Goal setting in recovery: families where a parent has a mental illness or a dual diagnosis

Goal setting is an important element within mental health recovery models; however, parenting and children are rarely recognized in such approaches. This study outlines a family recovery planning model where a parent has a mental health or dual substance and mental health problem. The differences between family types (parent with a mental illness or parent with dual diagnosis) and family members (parent and children) are illustrated in terms of goals across 11 domains. There were a total of 33 parents and 50 children from 10 mental illness and 10 dual diagnosis families. Education and specifically mental health knowledge are important goals across all families and appear especially important for children whose parent has a dual diagnosis. Specific goals and achievement levels for each type of family and parents and children are also outlined. Clear areas for action by clinicians and family members are indicated by this study.     

Schizophrenia: The Impact of Parental Illness on Children

This research sets out to discover what impact parental schizophreniamakes on a child’s life. It focuses on the daily lifeand experiences of children. Their health, education, familyand leisure activities are examined. Contact with helping agenciesand their unmet needs are investigated. The sample was drawnfrom the children of patients attending the mental health servicesin South West Dublin. They were matched with a control groupof children of well parents. The majority of children who haveone parent with schizophrenia had similar profiles to the childrenof well parents in the areas of physical health, positive familyfeelings, friendships, hobbies and household tasks. In a numberof other areas, however, differences were found. Sample childrenhad more psychiatric disturbance, more problems associated withschool, less contact with relatives and spent more time at home.The children had little access to services and were upset byhospital visiting. The need for an educational programme andsupport for these children was demonstrated. It is recommendedthat a more co-ordinated approach is required by both adultand child mental health services in order to meet their needs.     

Attachment and Coping Strategies in Middle Childhood Children whose Mothers Have a Mental Health Problem: Implications for Social Work Practice

Mental health has implications for the quality of relationshipswithin a family, particularly between parents and children,but also between other family and non-family members. Previousresearch has investigated parental reports of attachment infamilies with mental health problems, but relationship representationsas experienced by these children, especially in middle childhood,have not been so frequently investigated. An understanding ofchildren’s representations of attachment relationshipsand the different coping strategies that may result is importantfor social work practice when offering support, not only tothe children, but also other family members. Methods of investigatingattachment, such as the Separation Anxiety Test, have been usedto understand the relationship issues, fears and coping strategiesof other vulnerable children, and this study was designed specificallyto investigate relationship issues in middle childhood childrenwhose mothers had previously been hospitalized with mental healthproblems. We found that these children tended to be less emotionallyopen and secure, and generated fewer adaptive coping strategiesthan children whose mothers had never had mental health problems.Other themes also emerged from the interviews, such as a senseof trust in the parent–child relationship and the ‘containment’of fears. Implications for social work practice are discussed.     

Predictors of mental health literacy among parents of youth diagnosed with mood disorders

Research reveals limited knowledge of children's mental health among caregivers. This paper identifies predictors of mental health literacy among parents of children diagnosed with mood disorders that are seeking or already receiving help. Secondary data analysis using multivariate regression was conducted on data from a randomized, controlled efficacy trial with a sample of 165 children. Mental health literacy was higher for parents who were female, white, higher educated and had children who were older, had a bipolar diagnosis or received more services. Lifetime experience with mental health disorders also predicted literacy. Public mental health efforts are needed to raise caregiver mental health literacy.     

Gaining knowledge about parental mental illness: how does it empower children?

This study examined the utility of a digital video disc (DVD) intervention, designed to educate children, whose parents have depression and/or anxiety. Twenty‐nine children completed pre‐ and post‐DVD exposure questionnaires, on mental health knowledge and help seeking, and 18 were interviewed about their experiences and use of the DVD. Post‐DVD, children's knowledge of mental illness improved. The DVD also challenged mental illness misconceptions. Most children preferred watching the DVD with a parent. The study explains how children utilize information about mental illness.     

A family support service for homeless children and parents: user and staff perspectives

Children and their parents who become homeless constitute a group of families with a complex range of social care and health needs, including mental health difficulties. In response to this, a local authority housing department established a family support team (FST) that provides assessment and detection of a range of problems, support to parents and children, parenting interventions for child behavioural problems, liaison with other agencies, and referral to specialist services when appropriate. The aim of this study was to establish the perceptions of parents and staff on their experience of the service, and ways of improving it in the future. The study adopted a developmental evaluation approach and used multiple methods, including in‐depth interviews with families; diaries; reflective activities; participatory learning and action; and observation of the FST. The study mapped the innovative service and captured the range of skills in the team and the complexity of agencies the team interacted with. It also identified areas for further development in terms of the mental health needs of children and parents who have become homeless.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Pathways to parenting stress reduction among parents in South Africa

