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This exploratory study aimed to identify the ways psychologists working in schools supported students' mental health during school closures related to the COVID-19 pandemic. An online survey was developed to determine (a) how psychologists working in schools across the United States, Canada, Germany, and Australia supported students' mental health during COVID-19, (b) how their services changed during COVID-19, and (c) potential differences between countries concerning difficulties supporting students' mental health during this time. The survey was based on previous research and was subsequently piloted. Using convenience and snowball sampling, 938 participants (U.S. n = 665; Canada n = 48; Germany n = 140; Australia n = 85) completed the online survey. Overall, school psychology services across these four countries pivoted from psychoeducational assessments to virtual counseling, consultation, and the development/posting of online support directly to children or parents to use with their children. There was some variation between countries; during the pandemic, significantly more psychologists in Germany and Australia provided telehealth/telecounseling than those in the United States and Canada, and psychologists in Germany provided significantly more hardcopy material to support children than psychologists in other countries. There is a need to ensure psychologists have the appropriate technological skills to support school communities during periods of school closure, including, but not limited to, virtual counseling and the administration of psychoeducational assessments. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A student’s sense of school belonging is critical to school success, yet internationally, a large proportion of secondary students do not feel that they belong to their school. However, little is understood about how schools can address this issue, nor what evidence-based interventions are available to increase belonging among secondary school students. The aim of this study is to identify and critically review the evidence on school-based interventions that increase a sense of school belonging in adolescents. Seven electronic databases and the Cochrane Central Register of Controlled Trials were searched from 1999 to February 2021 using ‘school belonging’ and ‘intervention’ amongst the key search terms. A total of 22 controlled trials were identified with 14 studies reporting effective school-based interventions for enhancing a sense of adolescent school belonging. Successful interventions targeted students’ strengths and promoted positive interactions between students and between school staff and students. Overall, this review found a paucity of interventions that intentionally aimed to develop adolescent school belonging. Inconsistencies in terminology use and definitions describing school belonging were identified even when similar measurement tools were utilised. Findings of this review have important practice implications and provide information to support schools to select evidence-based interventions to improve students’ sense of school belonging.

BACKGROUND: This systematic review synthesized available research on the psychological implications for children and adolescents who either were directly or indirectly exposed to an infectious outbreak. On this basis, the current paper aims to provide recommendations for future research, practice and policy regarding children during pandemics. METHOD: A total of 2195 records were retrieved from the PsycINFO, SCOPUS and MEDLINE databases, and three from Google Scholar. RESULTS: Including only those papers that focused on children or adolescent's mental health in association with respiratory infectious outbreaks, 11 articles were identified. The majority of research utilized qualitative or retrospective hospital record data. Children and adolescents reported fear and anxiety, as well as disruptions to their day to day routines as a result of outbreaks. However, children were also able to demonstrate resilience during outbreaks with the right support. CONCLUSIONS: Children's psychological response to the outbreak appeared to be largely attributed to how their parents, healthcare providers and the media communicated the event. Recommendations for policy, practitioners and researchers concerning the current COVID-19 outbreak concludes the paper.

Adverse childhood experiences (ACEs) are related to increased risk of common mental disorders. This umbrella review of systematic reviews and meta-analyses aimed to identify the key ACEs that are consistently associated with increased risk of mental disorders and suicidality. We searched PsycINFO, PubMed, and Google Scholar for systematic reviews and meta-analyses on the association between ACEs and common mental disorders or suicidality published from January 1, 2009 until July 11, 2019. The methodological quality of included reviews was evaluated using the AMSTAR2 checklist. The effect sizes reported in each meta-analysis were combined using a random-effects model. Meta-regressions were conducted to investigate whether associations vary by gender or age of exposure to ACEs. This review is registered with PROSPERO (CRD42019146431). We included 68 reviews with moderate (55%), low (28%) or critically low (17%) methodological quality. The median number of included studies in these reviews was 14 (2-277). Across identified reviews, 24 ACEs were associated with increased risk of common mental disorders or suicidality. ACEs were associated with a two-fold higher odds of anxiety disorders (pooled odds ratios (ORs): 1.94; 95% CI 1.82, 2.22), internalizing disorders (OR 1.76; 1.59, 1.87), depression (OR 2.01; 1.86, 2.32) and suicidality (OR 2.33; 2.11, 2.56). These associations did not significantly (P > 0.05) vary by gender or the age of exposure. ACEs are consistently associated with increased risk of common mental disorders and suicidality. Well-designed cohort studies to track the impact of ACEs, and trials of interventions to prevent them or reduce their impact should be global research priorities.

