Identifying and Supporting Children of Mentally Ill Parents within Adult Mental Health Services

2017 ◽  
Vol 41 (S1) ◽  
pp. S38-S38
Author(s):  
C. Reedtz

BackgroundStudies have shown that implementing a change of practice in adult mental health care to identify and support children of mentally ill parents is challenging, even though the risk of transgenerational transmission of socioemotional problems and psychopathology has been thoroughly demonstrated the last decade.AimsThe current presentation describes the existing practice of identifying and supporting children of mentally ill parents within adult mental health services. The study was conducted after Norwegian health legislation had been changed to make these tasks mandatory. The effort included implementation of two interventions; Family Assessment, an intervention for practitioners to increase identification of patients who are also parents and their children, and child talks, an intervention designed to provide support for parents and children within the participating hospital.MethodThe sample included mental health professionals in a large university hospital in Northern Norway, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. Register data from the Electronic Patient Journals (EPJ) was analyzed to assess whether or not the self-reported routines match the reality in the clinic.DiscussionThe prospects of clinical change will be discussed in general, as well as to which extent the two implemented interventions have contributed to changes in the clinical practice, workforce knowledge and attitudes in the participating hospital.Disclosure of interestThe author has not supplied his declaration of competing interest.

1997 ◽  
Vol 21 (8) ◽  
pp. 495-497 ◽  
Author(s):  
Fiona Stormont ◽  
Tom Craig ◽  
Zerrin Atakan ◽  
Peter Loader ◽  
Cindy Williams

There is an increasing body of research literature investigating the effects of parental mental illness on children. This study investigates the views of psychiatric in-patients on consequences of their admission to hospital and their mental illness for their children. The results suggest that the parents do not readily acknowledge that their children have problems, and that interventional approaches require good liaison between adult mental health services and child-focused agencies.


2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.


2014 ◽  
Vol 3 (6) ◽  
pp. 56 ◽  
Author(s):  
Camilla Lauritzen

This article addresses the issue of parental mental illness. The theoretical background and rationale for developing new routines to change clinical practice is described, suggesting a policy change in which a child focus is implemented in adult mental health services. Furthermore, proposed strategies that have the potential of being effective within existing health care systems are discussed.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Lockertsen ◽  
Liv Nilsen ◽  
Lill Ann Wellhaven Holm ◽  
Øyvind Rø ◽  
Linn May Burger ◽  
...  

Abstract Background The transition period between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) has been identified as an especially critical time for patients with anorexia nervosa. In the present study, to better facilitate patients’ recovery process, we explored the experiences of professionals concerning the transition from CAMHS to AMHS. Method A qualitative explorative study was carried out based on recorded interviews from one multi-step focus group and two individual interviews with eight experienced health care professionals. Together they had experience with treating patients with AN and the transition from CAMHS to AMHS, both from specialized eating disorder units, specialized mental health care units, and from a school nurse context. Service users with parents` perspectives and patients’ perspectives were involved in all steps of the research process. Results Barriers experienced during the transition process were classified into four categories: (1) different treatment cultures that describe differences in how parents are included in CAMHS and AMHS; (2) mistrust between CAMHS and AMHS that can create a lack of collaboration and predictability for the patients’ transition; (3) Clinicians` factors such as lack of professional self-confidence can influence continuity of care for patients; and (4) lack of trust between services and not enough focus on building a new alliance in AMHS negatively influences the transition. Conclusions The present study revealed four important categories that professionals needs to consider when participating in the transition for patients with AN from CAMHS to AMHS. Awareness of these challenges might improve the transition process for patients with AN.


