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Background:As rates of pediatric concussion have steadily risen, and concerns regarding its consequences have emerged, pediatric concussion has received increased attention in research and clinical spheres. Accordingly, there has been a commitment to determine how best to prevent and manage this injury that so commonly affects young people. Despite this increased attention, and proliferation of research, pediatric concussion as a concept has rarely, if ever, been taken up and questioned. That is, little attention has been directed toward understanding what concussion ‘is’, or how young people are regarded in relation to it. As a result, pediatric concussion is understood in decidedly narrow terms, constructed as such by a biomedical way of knowing.Aim:We aim to demonstrate how conceptualizing concussion, and young people, ‘otherwise’, enabled the co-production of a more nuanced and complex understanding of the experience of pediatric concussion from the perspective of young people.Approach:Drawing on an illustrative case example from a critical qualitative arts-based study, we demonstrate how bringing young people into research as ‘knowers’ enabled us to generate much-needed knowledge about concussion in young people.Implications:The critical thinking put forward in this paper suggests a different approach to pediatric concussion, which is shared in the form of implications for clinical and research practice.

Purpose In the field of pediatric concussion, little to no scholarship has examined how clinical practice is shaped by patterned ways of thinking, talking about, and coming to understand concussion and young people (or "discourses of concussion in young people"). In this paper, we examine the ways in which one such discourse, the Pediatric Concussion Discourse (PCD), shapes how young people with concussion, their parents, and clinicians can think about, act in relation to, and experience concussion. Materials and methods This critical rehabilitation research is informed by the post-structuralist theory of Michel Foucault (1926-1984), and the key concepts of power/knowledge, discourse, and the subject. Results Circulating through clinical guidelines for the management of pediatric concussion, the PCD re/produces the expectation that young people with concussion and their parents will behave as "responsible" subjects who follow the recommendations of so-called experts without question. If recommendations are not implemented, the PCD has the potential to constitute these same groups as "nonadherent", re/producing problematic discourses of medical compliance. Conclusions By examining the effects of the PCD, it becomes possible to imagine how clinical practice and research might evolve in new ways that respect the knowledges and experiences of young people with concussion and their parents.Implications for RehabilitationEngaging in critical examination of clinical rehabilitative practice creates opportunity to imagine how we might approach commonly adopted clinical approaches, including the delivery of health education, differently.Implications for clinical rehabilitation practice include delivering health education in the context of supportive therapeutic relationships that respect the knowledges and experience of young people with concussion and their parents.Implications for rehabilitation research include engaging with critical scholarship within and beyond field and disciplinary boundaries, engaging in formal educational opportunities, and connecting with less formal but invaluable communities of practice.

Objectives Ensuring youth participation in policymaking that affects their health and well-being is increasingly recognized as a strategy to improve young people’s reproductive health. This paper aimed to describe the policy context and analyze underlying factors that influence youth participation in sexual and reproductive health (SRH) policymaking in Malawi. Methods This critical, focused ethnographic study is informed by postcolonial feminism and difference-centered citizenship theory, based on data collected from October 2017 to May 2018. Multiple research methods were employed: document analysis, focus group discussions, and “moderate” participant observation. Semi-structured interviews were conducted with key informants and youth, supplemented by open-ended drawing exercises with youth. Results Progressive policies and the presence of youth in some policymaking structures indicate substantial headway in Malawi. However, underlying structural and societal factors circumscribe young people’s lived experiences of participation. Conclusions Despite recent progress in involving young people in SRH policymaking, notable gaps remain between policy and practice. Recognizing and integrating young people in all stages of SRH policymaking is critical to catalyzing the social and political changes necessary to ensure their reproductive health and well-being. Electronic supplementary material The online version of this article (10.1007/s00038-020-01357-8) contains supplementary material, which is available to authorized users.

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.