For Editors, or at least for me, the peer review process can be instructive, helpful and stimulating, but also at times frustrating (I have one paper where I requested 23 reviewers before two revie...

This article reports a strengths-based intervention to support parents with mental illness and their children in adult mental health settings: “Let’s Talk About Children” (LTC) intervention. A qualitative methodology was adopted with parent participants receiving LTC in adult mental health and family services. The benefits for parents receiving LTC were described through in-depth interviews with 25 parents following the delivery of the program. Interview data identified an impact on parental self-regulation—mainly through a change in a sense of agency as a parent—and skill building, once a clearer picture of their child’s everyday life was understood. This study outlines the benefits of talking with parents about the strengths and vulnerabilities of their children during routine mental health treatment. The role for self-determination of parents in preventive interventions for children is an important consideration for mental health recovery, and it also helps to break the cycle of transgenerational mental illness within families.

COVID-19 is the biggest global crisis and challenge of our time, with an unparalleled impact on our economies, education, health and everyday lives. Governments have been forced to respond under im...

Purpose There is a paucity of interventions for young adults who have parents with a mental health or substance use issue. The 6-week mi.spot (supportive, preventive, online, and targeted) professionally moderated, online intervention fills this gap. The purpose of this study was to present evidence of the acceptability, safety, and preliminary effectiveness of this intervention. Methods In response to social media advertising, 31 young people aged 18–25 years participated in mi.spot. Intervention effectiveness was examined via a single-group pre, post, and 6-week follow-up study design, measuring primary changes in depression, anxiety, stress, and psychological well-being and secondary changes in coping, self-efficacy, social connectedness, attribution of responsibility, help-seeking, and mental health literacy. Acceptability and safety were determined by system use and participants' self-reports. Results Over the 6 weeks of the intervention, 28 (90.3%) of 31 participants used one or more components of the mi.spot intervention. Significant improvements were reported in depression and stress from preintervention to 6-week postintervention. Trend improvements were evident in well-being, social connection, and coping. No change was reported in general help-seeking, social connectedness, mental health literacy, self-efficacy, or attribution. No safety violations were reported. Participants reported mi.spot to be safe and acceptable. Conclusions mi.spot appears to be safe and acceptable and shows promise as an effective online intervention to improve the mental health and well-being of young adults with parents with mental health and/or substance use issues.

Contains fulltext : 237527.pdf (Publisher’s version ) (Open Access) Children whose parents have mental illnesses are among the most vulnerable in our communities. There is however, much that can be done to prevent or mitigate the impact of a parent's illness on children. Notwithstanding the availability of several evidence-based interventions, efforts to support these children have been limited by a lack of adequate support structures. Major service reorientation is required to better meet the needs of these children and their families. This editorial provides recommendations for practice, organisational, and systems change. 4 p.

Background Although the experiences of mothers with mental illness are well researched in Western countries, little is known about the experiences of Chinese mothers. This study aims to explore the experiences of family life and parenting of Chinese mothers, in the context of their mental illness. Methods Fourteen Chinese mothers with mental illness undertook in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was employed to guide the data analysis. Results Seven themes were identified: motherhood as a central identity, the stigma associated with being a mother with mental illness, participants’ perceptions about the impact of mental illness on parenting and their children, experiences of talking to children about mental illness, how having children impacts mothers’ illness and recovery, and support obtained and needed. Similar to Western mothers, Chinese mothers experienced stigma and fluctuating mental illness symptoms which impacted on parenting. Unlike mothers based in Western countries, the mothers interviewed in this study highlighted complicated co-caring relationships with parents-in-law and did not raise child custody concerns. Conclusions Mental health professionals need to have the skills to identify and recognize the mothering role of their clients. Culturally sensitive interventions are required to assist Chinese families where mothers have a mental illness. Future research is required to investigate family experiences of parental mental illness from the perspectives of children, partners, and mental health professionals.

