Parents with mental illness – a qualitative study of identities and experiences with support services

Abstract

Accessible summary What is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature. Parental mental illness can often be viewed from a risk perspective. Parents with mental illness and their families have unmet support needs. What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible. Many parents adopt an expert by experience identity. Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness. What are the implications for practice? Adult mental health services need to recognize and support parental role of service users. Joint care planning and family oriented care should be promoted. Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development. Abstract IntroductionParental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. AimThis study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. MethodThree focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. ResultsAdult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. DiscussionBeing able to see oneself as a ‘good’ parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents’ anxieties. Implications for practiceMental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice.

Families living with parental mental illness and their experiences of family interventions

“…Our study demonstrates that parents with mental illnesses are searching for support from psychiatric services in order to talk to their children about their illness, findings supported by recent work showing that these parents feel responsible for their parenting role and need for support (Jones, Pietilä, Joronen, Simpson, Gray, & Kaunonen, ; van der Ende et al., ), although this is seldom included in their psychiatric treatment. The finding that under‐age children comply when told by their parents to join an intervention in psychiatric services supporting the family is interesting and not observed earlier.…”

“…Jones, Pietilä, Joronen, Simpson, Gray, & Kaunonen, 2016;van der Ende et al, 2016), although this is seldom included in their psychiatric treatment. The finding that under-age children comply when told by their parents to join an intervention in psychiatric services supporting the family is interesting and not observed earlier.…”

Working with service users who are parents – looking beyond risk

“…Indeed, men and women with mental illness are just as likely to be parents as those without mental illness and more than half of service users and mental health nurses come into contact with, in the UK, are parents (Royal College of Psychiatrists 2014). In our study, published in this issue, we found that the parental role is highly meaningful and motivating, but its significance to service users is disregarded (Jones et al 2016).…”

“…Overall, the stance towards parents with mental illness fluctuates between ambivalence, i.e. overlooking them, or framing parenting through risk and accountability (Jones et al 2016). From a service perspective, this can lead to a situation where only immediate risk triggers extra support and in the absence of this risk, we overlook the needs of many families.…”

“…Care planning can also include parenting related goals and it is important to recognize the positive impacts of family life. Parents can view their illness experiences as sources of strength and knowledge (Jones et al 2016), which can be shared and acknowledged through collaborative working. Parenting programmes designed specifically for parents with mental illness can also provide a source of support, however, in order to be effective, they need to take into account participants' existing social networks and economic resources (David et al 2011).…”