Parenting stress has a range of effects on parents and their children. Despite existing evidence on the effectiveness of family-based interventions on reducing parenting stress, little is known about the mechanism of change that contributes to its reduction. This study investigates the mechanism of change in a parenting programme (Parenting for Lifelong Health [PLH]) on reducing parenting stress among parents of adolescents in South Africa. A pragmatic cluster randomized controlled trial was conducted among a total sample of 552 parents and primary caregivers (aged, M = 49.37; SD = 14.69) who were recruited from 40 communities in South Africa's Eastern Cape Province. A mediation analysis was performed to investigate direct and indirect effects using PROCESS macrostatistical software. The findings of the study indicate that parenting stress reduction operates via three significant mediators: improved parent–child relationship (β = 0.058, P < 0.000), reduced parental depression (β = −0.103, P < 0.000) and reduced family financial strain (β = −0.049, P < 0.000). The findings of the study highlight the importance of considering child, parental and contextual factors in the design and development of interventions aimed at reducing parenting stress in families in low- and middle-income settings.     

Relation between young children's anger and fathers' mental health during the COVID-19 epidemic: Moderating role of gender and child number

The father–child interaction deserves attention during the COVID-19 epidemic. This study administrated the Child Anger Questionnaire and the SCL-90 Symptom Checklist to collect primary data from 1862 fathers of Chinese young children during the COVID-19 outbreak, examined the relation between young children's anger and their fathers' mental health, and verified whether the relation was moderated by the gender or the child number. The results demonstrated that the detection rate of anger among Chinese young children was 60.08%, the scores of SCL-90 factors of their fathers were significantly lower than the Chinese normal adult male norms and those of infant parents, and the anger of young children had a significant effect on their fathers' mental health. Gender and child number moderated this relation. It is of great significance to strengthen the attention to the anger of young children and the mental health of fathers during the period of public health emergencies, and to promote the harmonious interpersonal relationship between young children and their fathers.     

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities

The study examined the effect of adult children’s disability on parents’ physical health in later life and the extent to which parents’ symptoms of alcoholism in mid-life moderates the link between children’s disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child’s mental health problems on parents’ later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.     

Mental health of parents with young children in Hong Kong: the roles of parenting stress and parenting self-efficacy

This study aimed to explore the sources of parenting stress and the mental health of parents with kindergarten and primary school children in Hong Kong. It also examined the intervening effects of parenting self-efficacy on mental health of parents. Results indicated that parents who perceived their children as more demanding, less acceptable and less reinforcing had more parenting stress. Those who found their parental roles to be more restrictive also had more parenting stress. Lastly, parenting self-efficacy moderated the effects of parenting stress on the mental health of parents. Cultural and social factors were put forward to explain these findings and suggestions were made towards reducing the parenting stress experienced by parents with younger children in Hong Kong.     

Parental mental health: disruptions to parenting and outcomes for children

The association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.     

Adult children of parents with mental illness: Family stigma and coping on sense of self

Family stigma is associated with persistent negative outcomes among adult children of parents with mental illness (ACOPMI). Loss of sense of self has been reported by ACOPMI; however, the role of family stigma on sense of self remains unclear. Additionally, research suggests coping behaviour (i.e. adaptive or maladaptive) influences the effect of stigmatization on sense of self. This study investigated the impact of family stigma and coping on sense of self among ACOPMI (N = 134, 63.4% female). As hypothesized, high family stigma was associated with weak sense of self (p < 0.001), and ACOPMI who endorsed adaptive coping demonstrated higher sense of self than those who coped maladaptively (p < 0.001). Further, coping moderated the relationship between family stigma and sense of self (p < 0.001). Unexpectedly, this relationship was only significant for ACOPMI with adaptive coping skills (p < 0.001). At higher levels of stigmatization, post hoc analysis revealed coping styles did not exert an influence on sense of self. Results suggest family stigma contributes to loss of sense of self among ACOPMI, with adaptive coping being protective only at lower levels of family stigma. Findings highlight the need for a systemic approach to eradicate family stigma.     

Factors associated with placement breakdown initiated by foster parents – empirical findings from Germany

This study investigates the effects of covariates on the probability of placement breakdown in non‐kinship family foster care. Breakdowns are distinguished according to the initiator: children, carers, foster parents and the local child welfare authorities. The children concerned had entered foster care at ages ranging from 0 to a maximum of 17 years (n = 14 171). A significantly higher risk of breakdown on the initiative of the foster parents is found in male children, children whose parents receive financial support, children whose parents were removed from the register of carers, children who were between 6 and 15 years old when they joined the foster family, children who had earlier lived in a different foster family or residential care, children from patchwork families and children whose joining of a foster family was the result of disruptive social behaviour. Two‐thirds of the children from non‐kinship family foster care who stay in the foster family was ended on the initiative of the foster parents are subsequently looked after in residential care. That is three times the rate for all terminated foster relationships. Breakdowns on the initiative of the foster parents thus indicate a high risk of unstable care history developing and accordingly necessitate prevention strategies.     

