Parenting and Serious Mental Illness (SMI): A Systematic Review and Metasynthesis

Abstract

The consequences of Serious Mental Illness (SMI) on parent and child outcomes can be profound. Supporting parents to manage their caregiving roles alongside parental SMI successfully has been recognised as a public health priority. To meet this priority and develop effective and acceptable interventions, it is imperative that parents’ experiences and support needs are understood. This systematic review aimed to synthesise qualitative research that explored parents’ experiences and perceptions of the impact of SMI on their parenting and their corresponding support needs. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Five databases were searched for terms associated with SMI, parenting, and qualitative research. Twenty-nine studies involving 562 parents who experienced SMI met inclusion criteria, and the methodological quality of included studies was appraised using the Critical Appraisal Skills Programme. After findings were synthesised using thematic synthesis, six themes were identified: (1) The constrained parent, (2) parenting difficulties, (3) the strained child, (4) inescapable threat, (5) combatting threat, and (6) wrap-around support needs. Novel insights into the centrality of SMI-related parenting difficulties and threat perceptions across parent, family, healthcare, and wider social systems on strained parent–child and distanced parent–support relationships were highlighted. Systemic practice change initiatives via compassionate and inclusive system-wide support were recommended.

Parents who experience psychosis: A qualitative exploration

“…This finding augments previous research in parents with broader experiences of SMI, highlighting the influence of shame on parents' sense of relationship security (Chan et al, 2019;Montgomery et al, 2006;Tjoflåt & Ramvi, 2013). The centrality of fear and shame, particularly around parents' perceptions of the negative impact of psychosis on their children, also echoes findings seen in studies and reviews of parents who experienced SMI (Ackerson, 2003;Dolman et al, 2013;Harries et al, 2022;Mulvey et al, 2021). These findings parallel recent research suggesting that children of parents who experience SMI can experience inflated responsibility to support their parents (Strand et al, 2020;Villatte et al, 2022), which may contribute to parents' sense of shame.…”

Parents' experiences of receiving their child's diagnosis of congenital heart disease: A systematic review and meta‐synthesis of the qualitative literature

“…Results were presented in words and numbers (No = 0, Partially agree = 0.5, Yes = 1). In line with other meta-syntheses (e.g., Harries et al, 2023;Tuck et al, 2023), quality/risk of bias was then categorized as high (>8-10), moderate (6-8) and low (<5). The methodological quality of all studies was assessed by the first author and an independent researcher; their agreement was 100%.…”

Running in the FAMILY: understanding and predicting the intergenerational transmission of mental illness

“…Healthcare systems do not sufficiently utilise (and in most cases substantially neglect) family history of mental illness into diagnostics and care of offspring of parents with a mental health disorder, leading to delays in diagnosing young offspring and missing opportunities for protective actions and resilience strengthening [4,5]. Although parents with mental illness are often concerned that their disorder may impact the wellbeing of their children, due to genetic risk or possible parenting difficulties [6], healthcare professionals seldomly discuss their patient's worries, parenting role and style [4,7]. Critically, a familybased approach to manage mental disorders is hampered by the generally strong focus on individual recovery and clinical management and the gap between child and adolescent and adult mental health services [8].…”