The Family Talk Programme in Ireland: A Qualitative Analysis of the Experiences of Families With Parental Mental Illness

Background: Parental mental illness is common, costly, can lead to children developing mental disorders and impaired lifetime outcomes, and places a substantial burden on caregiving partners. Family Talk (FT) is a widely implemented, 7-session, whole-family programme, with promising evidence of effectiveness in targeting the intergenerational transmission of mental illness. However, to date, very little qualitative research of family experiences of FT has been undertaken. The objectives of this study were to: (1) investigate the experiences of families attending FT; and (2) explore the key facilitators and barriers to engagement in mainstream mental health settings.Methods: This study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] implemented in 15 adult, child and primary care mental health sites in Ireland. Semi-structured interviews were conducted with a purposive sample of 45 participants, including 23 parents with mental illness (PMI), 7 partners and 15 children/young people aged 9 to 18 years. Interview data were transcribed verbatim and analysed using constructivist grounded theory.Results: Over two thirds of families across sites reported substantial benefits from participation in FT, including reduced stigma, giving children and partners a voice, increased service-user confidence, and improved family communication/relationships. Key facilitators identified by families included: programme delivery by a competent, non-judgmental clinician; the whole-family approach; and family readiness to engage. Barriers to engagement included stigma, family crises/relapse, service constraints, impact of COVID-19, and a need for further child, family and follow-up sessions/supports.Conclusion: This study is the first qualitative analysis of family experiences of FT to be conducted within the context of an RCT and national programme to introduce family-focused practise for families with PMI. The findings illustrate that FT is beneficial across cultural/policy contexts, different mental disorders and can be implemented across adult and child mental health settings, including children with existing mental health challenges. Key barriers and facilitators to implementation were identified by families, all of which should help to inform the future implementation of FT, and other similar interventions, both in Ireland and elsewhere.

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Family Talk versus usual services in improving child and family psychosocial functioning in families with parental mental illness (PRIMERA—Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children): study protocol for a randomised controlled trial

Trials ◽

10.1186/s13063-021-05199-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mairead Furlong ◽

Sinead McGilloway ◽

Christine Mulligan ◽

Colm McGuinness ◽

Nuala Whelan

Keyword(s):

Mental Health ◽

Mental Illness ◽

Randomised Controlled Trial ◽

Psychosocial Functioning ◽

Controlled Trial ◽

Evidence Base ◽

Parental Mental Illness ◽

Research And Innovation ◽

Mental Health Settings ◽

Randomised Controlled

Abstract Background Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed method evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness. Methods The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost-effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5–18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are as follows: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention and at 6- and 12-month follow-up. Discussion Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings. Trial registration ISRCTN Registry, ISRCTN13365858. Registered 5th February 2019.

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A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.783161 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mairead Furlong ◽

Christine Mulligan ◽

Sharon McGarr ◽

Siobhan O'Connor ◽

Sinead McGilloway

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Illness ◽

Qualitative Study ◽

Child Protection ◽

Service Providers ◽

Controlled Trial ◽

Parental Mental Illness ◽

Structured Interviews ◽

Mental Health Settings

Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise “gap,” very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings.Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework.Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change).Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a “think family” infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.

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Family Talk Versus Usual Services In Improving Child And Family Psychosocial Functioning In Families With Parental Mental Illness (PRIMERA - Promoting Research And Innovation In Mental Health Services For Families And Children): Study Protocol For A Randomised Controlled Trial

10.21203/rs.3.rs-215175/v1 ◽

2021 ◽

Author(s):

Mairead Furlong ◽

Sinead McGilloway ◽

Christine Mulligan ◽

Colm McGuinness ◽

Nuala Whelan

Keyword(s):

