Developing an Australian-first recovery model for parents in Victorian mental health and family services: a study protocol for a randomised controlled trial

Abstract

BackgroundA considerable number of people with a mental illness are parents caring for dependent children. For those with a mental illness, parenting can provide a sense of competence, belonging, identity and hope and hence is well aligned to the concept of personal recovery. However, little research has focused on the recovery journey of those who are parents and have a mental illness. This randomised controlled trial aims to (i) evaluate the effectiveness of an intervention model of recovery for parents (Let’s Talk about Children) in three different mental health service sectors and (ii) examine the economic value of a larger roll out (longer term) of the parent recovery model.MethodsA two arm parallel randomised controlled trial will be used with participants, who are being treated for their mental illness in adult mental health, non-government community mental health or family welfare services. The study will involve 192 parents, who are considered by their treating practitioner to be sufficiently well to provide informed consent and participate in an intervention (Let’s Talk about Children) or control group (treatment as usual). Participant randomisation will occur at the level of the treating practitioner and will be based on whether the randomised practitioner is trained in the intervention. Outcomes are compared at pre, post intervention and six-month follow-up. Recovery, parenting and family functioning, and quality of life questionnaires will be used to measure parent wellbeing and the economic benefits of the intervention.DiscussionThis is the first randomised controlled trial to investigate the efficacy of a parenting intervention on recovery outcomes and the first to provide an economic evaluation of an intervention for parents with a mental illness. An implementation model is required to embed the intervention in different sectors.Trial registrationThe trial was retrospectively registered: ACTRN12616000460404 on the 8/4/2016.

Psychopathology and impairment of quality of life in offspring of psychiatric inpatients in southern Brazil: a preliminary study

“…The adequate identification of children at risk allows a quick referral for care. The possibility of intervention and follow-up of these children could reduce the suffering and psychiatric symptoms in children and adolescents, as shown by international strategies and studies like Preventive Basic Care Management (PBCM) [ 55 ], and Let’s Talk in Australia [ 57 ], which are programs that aim to identify if the children of patients with mental disorders situations need intervention and to promote well-being and quality of life. Screening and early intervention in children from high-risk psychopathology groups is a challenge that needs to be addressed.…”

Leadership perspectives on key elements influencing implementing a family‐focused intervention in mental health services

“…A four-year RCT of Let's Talk engaged three service sectors in Australia that commonly see parents diagnosed with a mental illness (Maybery et al, 2017). These included Adult Mental Health Services (AMHS) providing clinical services for adults diagnosed with severe mental illness, non-government agencies providing Mental Health Disability Support (MHDS) also described as psychiatric rehabilitation for adults with ongoing mental health issues, and Child and Family Support (CFS) who provide child-focused support to vulnerable families.…”

“…consolidated framework for implementation research (CFIR), implementation, leadership, let's talk about children, managerial support, parents diagnosed with a mental illness Children" (Let's Talk) as a recovery tool for parents diagnosed with a mental illness, as defined by DSM-5, by either a GP or mental health practitioner (Maybery et al, 2017). The trial involved building capacity within services to implement Let's Talk as part of their everyday work.…”

“…Let's Talk has been implemented in Europe, Asia and Australia and uses a health promotive approach to address known risks to mental health outcomes for children through working directly with the parent diagnosed with a mental illness (Solantaus, Reupert, & Maybery, 2015;Ueno, Osada, Solantaus, Murakoshi, & Inoue, 2019). In the brief practice model of two to three conversations, a practitioner and parent collaboratively explore the everyday life of the child, highlighting strengths and vulnerabilities, in order to enhance well-being (Maybery et al, 2017;Punamäki, Paavonen, Toikka, & Solantaus, 2013;. The first conversation is centred on a structured log that prompts the parents to consider the well-being of the child.…”

“…In the second conversation, the parent develops plans to promote and support their well-being. Viewing the person in roles beyond their mental illness and working from a strength-based, parent-empowerment standpoint, Let's Talk aligns well with personal recovery (Maybery, Meadows, et al, 2015;Maybery et al, 2017). Building family-focused practice into adult-focused mental health and family services has many known barriers (Maybery, Foster, et al, 2015) The aim of the current study was to identify key elements that influenced the process of implementation of Let's Talk from leadership's perspective.…”