Background Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices. Methods In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0–100 point likert scale. Results Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user. Conclusion Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.

Much has been written about the adverse impacts from COVID-19, on our economies, hospitals, workplaces, schools and to our mental and physical health. In the face of these unprecedented problems, t...

Parental mental illness is a topic that is close to my heart, as a researcher, clinician, daughter and parent and so, I was most interested to review this book. Dr Alan Cooklin (one of the two edit...

Unprecedented, unparalleled, extraordinary, unique, once in a lifetime event – all terms which have been used to describe COVID-19 and its impact on our daily lives. The way we socialise and connec...

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Stigma is a pervasive social mechanism with negative ramifications for people who experience mental illness. Less is known about the stigma experiences of families where a parent has a mental illness. This review aims to identify and synthesize evidence on the concept of stigma and stigma-related experiences and outcomes reported by parents and children living with parental mental illness. An integrative review method was employed, with PRISMA (Preferred Reporting Items of Systematic Review and Meta-Analyses) guidelines to search and select literature and extract and analyse data. This approach allows for inclusion of theoretical and empirical literature and for concept definition. Fifty-eight papers, mostly from the USA, Australia, and the UK, met the inclusion criteria. Stigma was primarily conceptualized in families as a marked difference that was negatively appraised, and which could be internalized. Some articles examined how underpinning assumptions could shape the behaviour of individuals and groups and be embedded within social institutions and structures. For parents, mental illness stigma was interconnected with stigma relating to perceived violations of social and cultural norms related to parenting. Children’s experience of stigma resulted in bullying, embarrassment, guilt and social isolation, and efforts to conceal their parent’s mental illness. One outcome was that stigma prevented children and parents from seeking much needed supports. Public health policies and campaigns that focus exclusively on promoting open disclosure of mental illness to foster community education outcomes are unlikely to be effective without additional strategies aimed at preventing and redressing the structural impacts of stigma for all family members.

The COVID-19 pandemic has had profound implications for communities around the world. The physical health impacts of a pandemic alone are devastating, however the “mental health implications can la...

The challenges experienced by families in western countries, where a parent has a mental illness, are well established. However, research documenting the experiences of Chinese families with parental mental illness appears limited. This study aimed to systematically review qualitative research about the experiences of families, living in mainland China, Hong Kong, Macao, and Taiwan, where parents have a mental illness. Eight databases were comprehensively searched, along with manual search of reference lists. The identified studies were critically appraised and analysed using a thematic synthesis approach. Ten papers were identified, with nine investigating mothers' experiences, one focusing on children's experiences, and none reporting on fathers' experiences. Subsequently, only papers presenting mothers' experiences were included for thematic synthesis. Five primary themes were identified including managing parenting in the context of mental illness; failure to meet one's expectations of motherhood; being burdened by others' expectations; stigma from self, others and service providers; and support obtained and needed. Similar to western mothers, Chinese mothers struggled to balance the demands of parenting and their illness, and experienced stigma associated with being a parent with a mental illness. Western and Chinese mothers' experiences differ in regard to the influence of parents-in-law and the division of domestic labour. Future research might investigate Chinese mothers with various mental health diagnoses, the perspectives of Chinese fathers with a mental illness, and the children in these families.

Background Adult children of parents with mental illness experience a myriad of complex emotions as they attempt to make meaning of the lived experiences of their parents. A crucial time for adult children is emerging adulthood, a time when they move away from their family of origin and establish their own identity and independence. Despite existing research that provides a static description of adult children’s lived experiences, the literature lacks an explanatory theory about the dynamic, relational processes that occur as adult children progress from one life stage to the next. Methods The current study aimed to develop an explanatory theory of the relational trajectory that adult children might experience as they course through adulthood and parenthood over time. Semistructured interviews using grounded theory analysis were conducted with 10 adult children aged between 27 and 51 years old. Results Three key phases within the Relational Trajectory Model (RTM) were identified: (i) confusion, (ii) contemplation, and (iii) reconciliation. By reflecting on their own parenting role, adult children were able to reach an evolved parental identity, with the majority of participants also making relationship reparations with their parents with mental illness. Parallels are drawn to theories of identity and intergenerational family systems to further explain and substantiate the processes encompassed within the RTM. Conclusion Generating an explanatory theory serves as a potential guide for mental health professionals working with families with parental mental illness, by drawing attention to the intricacies of familial relationships and interpersonal ties.

