Parents’ Descriptions of How Their Psychosis Affects Parenting

Abstract

Objectives Parental psychosis poses a risk factor for a child's well-being. Few studies have focused on the parents' views of how their psychosis affects their parenting, and results for parenting ability in this group are contradictory. The present study aimed to explore how parents with psychosis experience the effect(s) of their illness on parenting. Methods In-depth and semi-structured interviews were conducted with 15 parents who attended outpatient clinics specializing in psychosis. The transcripts were analyzed using thematic analysis. Data related to the research aim were analyzed deductively according to the protection, reciprocity, control, guided learning, and group participation model of parenting. Data in each domain were subsequently coded inductively to form subthemes. Results Results show that all domains of parenting appear to be affected by psychosis. The parents specifically mentioned that depression, fatigue, and difficulty focusing because of hearing voices had negative impacts on their abilities to provide protection, reciprocity, and control. The parents also expressed difficulties in maintaining routines in the child's everyday life. Furthermore, the theme "Unpredictable absences" crosses all domains and highlights the parents' recurrent mental and physical absences from their children during psychotic episodes. Conclusions The present study provides some insight into how different aspects of parenting may be affected by psychosis. We suggest that these effects on parenting need to be further explored and confirmed by research focusing on the child's perspective and on observations of parent-child interaction. Keywords Parental psychosis • Parenting • Psychiatric services • Schizophrenia • Qualitative study Nearly 6% of children in Sweden grow up with a parent with mental illness (Hjern and Manhica 2013), but international figures point to as many as one in five children (Reupert et al. 2012). International as well as studies from Scandinavia estimate that a substantial minority of patients in adult psychiatric care have children under 18 years old (Lauritzen 2014; Maybery and Reupert 2018; Ruud et al. 2019). The increased risk of developing mental health problems is well established in children growing up with a parent with mental illness (LeFrancois 2012; Leijdesdorff et al. 2017; Ramchandani and Psychogiou 2009).

Parents with psychosis and their children: experiences of Beardslee’s intervention

“…It is possible that supporting parents in this area requires more directed support; for example, by professionals actually initiating and taking part in school meetings, in case, it would be perceived as beneficial for the child. Furthermore, for children to participate in leisure activities, the fact that previous studies show that many parents with psychosis encounter poverty (Campbell et al, 2012; Park, Solomon & Mandell, 2006; Strand, Boström, & Grip, 2020) may be a concrete hindrance to promoting resilience, and cannot be sufficiently met by an intervention focusing mainly on communication.…”

“…One study found that 50% of fathers and 36% of mothers were identified with severe impairments in parenting (Campbell et al, 2012). Another study reported that parents with psychosis described impairments in all parenting domains (Strand, Boström, & Grip, 2020), and specifically mentioned that depression, fatigue, and difficulty focusing because of hearing voices had a negative impact on their ability to provide protection, reciprocity, and control. Many parents with psychosis also encounter unemployment, poverty, isolation, and stigmatization (Campbell et al, 2012; Park, Solomon & Mandell, 2006).…”

“Adding salt to wounds”: Parentification among children living with parents with mental illness during the COVID-19 pandemic and the role of social workers

“…This is much so when the parents have serious mental illness. For example, parents with psychosis have reported that depression, hearing voices and fatigue impacted their abilities to provide protection, reciprocity and control for their children (Strand et al, 2020). Mothers, especially, attach pride to their parenting role.…”

“…Parental mental illness can impair parenting capacity to the extent that children are burdened with responsibilities for protecting and caring for their parents and siblings (Simpson-Adkins & Daiches, 2018; Van Parys et al, 2015). An outcome of parental mental illness is the parent’s experience of difficulties in performing their parental or caregiving responsibilities at optimum levels (Strand et al, 2020). In cases where the parent with mental illness fails to perform their caregiving role, role reversal between the parent and the child may take place where the child begins to take care of other members in the family including the parent (Van Parys et al, 2015).…”

Children and parents with psychosis—Balancing between relational attunement and protection from parental illness

“…The complex task of parenting is more challenging for parents with severe mental illness (Campbell et al, 2012; Wan & Green, 2009). Parents with psychosis describe that depression, fatigue, and difficulty focusing negatively impact their ability to provide protection, reciprocity, control, and routines (Strand et al, 2020). Mothers with psychosis struggle with maintaining discipline, boundaries, and their parental role while experiencing symptoms or side effects of medication, and worry about the possible effects of their illness on their children (Dolman et al, 2013).…”