved outcomes for the parent–child dyad. The current study sought to investigate the practice of mental health practitioners working in UK adult mental health services with regard to the following: Ascertaining whether patients have children; engagement with the parenting role of patients; engagement with the construct of ‘think patient as parent’. Methods Self‐report online/paper survey of 1105 multi‐disciplinary adult mental health practitioners working in 15 mental health trusts in England. Results A quarter of adult mental health practitioners did not routinely ascertain whether patients had dependent children. Less than half of practitioners engaged with the parenting experience or the potential impact of parental mental health on children. Conclusions The parenting role of patients is not routinely captured by large numbers of practitioners working in adult mental health settings. This is despite it being a mandatory requirement and an integral component of the systematic care of the adult, and preventative care for the offspring. Failure to engage with patients who are parents is a missed opportunity with profound downstream public health implications. The practice deficits identified in this study should be viewed in terms of broader structural failures to address the intergenerational transmission of poor mental health. Practitioner points Some parents who have mental health difficulties may struggle to provide appropriate and effective care to their children. The parenting role can also exacerbate mental health difficulties. Identification of dependent children is a mandatory component of adult mental health clinical practice and is necessary to understand a parent’s support needs. A quarter of adult mental health practitioners are failing to do so. A missed opportunity to engage with the support needs of the parent–child dyad.

Obstacles and facilitators to communicating with children about their parents’ mental illness: a qualitative study in a sub-district of Mpumalanga, South Africa

“…HCPs’ perceived lack of knowledge and skills around mental illness is likely to impede their confidence to raise the issue of children with their patients, or indeed offer parents a rationale for communication with children and concrete advice about how to do this. This is consistent with previous research in Europe [ 34 , 44 , 45 ]. The development of a step-by-step guide for HCPs may provide a helpful framework to structure these potentially sensitive conversations with patients around disclosure of their illness to children [ 18 , 46 ].…”

“…The development of a step-by-step guide for HCPs may provide a helpful framework to structure these potentially sensitive conversations with patients around disclosure of their illness to children [ 18 , 46 ]. However, it is vital to acknowledge that personal and professional capacity development of knowledge and skills about family-focused practice is unlikely to be translated into meaningful, sustainable progress without broader systemic changes [ 44 , 47 ]. The success of such initiatives would require organisational commitments such as specific policies, resource allocation and support from healthcare management [ 48 ].…”

A Sustainability Model for Family-Focused Practice in Adult Mental Health Services

“…Inadequate family-focused training has been identified at the practitioner level, as has a lack of the necessary knowledge, skills and confidence in family-focused practice, limiting their ability to identify and support the parenting role of their clients while also holding their clients' children in mind ( 31 – 39 ). These barriers are reinforced by organizational contexts that do not routinely identify their client's parental status ( 29 , 40 – 42 ) and are funded to work with individuals within a biomedical professional-centered approach that is focused on treatment in acute episodic care ( 10 , 11 , 20 , 43 ). The formalized, centralized organizational structures common in AMHS are also known to foster the continuation of existing cultures, making innovation and change more difficult ( 44 ).…”

Workplace Support for Mental Health Workers Who Are Parents: A Feasibility Study

“…A secondary goal of the study was to explore whether the staff who took part increased in their use of parent-focused practice at work—i.e., thought about the parenting role of their clients. Parent-focused practice was measured using a 26-item scale developed by the research team for administration in a previous research project ( Dunn et al, 2021 ). It comprised six items assessing the extent to which practitioners engage with the parenting role of patients in the service; nine items assessing practitioners’ attitudes and beliefs related to supporting “patient as parent” and 11 items assessing barriers to practice.…”