Background One in 5 young people grow up in a family where one parent has experienced a mental health problem or substance use concern. Compared with their same-aged peers, these youth are at a higher risk of academic failure and acquiring a substance abuse and/or mental health issue. There is a paucity of accessible, age-appropriate interventions that address their needs. Objective A 6-week, web-based intervention, “mental illness: supported, preventative, online, targeted” (mi.spot), was developed based on previous research and the competence enhancement model. This paper describes the protocol for a randomized controlled trial and details how the usage, safety, acceptability, and feasibility of the intervention will be determined. Methods Participants will be recruited through social media and clinician referral. A total of 70 Australians, aged 18 to 25 years, who grew up with parents with a mental illness or substance use concern will participate in a 2-arm parallel randomized controlled trial. The assessment will consist of a baseline measurement and 2 follow-up periods, posttest and 6-week follow-up, using the Mental Health Continuum short form; the Depression, Anxiety, and Stress Scale; the Coping Orientation to Problems Experienced inventory; the General Help Seeking Questionnaire; the Social Connectedness Scale; the Mental Health Literacy Scale; the General Self-Efficacy Scale; and the Attribution of Responsibility for Parental Mental Illness Measure. Impact will be examined at pre, post, and follow-up time periods using analyses of variance that will include a within-subjects factor (time) and a between-subjects factor (intervention/control). Facilitator interviews will ascertain intervention feasibility. Participant interviews will ascertain intervention acceptability. Interview data will be analyzed within a qualitative framework. Usage (data analytics) across site features and several indicators of clinical safety will also be reported. Results The impact of mi.spot will be examined at pre, post, and follow-up time periods using analyses of variance on each of the measures outlined above. There will be a within-subjects factor (time) and a between-subjects factor (intervention/control). Data analysis will employ the intention-to-treat principle by including all participants in the analyses. Qualitative interview data will be analyzed using interpretative phenomenological analysis along with respondent validation. The Monash University Human Research Ethics Committee (reference number: 2019-18660-30434) approved the trial on April 17, 2019. As of October 2, 2019, 30 participants were enrolled in the control group and 34 participants were enrolled in the intervention group. Result are expected to be submitted for publication in December 2020. Conclusions Study results will provide reliable evidence on a web-based intervention that has the potential to make a difference to the lives of many vulnerable young adults. Implementation guidelines are needed to embed the intervention in different service sectors. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12619000335190; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619000335190 International Registered Report Identifier (IRRID) DERR1-10.2196/15626

© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.People affected by mental illness often come from families with patterns of mental illness that span across generations. Hence, child and adolescent mental health services (CAMHS) likely provide treatment to many children with parents who also experience mental illness. The aim of this scoping review was to: (1) identify the prevalence of mental illness among parents of children in CAMHS; (2) identify and appraise the methodologies that have been implemented to assess the prevalence of parental mental illness in CAMHS; (3) identify additional circumstances associated with families where both parent and child experience mental illness; and (4) present recommendations that have been made for CAMHS practice based on these findings. English language, peer-reviewed studies (2010–2018) that had investigated the mental health of parents in CAMHS were included in the review. Literature searching yielded 18 studies which were found to have utilised diverse methodologies to assess parental mental health. Overall, reported prevalence of parental mental illness ranged from 16 to 79%; however, a single study that was deemed to be comprehensive reported prevalence rates of 36% for mothers and 33% for fathers. Across studies, parent and child mental illness was found to be associated with additional adversities impacting family functioning and wellbeing. For children who receive treatment for mental illness, having a parent who also experiences mental illness is a frequent family circumstance that has implications for their prospects for recovery. Accordingly, the mental health of parents should be an important consideration within the mental health care CAMHS provide to children.