Schools are important spaces for mental health promotion, prevention and early intervention. This chapter describes a study that used mural art created by young people to translate knowledge about first episode psychosis and pathways to mental healthcare. Our interest was in gauging reactions to the mural by using forms of expression via a ‘graffiti wall’ medium. A number of ‘graffiti walls’, blank scrolls of paper positioned near the mural, were created for secondary students to record their reactions to the mural. Cognitive and affective reactions to viewing and engaging with the mural installation were collected. Over 600 textual and visual responses were recorded on the walls across multiple school settings. Our analysis was inspired by new materialism theory, which helped us to explicate the role played by the graffiti walls as non-human actors within mural-wall-respondent assemblages. We used an interpretive thematic analysis, attending to the relational connections, affective forces and agential capacities generated within mural-wall-respondent assemblages. The graffiti wall afforded diverse agential capacities both inwards, in the form of affective forces and proliferating interpretations of the work, and outwards, in the form of creating relational connections between the artists and the students, and among the students themselves. Implications for youth-centred education and mental health awareness are discussed.

Objective: In the knowledge base examining experiences of childhood brain injury, the perspectives of children with brain injury are notably lacking. This failure to represent the voices of pediatric clients has resulted in an incomplete knowledge base from which to inform evidence-based rehabilitation practice. In this paper, we examine why the perspectives of children with brain injury are rarely sought and propose a new way forward.Methods: We draw upon current evidence and practices in related fields and present an exemplar from an in-progress qualitative arts-based research project with children with brain injury.Results: Assumptions ingrained in research practices, particularly those surrounding the capacity of 'doubly vulnerable' children with brain injury to produce knowledge, have resulted in the relative exclusion of this group from research that concerns them. For the field to evolve, research practices must value children's first-hand accounts, engage them in co-constructing knowledge about their lives, and invite methods that meet their interests and abilities.Conclusion: By reframing how we think about the capacities of children with disabilities and shifting our research practices to include children with brain injury as knowledgeable participants, it becomes possible to expand the knowledge base upon which clinical rehabilitation practices are built.Implications for RehabilitationCurrent research practices preclude 'doubly vulnerable' pediatric populations, including children with brain injury, from actively contributing to research that concerns them.As a result, the perspectives of children with brain injury are virtually absent from research, rendering the evidence base upon which rehabilitative practices are built incomplete.Reframing how we think about the capacities of children with brain injury can shift how we engage with them, both in research and clinic, and may subsequently impact the knowledge available to us.Implications for client-centred rehabilitation are discussed, including the need to understand children as capable of insight into their own experience, as able to contribute to a more complete understanding of the health phenomena that affect them, and as invaluable and active participants in research and clinical care.

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.

Although the Capability Approach (CA) has been applied in research about children, the extent of this is unclear. Developing knowledge about the CA applied to childhood is important to facilitate support that may benefit children’s well-being. To identify and synthesise the literature on this topic, we used a scoping review methodology with the guiding questions: How has the CA been used in research with children and their social contexts? Which data generating strategies have been used in this research? Searches conducted in June 2018 yielded 6773 records. Seventy-one studies met our inclusion criteria. While the CA was initially described in 1979, most studies were published from 2011 onwards. The CA was used most often in education research, with few studies in health research. The majority of studies used qualitative and/or participatory approaches. Children’s perspectives were included in the majority of studies, but only a fifth were with young children (

Much qualitative research produces little new knowledge. We argue that this is largely due to deficits of analysis. Researchers too seldom venture beyond cataloguing data into pre-existing concepts and scouting for “themes,” and fail to exploit the distinctive powers of insight of qualitative methodology. The paper introduces a “value-adding” approach to qualitative analysis that aims to extend and enrich researchers’ analytic interpretive practices and enhance the worth of the knowledge generated. We outline key features of this form of analysis, including how it is constituted by principles of interpretation, contextualization, criticality, and the “creative presence” of the researcher. Using concrete examples from our own research, we describe some analytic “devices” that can free up and stretch a researcher’s analytic capacities, including putting reflexivity to work, treating everything as data, reading data for what is invisible, anomalous and “gestalt,” engaging in “generative” coding, deploying heuristics for theorizing, and recognizing writing as a key analytic activity. We argue that at its core, value-adding analysis is a scientific craft rather than a scientific formula, a creative assemblage of reality rather than a procedural determination of it. The researcher is the primary generative and synthesizing mechanism for transforming empirically observed data into the key products of qualitative research—concepts, accounts and explanations. The ultimate value of value-adding analysis resides in its ability to generate new knowledge, including not just the “discovery” of things heretofore unknown but also the re-conceptualization of what is already known, and, importantly, the reframing and reconstitution of the research problem.

