Risk and Protective Factors Associated With Health-Related Quality of Life of Parents With Mental Illness

Purpose: Health-related quality of life (HRQoL) can be reduced in parents with mental illness (mental illness) who face the dual demands of disabling symptoms and their impact on family, social, and occupational life. This study aimed at analyzing the influence of various factors on HRQoL in parents with mental illness.Method: Baseline data of the German randomized controlled multicenter project CHIMPS (children of parents with mental illness) was used for analyses. The final sample consisted of n = 208 parents with mental illness and n = 197 children and adolescents aged 8–18 years. HRQoL was assessed with the EQ-5D.Results: Parents with mental illness reported significantly lower global and specific HRQoL than the German reference population. They were least satisfied with aspects that relate to anxiety and depression followed by usual activities, pain and discomfort. Better global HRQoL was primarily associated with self-reported physical and mental health, as well as adaptive coping behavior. Associations with mobility, self-care, usual activity, pain and discomfort, anxiety and depression were analyzed and discussed.Conclusions: HRQoL in parents with mental illness is reduced. Clinical interventions should focus on the alleviation of mental health symptoms and probably somatic symptoms and promote adaptive coping skills.

Parents With Mental Illness: Parental Coping Behavior and Its Association With Children's Mental Health

The relevance of coping behavior for the individual's own mental health has been widely investigated. However, research on the association between coping of parents with a mental illness and their children's mental health is scarce. In the current study, we address the role of several parental coping strategies and their relation to child psychological symptoms. As part of the German randomized controlled multicenter study CHIMPS (children of mentally ill parents), parents with mental illness completed questionnaires on illness-related coping and child mental health symptoms. Children's diagnoses of a mental disorder were assessed with diagnostic interviews. The sample comprised n = 195 parents with mental illness and n = 290 children and adolescents aged 4–18 years. We conducted mixed models to investigate the associations of parental coping strategies with internalizing and externalizing symptoms as well as the diagnosis of a mental disorder in children controlling for sociodemographic factors and parental symptom severity. Parental coping characterized by religiosity and quest for meaning was significantly associated with fewer mental health symptoms and lower odds of a mental disorder in children, whereas a depressed processing style was related to increased internalizing problems in the children. Coping behavior in parents with mental illness is a relevant factor for the mental health of their children and should be considered in preventive interventions.

Costs of health and social services use in children of parents with mental illness

Background Children of parents with mental illness have a higher risk of developing mental health problems when compared with the general population. Therefore, families with parents with mental illness are a suitable target group for selective prevention. In order to plan and evaluate the health economic consequences of preventive interventions for this target group, data on the societal costs related to parenthood under the condition of mental disorders are needed. To date, within Germany there has been a lack of research evaluating the costs of mental health treatment and use of social services by children and adolescents with parents with mental illness. Methods As part of a multicentre randomised controlled trial, use and costs of health and social services were assessed for a sample of 332 children and adolescents with parents with mental illness in six regions of Germany. Service use at baseline was assessed by the German version of the Children and Adolescent Mental Health Service Receipt Inventory. Costs were calculated for 12 months based on diagnosis and service user status and described separately. Cost drivers were identified by means of a two-part regression model. Results Total mean costs for 12 months for the total sample amount of € 3736.35 (95% CI: € 2816.84–4813.83) per person. Children with a psychiatric diagnosis generated a total of € 5691.93 (95% CI: € 4146.27–7451.38) of costs per person, compared to € 1245.01 (95% CI: € 657.44–1871.49) for children without a psychiatric diagnosis. The logit part indicates significant odds ratios for individual functioning and diagnosis of the child as well as for family functioning. The linear part reveals that increasing individual functioning in the child is related to decreasing costs. Conclusions Children of families with parents with mental illness use a broad spectrum of mental health care, school-based support and youth welfare services even if they are not yet diagnosed as having a mental disorder. Further research should examine whether these institutions are sufficiently qualified and interlinked to meet the support needs of this vulnerable group. Trial registration The study was registered at the 07/10/2014 before the start of data collection (04/11/2014) at the German clinical trials register (Deutsches Register Klinischer Studien, DRKS, nr: DRKS00006806, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006806).

Exploring Peer Support as a Strategy to Reduce Self-Stigma for Marginalised Children of Parents with Mental Illness (COPMI)

Many children of parents with mental illness (COPMI) experience stigma, resulting in detrimental effects and the need for support. Peer support programmes are widespread interventions, commonly providing relational, psychological and educational support. Some evidence suggests that these programmes result in positive changes to COPMI experiences of self, peers and their families. This article adds to the evidence base, presenting findings from a primarily qualitative, mixed-methods programme evaluation of a COPMI service in Aotearoa/New Zealand. Formative evaluation data were gathered from a COPMI service which supports families adversely affected by chronic and severe parental mental illness, via interviews (N = 10) and four age-differentiated focus groups (N = 24) of child/youth service-users aged eight to eighteen years, and mixed-method surveys of adult service-users (N = 32). This article reports data from child/youth service-users who participated. Findings indicate that many participants experienced stigma outside the service, and self-stigma was reduced for many due to supportive peer relationships formed during service delivery. Further understanding of the relationship between peer support and self-stigma in these programmes is needed, and how positive changes to self-perceptions might translate to other spheres. The application of socio-ecological resilience theory to findings implies that COPMI service delivery should address differential needs in relation to marginalisation and promote sustained peer relationships for those who are marginalised.

Mapping the literature on parents with mental illness, across psychiatric sub-disciplines: a bibliometric review

Background Research on parental mental illness is often carried out in disorder specific research silos. Drawing on the different research areas, it is possible to leverage and combine existing knowledge, and identify insights that can be transferred across research areas. In this study, we identify the overarching structure of research on parents with psychiatric disorders, and the structure of the different research areas, as defined by psychiatric disorder groups in ICD-10, and identify both topics that are commonly examined, and topics that received attention in only a few of the research areas. Methods We use bibliometric science mapping to examine keywords in 16,734 articles, showing the overarching structure of research on parents with mental illness, both overall and within ICD-10 psychiatric disorder categories. The search was conducted using the Scopus database for journal articles published between 1999 and 2018, with no restrictions on language. Results Co-occurrence analysis of the keywords in the 16,734 articles on parental mental illnesses in different psychiatric disorder categories, indicate there are six general themes in the literature: ‘expectant mothers and early motherhood’, ‘substance use and abuse’, ‘Socio-economic status’ (SES) and support practices’, ‘biomedical research‘, ‘diagnoses, symptoms and treatment’, and ‘child–parent interaction and context’. Although the same themes are covered in different areas, the contexts, in terms of content and relation to other topics, vary between the research areas. Some topics are heavily researched in some areas, but seem to be neglected in others. Conclusions This study provides data both in interactive maps and an extensive table, allowing readers to dive deep into their topic of interest, and examine how this connects to other topics, which may in turn guide identification of important gaps in the literature, and ultimately inspire and generate novel research avenues.