Family members often provide significant support and care to their relative who has a mental illness. Nonetheless, how family members might be part of an individual's mental health recovery journey is rarely considered. The aim of this study was to investigate how those with a mental illness define 'family' and the role of family (if any) in their recovery journey. A qualitative approach was used. Purposive sampling and snowballing were used to recruit and conduct semi-structured interviews with 12 people who have been diagnosed with a severe mental illness. Participants defined family in various ways with some being very inclusive and others more selective. There was acknowledgement that family contributed to the individual's recovery in a myriad of ways, although the need for boundaries was stressed. While no participants suggested that their family might become active treatment facilitators, they did want clinicians to support them in talking to their family about their mental illness. A multifaceted approach is needed to promote family-focused recovery practice. The needs of different family members and the needs of the family as a group should be considered concurrently alongside the individual's needs in their recovery plan. Individual and relational components of recovery should be embedded in policy and clinical practice.

Background When clinicians in the adult mental health sector work with clients who are parents with dependent children, it is critical they are able to acknowledge and respond to the needs of the parents and their children. However, little is known about clinicians’ personal perspectives and reactions towards these parents and children or if/how they balance the needs of both. Methods Semi structured interviews were conducted with eleven clinicians from adult mental health services in Australia. Interviews focused on clinicians’ experiences when working with parents who have mental illness. Transcripts were analysed within an Interpretative Phenomenological Analysis framework to examine participants’ perspectives and personal reactions to parents and children. Results There was considerable divergence in participants’ reactions towards parents and children and the focus of their perspectives when working with parental mental illness. Feelings of sympathy and responsibility made it difficult for some participants to maintain a dual focus on parents and children and contributed to some adopting practices that focused on the needs of parents (n = 3) or children (n = 1) exclusively. Other participants (n = 7) described strategies and supports that allowed them to manage these feelings and sustain a dual focus that incorporated the experiences and needs of both parents and children. Conclusions It is difficult for some mental health clinicians to maintain a dual focus that incorporates the needs and experiences of parents and their children. However, findings suggest that the challenges of a dual focus may be mitigated through adequate workplace support and a strengths-based practice framework that emphasises parental empowerment.

I can only hypothesise as to the motivations that authors may have when they submit their work to this journal. Some may be genuinely curious and seek answers to questions they have, while others m...

Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere.

Mental health and wellbeing is essential, not only for quality of life, but also because it is a significant determinant for physical health and critical to the social and economic prosperity of so...

During the preschool years (3–5 years), children living with parental mental illness are more at risk of various adverse developmental outcomes, compared to other children. Early childhood services are opportune settings for prevention and early intervention strategies that may support preschool children living with parental mental illness. However, there is limited research examining how the early childhood sector supports the child, parent and family. The aim of the study was to explore family focused practices within the early childhood sector in terms of the level of self-perceived knowledge, skill and confidence; and compare the self-perceived knowledge, skill and confidence between preschool teachers and childcare workers. A sample of 40 preschool teachers and 39 childcare providers rated themselves across eight domains that describe their knowledge, confidence and skill using the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Overall, the sample rated themselves positively across all domains. In a cross-sectional analysis, a t-statistic comparison of preschool teachers and childcare providers showed that childcare providers scored significantly higher than preschool teachers in parenting support, referrals and assessing the impact of parental illness on the child. Future studies might identify the barriers and enablers for Family Focus Practice (FFP) across different groups of workers in the early childhood sector.

Background Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients’ parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals’ family-focused knowledge and practices when working with parents with mental illness and their children and families. Methods This cross –sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ). Results The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families. Conclusions The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice.

In 2014, a Mental Health Act was introduced in Victoria, Australia which mandated clinicians to recognize and support consumers’ children. Interviews were conducted with 11 clinical adult mental health professionals about their views and experiences of the introduction of the Act and its impact on their practices. Interviews revealed that sections of the Act relating to consumers’ children were not promoted within organizations and did not result in revolutionary practice change. Instead, practice development staff within organizations were viewed as the main drivers of practices to support consumers’ children. Suggestions are made for enhancing the impact of legislation to promote practice change.