Background: Trauma is a factor impacting the lives of many people experiencing psychiatric disorders. Trauma affects people’s responses to illness as well as their interactions with services. Aim: This study aimed to explore the understandings and experiences of psychiatrists of working with trauma and emerging models of Trauma-Informed Care. Methods: An interpretive qualitative inquiry was undertaken using semi-structured in-depth interviews with psychiatrists. Results: Four themes were identified: Making sense of trauma; A contentious relationship between trauma and mental illness; Treatment made more challenging by trauma; Trauma-Informed Care highlights tensions. Psychiatrists are familiar with the concept of trauma but there are differences in beliefs about its relationship to mental illness that are consequential for practice. Trauma-Informed Care is seen as an effort to humanise mental health services, but with perceived limited impact on psychiatrists’ roles. Conclusion: Findings indicate need for further consultation and collaboration with psychiatrists around trauma-informed care implementation; as well as consideration of what is required to develop professional consensus on trauma and its relationship to illness.

Although claims to “give voice” to children through qualitative inquiry seem morally just and have been largely framed by good intentions, critical scholarship has called for reflexive reconsiderations of such claims. Re/presentations of voice permeate published accounts of qualitative research with children; similarly, voice is a term invoked frequently in qualitative research with informants of all ages. In this article, we follow Spyrou’s notion of “troubling” to review, critique, and synthesize key works by critical child-focused scholars who have reflexively queried and worked with the epistemological and methodological limits of “giving voice” to children through qualitative inquiry. Building on the reviewed literature, as well as poststructural approaches to framing voice in research more generally, we briefly discuss how we have built on these critiques in our own research. In so doing, we join ongoing dialogues aimed at generating alternative approaches to theorizing and re/presenting children’s perspectives in qualitative inquiry more justly.

Problem identification Improvements in pediatric cancer survival have increased interest in the experiences of children undergoing treatment; however, no review of the qualitative literature describing these experiences has been conducted. Literature search Databases were searched from January 2000 to January 2016 for qualitative studies describing the experience of children with cancer aged 18 years or younger. Data evaluation Two reviewers assessed abstracts for relevance and rated reporting comprehensiveness. Participant quotations and descriptions of participants' comments and behaviors were coded. Coded data were pooled to provide a thematic synthesis. Synthesis 51 studies were included. Five themes were identified. Implications for research Results provide data related to the experience of children with cancer that can inform practice changes and research activities aimed at enhancing quality of life.

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Supportive care Prioritization, Assessment and Recommendations for Kids (SPARK) is a web-based application that enables symptom screening and access to clinical practice guidelines for symptom management. Objective was to determine the feasibility of a randomized trial of daily symptom screening for 5 days among children receiving cancer treatments. We included English-speaking pediatric cancer and hematopoietic stem cell transplantation (HSCT) patients who were 8–18 years of age at enrollment and who were expected to be in the hospital or in clinic daily for five consecutive days. We randomized children to either undergo daily symptom screening with symptom reports provided to the healthcare team using the SPARK vs. standard of care. The primary endpoint was feasibility, defined as being able to enroll at least 30 participants within 1 year, and among those randomized to intervention, at least 75% completing symptom screening on at least 60% of on-study days. From July 2018 to November 2018, we enrolled and randomized 30 participants. The median age at enrollment was 12.5 (range 8–18) years. Among the intervention group, the median number of days Symptom Screening in Pediatrics Tool (SSPedi) was completed at least once was 5 (range 4 to 5), with one participant missing 1 day of symptom screening. Among all participants, baseline and day 5 SSPedi scores were obtained in 29/30 participants. A randomized trial of the SPARK with daily symptom screening for 5 days was feasible. It is now appropriate to proceed toward a definitive multi-center trial to test the efficacy of SPARK to improve symptom control.