2013 ◽  
Vol 37 (3) ◽  
pp. 85-88 ◽  
Author(s):  
Kate Daley ◽  
Jonathan Richardson ◽  
Ian James ◽  
Annette Chambers ◽  
David Corbett

Aims and methodTo explore the experiences and attitudes of mental health professionals working in acute elderly care to a new clinical dashboard system. Metrics were identified from the Royal College of Psychiatrists' Accreditation for Inpatient Mental Health Services – Older People (AIMS-OP); these were tracked from baseline to 6 months. A questionnaire was developed and distributed across the three clinical areas involved in the clinical dashboard mental health pilot.ResultsStaff completed the questionnaire 3 months after the initial implementation. At this point the benefits of the introduction of the dashboard were suggested as: improved access to information, increased communication and information-sharing, increased staff awareness, and data quality.Clinical implicationsThe introduction of the clinical dashboard in older adult mental health services allowed for better data availability and resulted in better data quality.


2016 ◽  
Vol 11 (5) ◽  
pp. 286-293 ◽  
Author(s):  
Aurélie Schandrin ◽  
Delphine Capdevielle ◽  
Jean-Philippe Boulenger ◽  
Monique Batlaj-Lovichi ◽  
Frédérick Russet ◽  
...  

Purpose Adolescents and young adults’ mental health problems are an important health issue. However, the current organisation of the care pathway is not robust enough and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) has been identified as a period of risk. The paper aims to discuss these issues. Design/methodology/approach A retrospective survey was conducted in Montpellier University Hospital concerning transitions organised between CAMHS and AMHS between 2008 and 2009. The aim was to assess if transitions met four criteria identified in literature as warranting an optimal transition. Findings In total, 31 transitions were included. Transition was accepted by AMHS in 90 per cent of cases but its organisation was rarely optimal. Relational continuity and transition planning were absent in 80 per cent of cases. The age boundary of 16 often justified the triggering of the transition regardless of patient’s needs. Discontinuity was observed in 48 per cent of transition cases, with an average gap of three months without care. Psychiatrists reported difficulties in working together. Finally, at the moment of the survey (one to three years later), 55 per cent of patients were lost to follow-up. Research limitations/implications This is a retrospective study on a small sample but it reveals important data about transition in France. Practical implications Transition process should include collaborative working between CAMHS and AMHS, with cross-agency working and periods of parallel care. Social implications Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU. Originality/value Data related to the collaboration between CAMHS and AMHS services are scarce, especially regarding the transition in France.


2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.


2000 ◽  
Vol 34 (5) ◽  
pp. 748-754 ◽  
Author(s):  
Ian Hickie ◽  
David Burke ◽  
Margaret Tobin ◽  
Carolyn Mutch

Objective: The objective of this study was to examine the impact of the organisation of mental health services on the quality of medical and psychiatric assessment provided to patients with depression over 50 years of age. Method: A retrospective clinical audit of 99 patients with primary depressive disorders who were over 50 years of age was used. These patients were assessed initially by specialised psychogeriatric outpatient and community services (44%), community-based adult mental health services (35%) or an inpatient service (21%). At 2–3 years follow up, clinical outcomes were rated by treating physicians and included current depression status, cognitive and medical status, course of illness since initial assessment and current living circumstances. Results: Patients who were assessed by the community-based adult mental health service received the least comprehensive assessment. Although these patients were more likely to be living independently, they tended to have the poorest depression outcome. Patients who were assessed by the specialised or inpatient services received more comprehensive initial assessment and better coordinated long-term care. Although these patients had more medical and cognitive comorbidity they had better overall depression outcomes. Conclusions: Within a service system that determines access according to an arbitrary age of onset, patients with depression receive the best assessment from specialised psychogeriatric services. However, patients with an early age of onset, more chronic disorders and poor outcomes are treated largely within community-based adult services. Psychiatric services need to ensure that all older patients with depression receive appropriate biomedical and psychosocial assessment, as well as continuity of medical and psychological treatment.


2020 ◽  
Vol 25 (3) ◽  
pp. 277-288
Author(s):  
Rosie Martin ◽  
Jackie Sturt ◽  
Frances Griffiths

Background Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods Use of Neale’s (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people’s perceptions of adult services as supportive, empowering and available. DC can be used for frequent ‘check-ins’ and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting.


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