Source at https://doi.org/10.3389/fpsyt.2019.00163. Background: A strong connection exists between parental mental illness and lifetime mental health risk for their children. Thus, it is important to determine, when parents attend for treatment for their illness, the prevalence and characteristics of parents with a mental illness and identify referral actions for their children. Previous studies indicate that 12–45% of adult mental health service patients are parents with minor children. There is a need for studies with larger sample sizes that investigate the prevalence and characteristics of parents, and factors associated with referral actions for their children. Method: Data on 23,167 outpatients was drawn from a national census study across 107 Norwegian adult mental health outpatient clinics during 2 weeks in April 2013. Clinicians identified various socio-demographic characteristics of patients who were parents and referral actions for their children. Results: Eight thousand thirty-five (36%) of outpatients had children under 18 years. Thirty-one percent were provided with referrals for their children and 58% were reported to have children with no need for referral. Three percent were reported to have children with unmet needs who were not referred. There were missing data on children's needs and referral actions for 8% of parents. Patients who care for minor children were more likely to be refugees, and less likely to be single, male, not own a house/apartment, and have a schizophrenia spectrum illness or substance use disorder. Children were more likely to be referred when their parent was single, with no income from paid work, low education, not owning house/apartment, poor family network, long outpatient treatment, and an individual care plan; and less likely for men with a moderate or less severe mental illness. Children were referred to child protection agencies, child and adolescent mental health services and school psychological/pedagogic services. Discussion: The prevalence of outpatients with children is similar to other studies. Referrals were made for children of one third of outpatients with minor children. Needs and referrals of children was unknown for one in ten outpatients. Mental health outpatient clinics must improve procedures to identify parenting status and ascertain and act on children's needs.

The transition to adulthood can be a vulnerable period for certain population groups. In particular, young adults aged 18-25 years who have a parent with mental illness and/or substance use problems face increased risks to their mental health compared to same aged peers. Yet these young adults may not have access to age-appropriate, targeted interventions, nor engage with traditional face-to-face health services. To support this vulnerable group, services need to engage with them in environments where they are likely to seek help, such as the Internet. This paper describes the risk mechanisms for this group of young adults, and the theoretical and empirical basis, aims, features and content of a tailored online group intervention; mi.spot (mental illness: supportive, preventative, online, targeted). The participatory approach employed to design the intervention is described. This involved working collaboratively with stakeholders (i.e., young adults, clinicians, researchers and website developers). Implementation considerations and future research priorities for an online approach targeting this group of young adults conclude the paper.

Although research on children of parents with mental illness is growing, few researchers have examined the long-term impact of parental mental illness on adult children. This study explored the potential impact growing up with a parent with a mental illness on the parenting role assumed by adult children. The qualitative study included ten participants, who were individually interviewed using a semi-structured interview schedule. Interpretative phenomenological analysis (IPA) along with member checks were utilised to derive themes from participants&rsquo, narratives. Three main themes were identified, including: &lsquo, this is me&rsquo, &lsquo, a whole new world&rsquo, and &lsquo, because of you&rsquo, This is me&rsquo, consisted of narratives highlighting how adult children intentionally went about parenting in ways different from their parents, and &lsquo, captured the salient identity that parenthood served for adult children. The third theme, &lsquo, highlighted the challenges adult children faced in their parenting roles as a result of their childhood experience living with a parent with mental illness. Participants highlighted the main challenges to be an absence of a reference point and lack of informal social supports. Recommendations for mental health practitioners and future research are presented in order to develop better ways to support adult children and their families.

Primary care physicians are often the first contact for people with mental health concerns. Moreover, many patients with mental health concerns are parents caring for dependent children. The aim of this study was to investigate the family focused practices of a group of primary care physicians when working with patients who are parents and experience mental health concerns. A sequential mixed method design (questionnaire followed by interviews) was employed, early 2015, in general medical settings across six Australian states. Twenty one primary care physicians (12 female, 9 male) across different medical settings completed the Family Focused Mental Health Practice Questionnaire; nine of these were interviewed. Participants reported a moderate amount of family focused practice when working with patients who are parents with mental health issues. Many acknowledged the importance of working with patients on family issues but reported barriers in doing so. Clear guidelines, including the recording of parenting status, need to be in place for primary care physicians working with patients who are parents.