Hiring and promotion of qualitative researchers in the health sciences, in Canada and internationally, is impacted by the prestige of quantification as the ultimate measure of scientific quality in current academic and health-care settings. This is further exacerbated by neoliberal notions of productivity, which offer very limited forms of assessment for different ways of producing knowledge or doing science differently. While qualitative researchers share the effects of the politics of productivity and corporate university policies with other academics, we argue that they are disadvantaged by the combination of the latent biomedical conservatism that characterizes the health sciences in Canada with the lack of frameworks to acknowledge and properly assess alternative forms of interdisciplinary scholarship. In our experience, it is challenging for qualitative researchers to advance in Canadian health sciences faculties. In light of this, we propose a framework for evaluating their scholarly work. We have structured this article in three sections: (a) to characterize the academic landscape in which qualitative health scholars find themselves when housed in Canadian faculties of medicine and their schools of health sciences, (b) to report on an organizational scan we undertook in order to understand current practices of evaluating scholarly productivity at these institutions, and (c) to propose a set of criteria that could more appropriately evaluate the contributions made by qualitative researchers working in the health sciences.

Using the Canadian context as a case study, the research reported here focuses on in-depth qualitative interviews with 36 researchers, artists and trainees engaged in ‘doing’ arts-based health research (ABHR). We begin to address the gap in ABHR knowledge by engaging in a critical inquiry regarding the issues, challenges and benefits of ABHR methodologies. Specifically, this paper focuses on the tensions experienced regarding academic legitimacy and the use of the arts in producing and disseminating research. Four central areas of tension associated with academic legitimacy are described: balancing structure versus openness and flexibility; academic obligations of truth and accuracy; resisting typical notions of what counts in academia; and expectations vis-à-vis measuring the impact of ABHR. We argue for the need to reconsider what counts as knowledge and to reconceptualize notions of evaluation and rigor in order to effectively support the effective production and dissemination of ABHR.

Background Facial morphoea is a chronic inflammatory skin disorder, typically presenting in childhood and adolescence, which can be disfiguring, and which has been suggested to cause mild-to-moderate impairment in quality of life. Objectives To explore the everyday experiences of children with facial morphoea by examining the psychosocial impact of living with facial morphoea and how children and their families manage its impact. Methods We used a qualitative, social constructionist approach involving focus groups, in-depth interviews and drawing activities with 10 children with facial morphoea aged 8-17 years and 13 parents. Interpretive thematic analysis was utilized to examine the data. Results Children and parents reported on the stress of living with facial morphoea, which was related to the lack of knowledge about facial morphoea and the extent to which they perceived themselves as different from others. Self-perceptions were based on the visibility of the lesion, different phases of life transitions and the reactions of others (e.g. intrusive questioning and bullying). Medication routines, and side-effects such as weight gain, added to the stress experienced by the participants. To manage the impact of facial morphoea, children and their parents used strategies to normalize the experience by hiding physical signs of the illness, constructing explanations about what 'it' is, and by connecting with their peers. Conclusions Understanding what it is like to live with facial morphoea from the perspectives of children and parents is important for devising ways to help children with the disorder achieve a better quality of life. Healthcare providers can help families access resources to manage anxiety, deal with bullying and construct adequate explanations of facial morphoea, in addition to providing opportunities for peer support.