Mental Health ◽

Mental Illness ◽

Randomised Controlled Trial ◽

Psychosocial Functioning ◽

Controlled Trial ◽

Evidence Base ◽

Service Utilisation ◽

Parental Mental Illness ◽

Mental Health Settings ◽

Randomised Controlled

Abstract Background: Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed methods evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness.Methods: The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5-18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention, and at 6-, 12-month follow up.Discussion: Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings.Trial registration: ISRCTN Registry, ISRCTN13365858. Registered 5th February 2019. http://www.isrctn.com/ISRCTN13365858

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A parent’s perspective of the bidirectional impact of mental illness in families

Clinical Nursing Studies ◽

10.5430/cns.v7n1p46 ◽

2018 ◽

Vol 7 (1) ◽

pp. 46 ◽

Cited By ~ 1

Author(s):

Michael Frederick Naughton ◽

Darryl Maybery ◽

Melinda Goodyear

Keyword(s):

Mental Health ◽

Mental Illness ◽

Interpretative Phenomenological Analysis ◽

Phenomenological Analysis ◽

Family Type ◽

Parental Mental Illness ◽

Family Experiences ◽

Narrative Design ◽

Parents And Children ◽

The Impact

Objective: Recent research has found over 70% of children attending a mental health service also have a parent with a mental illness. Research on the impact of mental illness in families focuses primarily on how parental mental illness impacts on children. What is not understood is the experience of parents and children where both have a mental illness. The aim of this study was to investigate the experiences of parents where both a child and a parent have a mental illness.Methods: Thirty-seven parents were interviewed using a narrative design to determine their personal and family experiences. Interviews were analyzed using interpretative phenomenological analysis with a number of themes highlighted.Results: Themes particular to this family type were: impact of parental mental illness; specific strategies; bidirectional impacts of mental illness; and intergenerational factors. Also raised were supports parents would have liked. From the narrative of these parents the challenges of families, where both a parent and a child have a mental illness, are highlighted.Conclusions: It is from these interviews, that awareness of clinicians can be raised, and more effective, well-thought-out interventions put in place. Interventions that take account of the bidirectional influences of mental illness will be more successful in meeting the needs of all members of a family. People do not operate in isolation and providing a family focused approach is an essential first step in helping people manage where mental illness is a prevalent factor for different family members.

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MyCare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial, clinical outcomes and hospital admission rates for adults with severe mental illness

BMJ Open ◽

10.1136/bmjopen-2020-040610 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040610

Author(s):

Renée O'Donnell ◽

Melissa Savaglio ◽

Debra Fast ◽

Ash Vincent ◽

Dave Vicary ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Hospital Admission ◽

Clinical Outcomes ◽

Controlled Trial ◽

Community Based ◽

Admission Rates ◽

Mental Health Support ◽

Health Support

IntroductionPeople with serious mental illness (SMI) often fail to receive adequate treatment. To provide a higher level of support, mental health systems have been reformed substantially to integrate mental healthcare into the community. MyCare is one such community-based mental health model of care. This paper describes the study protocol of a controlled trial examining the effect of MyCare on psychosocial and clinical outcomes and hospital admission and duration rates for adults with SMI.Methods and analysisThis is a multisite non-randomised controlled trial with a 3, 6 and 12-month follow-up period. The study participants will be adults (18–64 years of age) with SMI recruited from Hobart, Launceston and the North-West of Tasmania. The treatment group will include adults who receive both the MyCare intervention and standard mental health support; the control group will include adults who receive only standard mental health support. The primary outcome includes psychosocial and clinical functioning and the secondary outcome will examine hospital admission rates and duration of stay. Mixed-effects models will be used to examine outcome improvements between intake and follow-up. This trial will generate the evidence needed to evaluate the effect of a community mental health support programme delivered in Tasmania, Australia. If MyCare results in sustained positive outcomes for adults with SMI, it could potentially be scaled up more broadly across Australia, addressing the inequity and lack of comprehensive treatment that many individuals with SMI experience.Ethics and disseminationThis study has been approved by the Tasmanian Health and Medical Human Research Ethics Committee. The findings will be disseminated to participants and staff who delivered the intervention, submitted for publication in a peer-reviewed journal and shared at academic conferences.Trial registration numberACTRN12620000673943.