Parents' perceptions of a group‐based parenting programme in families with child protection and other family support services in a real‐life setting

The aim of this study was to assess parents' satisfaction and perceived usefulness of the Incredible Years® (IY®) parenting programme in the Child Protection Services (CPS) context, where children's behaviour problems are common. Evidence‐based programmes are rarely offered in CPS, and little is known about how they are perceived by parents. We compared parents (N = 62) with (N = 43) and without (N = 19) CPS contact regarding their satisfaction with the IY® parenting programme, with information gathered from weekly and final evaluation forms. The attendance rate of parents to the weekly sessions (max 19) was also calculated. Comparisons between CPS and non‐CPS clients were analysed using multilevel models. Satisfaction scores ranged between 5.8 and 6.2 (max 7) for all studied domains. Mean attendance rate to the group sessions was 11.5 (SD 5.9), and 74% of participants attended at least nine out of 19 sessions. No group differences emerged in satisfaction or attendance between CPS and non‐CPS parents. Parents in CPS committed well to the programme and found it as useful as parents without CPS contact. IY® appears to be acceptable to parents involved in CPS, and their engagement to the programme can be considered as reasonably good.     

Two‐generation preschool programme: immediate and 7‐year‐old outcomes for low‐income children and their parents

Preschool children living in low‐income families are at increased risk for poor outcomes; early intervention programmes mitigate these risks. While there is considerable evidence of the effectiveness of centre‐based programmes in other jurisdictions, there is limited research about Canadian programmes, specifically programmes that include children and parents. The purpose of this study was to evaluate a single‐site, two‐generation preschool demonstration programme for low‐income families in Canada. A single group, pre‐test (programme intake) /post‐test (programme exit) design with a 7‐year‐old follow‐up was used. Between intake and exit, significant improvements in receptive language and global development were found among the children, and significant improvements in self‐esteem, use of community resources, parenting stress and risk for child maltreatment were found among the parents. These positive improvements were sustained until the children were 7 years old. Public investment in two‐generation preschool programmes may mitigate risks for suboptimal child development and improve parental psychosocial outcomes.     

A preliminary review of the parenting assessment and skill development service: A 10-day residential service for families at risk of child maltreatment

Tweddle's Parenting Assessment and Skill Development Service (PASDS) is a 10-day residential programme for families at risk of child maltreatment. The service aims to conduct a comprehensive parenting capacity assessment to inform case management and improve parenting practices. The aims of the study were to (1) describe the psychosocial functioning of parents taking part in PASDS, (2) describe the key parenting assessment outcomes, and (3) explore parents' experiences of participation in PASDS including (a) perceived barriers and enablers of participation and (b) perceived outcomes for their family. Participants were 18 parents who participated in Tweddle's PASDS in Melbourne, Australia. A mixed methods study comprising a case file review and qualitative interviews was conducted. Parents accessing PASDS had experienced adverse childhood events, and many were experiencing mental health difficulties. Interviews with parents revealed perceived benefits of PASDS in improving parenting knowledge and skills, family relationships, and parenting confidence. At the time of discharge, 33% of families were assessed as unable to provide independent care for their child. The current findings have important implications for the further evaluation of evidenced-based services which can improve the accuracy of parenting capacity assessments, aiding in child protection decision-making related to child placement and safety.     

Children's understanding of mental ill health: implications for risk and resilience in relationships

Research shows that having a parent with a mental health problem has associated risks for children, but some families seem very resilient and do not always suffer these difficulties. In order for social workers to be able to support the development of resilience in families who appear to be at risk, we need to understand what factors may ameliorate some of these risks. Research seems to suggest that children who can conceptualize their parent's mental health problem as something 'outside' their representation of that parent as an attachment figure are likely to have better outcomes than children who see the mental-health problem as part of, and embedded within, their representation of that parent. However, in order to develop an understanding of how this conceptualization affects attachment relationships and outcomes, we need to know what children understand by mental ill health. We also need to consider how this conceptualization might be changed, and it appears that parents, other attachment figures and other support figures may play a key role here. This paper provides a selective review of the research area and discusses the mechanisms which may govern this complex process. The review concludes with recommendations for future research and practice.