This research explored the intersection between participants’ parenting role and housing difficulties, in rural communities. Thirteen parents were recruited from drug and alcohol and mental health agencies in rural Australia. Transcripts were analysed using content analysis, along with inter-rater reliability. The quandary of gaining access to their children while living in inadequate housing was indicated. Participants also described the ‘spiral’ nature of problems, highlighting the interrelated nature of mental illness, substance use, housing difficulties and losing access to children. The impacts of housing problems on parenting roles and children were described as well as those supports considered to be useful in obtaining appropriate housing. Living in rural areas where ‘everyone knew everyone’ made it difficult for some to obtain housing. The need to address housing, parenting, mental illness and substance abuse as interrelated, rather than as singular issues is highlighted.

Young people of parents with a mental illness are at significant risk of developing a mental illness. This risk may be reduced if appropriate interventions are provided. While there are several supports available, their needs are rarely heard in either intervention development or evaluation. This study presents young people’s perspectives of the types of supports they want. One hundred and seventy-two young people (13–17 years) whose parent has a mental illness completed a self-constructed questionnaire and six of these participants engaged in individual follow-up interviews. Frequency data indicated that youth want to learn how to cope or manage their parent’s mental illness and highlighted a need to access support online. Interview thematic analysis reflected a need for psycho-education, confidential and/or anonymous support, and a preference to access information from health care professionals. Given the diversity of views presented, this study suggests that “not one size fits all”.

This qualitative study ascertained how parents with an affective disorder perceived their family to function during times with and without symptoms of their mental health concern. Fourteen parents with depression and/or anxiety responded to theoretically derived questions about family functioning when mentally well and ill. The data were subject to thematic content analysis, in conjunction with being coded using seven a priori codes originating from the domains within a family functioning model. Four identified themes pertained to enjoyment of parenting, mental health concerns as a barrier to parenting and family interaction, psychological outcomes of parenting with mental health concerns and incentives to focus on parenting and family functioning. At least 12 parents reported three domains of family functioning (communication, role performance, affective involvement) changed between times of mental illness and wellness. Some parents perceived changes to family values and norms, and approximately ...

Welcome to the second issue of 2017. The papers in this issue cover the full spectrum of mental health promotion, prevention and intervention which I trust will be of interest to you. Without speci...

Welcome to the first issue of 2017. This year heralds a time of uncertainty and a fear of the unknown coupled with an oddly discordant need for change. Such times underscore the need for objective ...

Children in care frequently experience poor educational outcomes, which in turn have been linked to a number of adverse circumstances later in life. Accordingly, it is important to identify the educational experiences of children in care and what they consider to be their needs in this space. This systematic review of qualitative research aimed to identify and synthesise the findings of relevant studies that documented the experiences of children in care in regard to their school experiences. Inclusion criteria included English language, peer-reviewed, qualitative, or mixed-methods studies that examined the educational experiences of children currently in care or youth/adults who had previously been in care. Five online databases were systematically searched, along with manual hand searching of a relevant journal and reference lists to identify relevant studies. Eleven studies were identified. Thematic analysis was employed to identify five primary themes: the importance of school being a ‘safe haven’; the importance of relationships with teachers and peers; children’s mental health, behaviour and educational experiences; children in care taking control; and what children in care say they need to improve their educational experiences. Results illustrate the important role of teachers and the need for children in care to have their opinions acknowledged in the decision-making process. The review provides future direction and recommendations for research, school policy, and practice.

Background While governments are urging adult mental health services to support consumers in the context of their family, there is little information about what family focused practice is, nor how it might be enacted. Methods Informed by the principles of Community Based Participatory Research, workshops were held in three rural Australian communities in 2015 to discuss the meaning of family focused practice and how such practices might be promoted. Results Participants described the need to raise community awareness about mental illness and provide practical support to the family. Participants emphasized the importance of practitioners genuinely communicating with consumers and their families about mental illness and the need for collaborative care and treatment planning. They also highlighted the challenges of living in rural places and posed some solutions. Conclusion On the basis of the results and previous literature, we developed a model of family focused practice that outlined various stakeholders and their enactments. The model has the potential to inform policy, professional development and practice guidelines.