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Concerns about the children of psychiatric in-patients – what the parents say

Psychiatric Bulletin ◽

10.1192/pb.21.8.495 ◽

1997 ◽

Vol 21 (8) ◽

pp. 495-497 ◽

Cited By ~ 7

Author(s):

Fiona Stormont ◽

Tom Craig ◽

Zerrin Atakan ◽

Peter Loader ◽

Cindy Williams

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Services ◽

Health Services ◽

Research Literature ◽

Parental Mental Illness ◽

Adult Mental Health

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.

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Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

Primary Health Care Research & Development ◽

10.1017/s1463423615000523 ◽

2015 ◽

Vol 17 (05) ◽

pp. 421-427 ◽

Cited By ~ 5

Author(s):

Alexandros Maragakis ◽

Ragavan Siddharthan ◽

Jill RachBeisel ◽

Cassandra Snipes

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Illness ◽

Quality Of Care ◽

Serious Mental Illness ◽

Mental Healthcare ◽

Policy Reforms ◽

Mental Health Settings ◽

Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

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Associations between common mental disorders and the Mental Illness Needs Index in community settings

The British Journal of Psychiatry ◽

10.1192/bjp.bp.106.027458 ◽

2007 ◽

Vol 191 (2) ◽

pp. 158-163 ◽

Cited By ~ 13

Author(s):

David L. Fone ◽

Frank Dunstan ◽

Ann John ◽

Keith Lloyd

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Disorders ◽

Mental Disorder ◽

Small Area ◽

Common Mental Disorders ◽

Common Mental Disorder ◽

Service Planning ◽

Individual Risk ◽

Community Settings

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.

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Empathy, Burnout, and Attitudes towards Mental Illness among Spanish Mental Health Nurses

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020692 ◽

2022 ◽

Vol 19 (2) ◽

pp. 692

Author(s):

Daniel Román-Sánchez ◽

Juan Carlos Paramio-Cuevas ◽

Olga Paloma-Castro ◽

José Luis Palazón-Fernández ◽

Isabel Lepiani-Díaz ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Disorders ◽

Protective Factor ◽

Maslach Burnout Inventory ◽

Personal Accomplishment ◽

Snowball Sampling ◽

Cross Sectional ◽

Mental Health Nurses ◽

Positive Attitudes

Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.

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Sistem Informasi Manajemen Pos Pelayanan TerpaduKesehatan Jiwa di Desa Bongkot

JPM (Jurnal Pemberdayaan Masyarakat) ◽

10.21067/jpm.v5i1.3572 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Athi Linda Yani ◽

Mohamad Ali Murtadho

Keyword(s):

Mental Health ◽

Mental Illness ◽

Information System ◽

Mental Disorders ◽

Community Service ◽

Management Information System ◽

Management Information ◽

Service Program ◽

Efficiency And Effectiveness

Bongkot village has many people suffering from mental disorders. There are around fifty people suffering from mental disorders. Prediction of mental disorders at table three is usually done through interviews. Cadres need to fill out the form provided on the Towards Healthy Soul Card (KMSJ) at the interview. The form needs to be filled out based on the results of the interview to predict whether the interviewee has a mental illness or not. If the results of the interview are predicted to have a mental disorder, the cadre will recommend appropriate follow-up. This process is certainly prone to mistakes because it only depends on cadre knowledge. Predictions will certainly affect the recommendations given. in this community service program, the authors propose to apply Information Technology (IT) to reduce the risk of such errors. The system is named the Mental Health Posyandu Management Information System (SIM). The system is expected to be able to improve the efficiency and effectiveness of services at the posyandu, the output of this service produces an online-based application related to the service of mental health posyandu with the address www. poskeswa.com.

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