The Needs and Experiences of Parents with Psychosis: A Qualitative Interview Study

Abstract

Over a third of individuals diagnosed with a psychotic disorder are also a parent. The symptoms of psychosis and side effects of antipsychotic medication can impact on parents’ awareness of the needs of their children and, at times, the parent may be emotionally and practically unavailable to their child. This study assessed the expressed emotion of parents with psychosis and used qualitative methods to investigate their needs and experience in order to identify how best to support this parent group. Twelve parents with a diagnosed psychotic disorder and with a child aged between 3 and 11 years took part in semi-structured interviews. The majority of parents displayed high levels of warmth and low levels of negativity towards their child. Four themes were generated using reflexive thematic analysis: (1) the impact of psychosis on parenting, (2) the need to protect their child, (3) the need to feel normal, and (4) the impact of parenting stress on psychosis. These results showed how parents want to protect their children and feel normal despite experiencing psychosis. They also highlighted the cyclical relationship between parenting stress and psychotic symptoms, whereby psychotic symptoms can impact on a parent’s capacity to care for their child and parenting stress can exacerbate psychotic symptoms.

A family perspective on parental psychosis: An interpretative phenomenological analysis study

“…We approached the 12 parents who had previously been interviewed (Radley et al, 2022), seven of whom gave consent for the research team to contact their family members. Two of these families could not be reached; therefore, five families in total took part.…”

“…These facts were not explicitly referred to so that they would not be revealed to participants through reading this paper. Furthermore, the parents with psychosis in this study form a subset of the twelve participants in another study (Radley et al, 2022), many of whom did not give consent for their families to be approached for this study, which the authors felt further alludes to the lack of intra‐family communication and stigma felt in relation to their psychotic episode.…”

“…In order to investigate the impact of parental psychosis on younger children, parents were eligible if they had a child aged between 3 and 11. The parent interviews in this study had previously been analysed alongside other parent interviews using thematic analysis (Radley et al, 2022). Only the parent interviews where a family member had also been interviewed were included in this analysis.…”

Parents who experience psychosis: A qualitative exploration

“…In Sweden, Strand et al (2020) explored the experiences of 15 parents experiencing psychosis using thematic analysis (Braun & Clarke, 2006), while Boström and Strand (2021) explored the experiences of six parents experiencing psychosis and their seven children using interpretative phenomenological analysis (IPA; Smith & Osborn, 2003). In the United Kingdom, Evenson et al (2008) analysed the narratives of ten fathers experiencing psychosis using IPA, while Radley, Barlow, & Johns (2022b) explored the accounts of 12 parents with psychosis using reflexive thematic analysis (Braun & Clarke, 2006, 2020). A family perspective was also sought by Radley, Barlow, & Johns (2022c) in the United Kingdom, who explored the perspectives of five parents, four children, three partners and one grandparent about how psychosis impacts the family unit using multiperspective IPA (Larkin et al, 2019; Smith et al, 2009).…”

“…Dolman et al, 2013), thus overlooking the integral role of fathers (Bakel & Hall, 2020). Moreover, only three qualitative studies exploring parenting experiences in psychosis were conducted in the United Kingdom (Evenson et al, 2008; Radley, Barlow, & Johns 2022b; Radley, Barlow, & Johns, 2022c), and significant socio‐economic and political change has occurred since 2008. In particular, the impact of parenting has become more recognised (Allen, 2011); Early Intervention in Psychosis services (EIPs) have become embedded in health care provision (National Institute for Health and Excellence [NICE], 2016) and the National Health Service (NHS) have committed to improving services for parents and children (The NHS Long Term Plan; NHS England, 2019).…”