In this chapter the authors bring together concepts around family-focused practice and recovery and translate these into particular psychiatric/mental health nursing practices when supporting such families. It illustrates how such work can be approached differently to ‘traditional’ or ‘historical’ efforts—such as they were—and focuses on families where a parent, who cares for children, has mental health challenges. The chapter points out how the recovery journey for such parents is intimately related to the relationships and interactions within their family and community. Further, the chapter also posits how focusing on the parent-child relationship not only contributes to positive outcomes in children but may also facilitate a client’s recovery. Subsequent to this, the chapter presents and considers the principles of family-focused practice, and the authors advance their theoretical framework of family-focused recovery. The chapter then examines and discusses the particular needs and associated challenges for these families, in the context of family-focused P/MH nursing. The chapter concludes by arguing that at its essence, family recovery means valuing and celebrating the family life of our clients and simultaneously conveying a sense of hope that the lives of these families will be better. It is therefore incumbent on services to provide the necessary organisational and policy initiatives that embed parenting and children as a routine part of treatment.

Many patients who present to primary care settings with mental health concerns are parents with dependent children. However, little is known about the family-focused practices of these clinicians.To identify the family-focused practices of a group of primary care clinicians.A sequential mixed methodology was employed; 21 primary care clinicians completed the Family Focused Mental Health Practice Questionnaire and then participated in one of three focus groups.Primary care clinicians do not commonly engage with patients about family issues though many acknowledged that family-focused practice was important. Some questioned whether being family focused was part of their role with other barriers related to funding. Most expressed a need for training, though some indicated that they would not engage in a family-focused manner nor be trained in this approach, unless it was compulsory. The study highlights the missed opportunity for family-focused practices in primary care settings.This study demonstrates the need for an "authorising" environment in which family-focused practices are not only supported but expected.

There has been little research attention paid to fathers’ experiences of mental illness stigma. This scoping review sought to (a) “map” the current state of academic knowledge about fathers’ experiences of mental illness stigma, and (b) make initial recommendations about how such knowledge may inform anti-stigma interventions and policies. A scoping study methodology was used and literature searched between December 2014 and January 2015 in Scopus, PsychINFO and MEDLINE for peer-reviewed, qualitative papers. Directed content analysis was conducted on 12 identified studies, using a 4-part typology of stigma (public, self, associative and structural) as an analytical framework. Stigma was identified as a theme in seven studies, with public stigma the most commonly experienced. A priority for stigma prevention needs to be changing the current ways in which fathers with a mental illness are portrayed and perceived by the public, mental health professionals and by fathers themselves.

Psycho-education is a key component of interventions for young people who have a parent with a mental illness. When your parent has a mental illness is a psycho-educational booklet designed for young people, developed by the Australian Children of Parents with a Mental Illness (COPMI) national initiative. The booklet aims to promote young people's understanding of their parents’ mental illness. This pilot study sought to ascertain possible differences in knowledge of mental illness after the young people viewed the booklet; another aim was to obtain young people's feedback on how they used the booklet. A mixed methods research design was employed. Nine participants between 12–15 years of age completed the Children's Knowledge Scale of Mental Illness questionnaire before and after reading the booklet. Five of these participants then took part in follow-up interviews. No significant change was recorded on the Knowledge Scale. In the interviews, young people indicated that the booklet helped them initiate co...

While many people with a mental illness care for young children, there is a paucity of resources for these families and the professionals working with them. The purpose of this paper is to describe a new online resource, Pathways of Care, specifically designed for parents with a mental illness, early childhood educators, and mental health workers, and report on a pilot evaluation of the resource. Using a mixed method design, the effectiveness of the online resource in effecting worker confidence, knowledge and family-focused practice change will be examined. Pathways of Care aims to promote collaborative practice between agencies, identify relevant agencies and support workers in talking to parents about mental illness in families. Fifteen workers completed the Family Focus Mental Health Practice Questionnaire pre- and post-viewing the resource, to measure confidence and practice change; semi-structured interviews were then conducted with eight of these same workers to further explore the utility of the r...