Researchers call for ‘whole of family’ approach within mental health services
An estimated 23pc of all families have at least one parent who has or had a mental health disorder, leaving their children at increased risk of also suffering the condition, new research revealed today.
This increases the lifetime risk of mental illness for their children by 41pc to 77pc.
The findings come from the five-year PRIMERA research programme on mental health within families by the Maynooth University Centre for Mental Health and Community Research.
The researchers said the findings of the comprehensive HSE-funded programme illustrated barriers that need to be addressed within mental health services.
It calls for the development of a ‘whole of family’ approach within mental health services, including automatic consideration of children when a parent has a mental health illness.
Principal investigator, Professor Sinéad McGilloway, recommended that ‘think family’ policy and practice be developed and incorporated as part of routine Adult and Child and Adolescent Mental Health Services in Ireland.
“We know that parental mental health can typically affect the entire family,” Prof McGilloway said.
"An estimated 23pc of all families have at least one parent who has or had a mental health disorder. We also know that the lifetime risk of mental illness for their children vastly increases by 41pc to 77pc.
“When child welfare is not considered in the treatment of parents with illness, our services are failing to identify a portion of children and adolescents who are at significant risk of becoming the next generation of mental health service users.
“These families often remain ‘invisible’ and are not identified due to little or no collaboration between Adult Mental Health Services (AMHS) and Child and Adolescent Mental Health Services (CAMHS); an individualised, crisis-oriented approach to assessment and treatment; confidentiality concerns amongst mental health professionals; and parental stigma/fear of social services and losing custody of their children.”
Mental Health Minister Mary Butler said: “I welcome the launch of PRIMERA’s research and its contribution to our understanding of the needs of families of people accessing mental health services.
"Outcomes for people with mental health difficulties tend to be better where family and carers are involved and where these families and carers themselves are supported.
“I am very supportive of the involvement of family members in an individual’s care with their consent, and this approach is supported by Sharing the Vision, our national mental health policy. Research such as this is a vital resource as we continuously seek to improve our mental health services.”
International studies estimate that 25pc–68pc of adult mental health service users are parents, and 35pc–60pc of children presenting at CAMHS have a parent with a mental illness.
Ireland is rated to have the third-highest incidence of adult mental illness across 36 countries in Europe — costing the Irish state €11 billion per year.
It is estimated that 280,000 children are dependent on parents who have a mental health illness.
Prof McGilloway added that there has been a growing recognition in most European countries of the need to support families in order to protect children, but Ireland lags well behind in terms of ‘think family’ policy and practice.
“Where a parent has a known mental health disorder, the needs of their children or partners should automatically be considered and provided for, if so required”, Prof McGilloway said.
The report recommended a number of approaches be taken, including:
- Auditing of the parenting status of adult mental health users
- Balancing the priority given to patient confidentiality with unmet family needs
- Increased collaboration between traditionally segregated adult and children’s services
- Equipping clinicians with time and resources to undertake family-focused practice.
These recommendations were identified by the PRIMERA research team as a result of their collaborative work with clinicians and HSE management to identify, implement and evaluate a family mental health intervention called Family Talk across a wide range of adult, child and primary care mental health sites.
Family Talk is the first family-focused mental health programme of its kind to be delivered in Ireland and involves a comprehensive whole-family approach designed to improve family communication/ relationships and resilience when there is parental mental illness.
PRIMERA research programme manager, Dr Máiréad Furlong, said despite the challenges – including Covid-19 restrictions – the findings showed that Family Talk was significantly beneficial for two thirds of families in the research, across different mental health settings and diagnoses.
Family Talk was evaluated using a randomised controlled trial involving 86 families –139 parents and 221 children – comparing outcomes with those who received ‘usual' services. The results showed that the families who received the intervention had:
- Fewer child behavioural and emotional problems at six-month follow up (less child depression, less conduct and hyperactivity problems, more prosocial behaviour)
- Enhanced family relationships (warmer, less disruptive and more adaptive)
- Enhanced mental health literacy (parents better understood the impact of mental illness on children, and children better understood their parent’s mental illness symptoms)
- Improvements in parents’ mental health symptoms, increased parental resilience and coping capacities.