Involving children in participatory health research (PHR) provides exciting opportunities to gain insights into their perspectives and capacities and encourages them to make a meaningful contribution to issues affecting their lives. It is underpinned by a rights-based approach, where children’s evolving expertise is valued. In PHR, children are not just research participants – they are co-researchers. This raises challenges and ethical issues on several levels, including the nature of child engagement, the role of adults, and methods to promote child agency, while also ensuring their safety is not compromised. This chapter uses real international exemplars to illuminate the complexity and debate on theory and practice in relation to PHR with children. These examples reflect the flexibility inherent in the approach to accommodate culture and context. They also highlight the need to avoid tokenism, which might undermine children’s agency, and encourage first attempts, reflexive practice, and progressive improvements in PHR competence. Children’s right to subvert or deny the participatory process is recognized as a challenge to the adults involved but is also a way to realize impacts and outcomes that are more relevant for those children. Finally, Kids in Action is presented as an international network of PHR projects involving children to promote best practice, develop and share resources, link similar projects to maximize impacts, and provide a platform for children’s voices in relation to global issues.

We report an ethnographic analysis of a psycho-education and peer-support program for school-aged children of parents with mental illnesses. We conducted a critical discourse analysis of the program manual and observed group interactions to understand whether children shared program goals predetermined by adults, and how, or if, the intervention was responsive to their needs. Children were expected to learn mental illness information because “knowledge is power,” and to express difficult feelings about being a child of a mentally ill parent that was risky. Participants used humor to manage group expectations, revealing how they made sense of their parents’ problems, as well as their own. Suggestions are made for determining good mental health literacy based on children’s preferences for explaining circumstances in ways they find relevant, and for supporting children’s competencies to manage relationships that are important to them.

Purpose: To explore the experiences of young people with physical disabilities relating to social inclusion and physical activity, in order to describe the characteristics of social environments that support participation in physical activity. Method: An iterative, qualitative design employed in-depth, semi-structured interviews with young people with physical disabilities aged 12–18 (n = 11). Data were analyzed using interpretive thematic analysis. Results: Young people described several ways that their social environments help motivate and support them in their physical activity participation. These include providing: fair and equitable participation beyond physical accommodations; belonging through teamwork; and socially supported independence. Conclusions: Supportive social environments characterized by equitable participation, a sense of belonging, and opportunities for interdependence, play a critical role in promoting the health and well-being of young people with physical disabilities. These characteristics are important to consider in the design of both integrated and dedicated physical activity programs.

Aim: To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis. Method: Eight focus groups were conducted involving an average of four to six participants per group, with each group consisting of young people who met provincial inclusion criteria for early intervention programmes. Thematic analysis was used to systematically code transcripts from the focus groups for concepts, patterns and themes related to early use of illicit substances. Results: Participants included 45 young people diagnosed with affective psychosis or non-affective spectrum disorders. Seventy-three per cent were male, with a median age of 23 years. In general, substance use was an important topic that emerged across all focus groups. Participants talked about three main factors attracting them to initiate use of substances, most predominantly cannabis: (i) using within a social context; (ii) using as a self-medication strategy; and (iii) using to alter their perceptions. Conclusions: The need for social relationships, coping strategies and pleasurable experiences appear to be important reasons for initiating substance use. Additional research is needed to identify whether prodromal youth report the same factors that attract them to initiate use in order to develop more effective prevention strategies.

Aim: This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care. Methods: A case study approach documents help-seeking pathways, encompassing two qualitative interviews with 10 young people and 29 significant others. Theoretical propositions derived from the REV NEM are explored, consisting of the content, structure and function of the: (i) family; (ii) community and school; and (iii) treatment system. Results: Although the aspects of the REV NEM are supported and shape pathways to care, we consider rethinking the model for help seeking with youth at ultra high risk for psychosis.

