Family assessment conversations as a tool to support families affected by parental mental illness: a retrospective review of electronic patient journals

Abstract

BackgroundPrevious research has shown a link between parental mental illness and adverse development in their offspring. In Norway, it is mandatory for health professionals to identify if patients in adult mental health services have children, and subsequently to provide support for the children. An important tool to detect if families are affected by parental mental illness and to assess if there is a need for further intervention is the Family Assessment Conversation. Family Assessment Conversations is potentially a powerful tool for communication with families affected by parental mental illness because it facilitates early identification of children at risk of various adversities due to the family situation. Additionally the tool may initiate processes that enable children and parents to cope with the situation when a parent becomes seriously ill. Little is however known about how the mental health practitioners use the family assessment form in conversations, and to what extent they record relevant information in the electronic patient journals.MethodsThe main aim of the study was to provide information about the existing practice within mental health services for adults in terms of parental mental illness and family assessment conversations. The project is a retrospective journal review. The data base consists of relevant journal data from 734 patients aged 20–60 years admitted. In total, 159 recordings of family assessment conversations were discovered.ResultsThe main result in this study was that many of the questions in the family assessment form lacked documented responses and assessments from the healthcare professionals. Only 17% of the participants had been assessed with the total family assessment form. Additionally, there was a lack of documentation about whether or not the children had been informed in a large proportion of the assessment forms (31%). A total of 55% say that the child has not been informed. This implies that there is still a long way to go in order to make sure that children of parents with a mental illness are given relevant information and support.ConclusionsThe documentation and family assessment frequency is low and reflects the challenges healthcare professionals and patient experience when the child’s situation becomes the topic of assessment. There is a need to further investigate the challenges of changing the mental health systems to incorporate the children and families of patients. More research should promote knowledge on what may facilitate family assessment dialogue.

«Å leve i krysspresset mellom foreldrerollen og kreftsykdommen»- En kvalitativ studie av unge voksne kreftpasienters erfaringer

“…Det er derfor et nedslående funn at informantene opplevde lite hjelp og støtte fra helsepersonell til tross for deres lovpålagte plikt om informasjon og oppfølging av barn som pårørende. Samtidig understøtter disse funnene tilsvarende resultatene fra flere norske studier (Lauritzen et al, 2018;Ruud et al, 2015). Dette kan bety at foreldre i stor grad står alene i en svaert utfordrende situasjon, og synliggjør en manglende implementering av gjeldende lovverk (Helsepersonelloven, 2010, §10a).…”

Identification of Children of Parents With Mental Illness: A Necessity to Provide Relevant Support

“…One study showed that 56% of health personnel at a large Norwegian university hospital did not identify patients' children (39), and a 5-years follow-up study showed that 28% of the health personnel in the same clinic still did not identify patients' minor children (42). Another recent Norwegian study showed that only 17% of patients in two psychiatric hospitals were assessed completely with family assessment forms (43). These results indicate that although the law requires identification of COPMI and provision of support in Norway, there has not been sufficient systematic work around implementing new clinical practice related to this issue in adult mental health care.…”

Overview of Confucianism and the Basic Content of Confucianism

“…Family assessment is a part of the evaluation but also can be used anytime to understand changes within each family. It also focus on the resources the family uses to support child development [3][4][5][6].…”