Aim: This paper provides a review of published qualitative research on children's experiences of parental mental illness. Methods: We undertook a comprehensive search of Medical Literature Analysis and Retrieval System Online, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts and Applied Social Sciences Index and Abstracts databases, as well as citation searches in Web of Science and manual searches of other relevant journals and reference lists of primary papers. Results: Although 20 studies met the search criteria, only 10 focused exclusively on children's descriptions of their experience – the remainder elicited adults' perspectives on children's experiences of parental mental illnesses. Findings are organized under three themes: the impact of illness on children's daily life, how children cope with their experiences and how children understand mental illness. Conclusions: Despite references to pervasive knowledge gaps in the literature, significant information has been accumulated about children's experiences of parental mental illness. Considerable variability in research findings and tensions remain unresolved. For example, evidence is mixed as to children's knowledge and understanding of mental illnesses and how best to deploy resources to help them acquire optimal information. Furthermore, children's desire to be recognized as important to their parents' well-being conflicted with adults' perceptions that children should be protected from too much responsibility. Nevertheless, the cumulative evidence remains a key reason for advocating for psychoeducation and peer-support group interventions for children, which are endorsed by child and adult study participants alike.

In this chapter, we explore some of the affinities that can be developed between new information and communication technologies and what has become known as aboriginal ways of knowing. This work documents some of these affinities via the collaborative development of an online project entitled “Nitsitapiisini—Stories and Spaces: Exploring Kainai Plants and Culture,” conducted with teachers, students, and elders of the Blood Tribe in southern Alberta. The pedagogy of this collaboration is then linked to rethinking the disciplines ofknowledge entrusted to teachers and students in schools as living disciplines that make demands on the possibilities inherent in new technologies. This particular orientation tubs against instructionist practices found in many classrooms yet, once awakened, spawns curiosity and creativity.

Primary data are rarely used explicitly as a source of data outside of the original research purpose for which they were collected. As a result, qualitative secondary analysis (QSA) has been described as an "invisible enterprise" for which there is a "notable silence" amongst the qualitative research community. In this paper, we report on the methodological implications of conducting a secondary analysis of qualitative data focusing on parents' narratives of help-seeking activities in the prodrome to psychosis. We review the literature on QSA, highlighting the main characteristics of the approach, and discuss issues and challenges encountered in conducting a secondary analysis. We conclude with some thoughts on the implications for conducting a QSA in children's mental health services and research.

BACKGROUND The concept of motivation involves a complex interplay of biopsychosocial and environmental determinants. For individuals diagnosed with schizophrenia, motivation has traditionally been approached from a neuro-biological standpoint, obscuring this complexity. The findings from this study underscore the importance of broadening our understanding of motivation and schizophrenia through an exploration of individual perspectives and identification of the psychosocial factors that clarify the experience of diminished motivation.

First episode psychosis represents a critical period for intervention to prevent future impairments and to initiate optimal interventions. Using an interpretive interactionist framework, a secondary analysis of interview transcripts was conducted based on the narratives of youth experiences of psychosis. Our goal was to better understand the factors involved in the decision to seek help (or not) from the mental health system. Findings suggest that help seeking is a social process involving a wide range of influences; two such influences are highlighted in this paper, an individual avoidant strategy of ignoring and hiding early symptoms, and the persuasive influence of significant others in the social network.

Children who live with a mentally ill parent are viewed primarily as being 'at risk' of developing a mental illness themselves and those who remain well are considered extraordinarily resilient. This particular risk/resilience discourse is embedded within larger contemporary discourses about risk and childhood. Childhood is seen as a critical period of development during which children need protection due to their physical and psychological vulnerabilities. In this paper, the implications of this dominant casting of children are explored and it is argued that the conceptual repertoire about those living with a mentally ill parent should be expanded. A critique of the literature that established the risk/resilience discourse is followed by a discussion of research about parenting with a mental illness within which children are surprisingly absent. Recent thinking about children arising out of the 'new' social studies of childhood is summarized to illustrate its resistance to the hegemonic image of children as passive, developing, 'unfinished' persons. A recasting of children as complex young persons who have competencies as well as vulnerabilities linked to their developmental stages, would lead to different lines of inquiry about children's experiences of mental illness in a parent.