Abstract
Background: A research project aimed to improve the situation of children of parents with a mental illness (COPMI) is underway in the Austrian region of Tyrol. The project aims to strengthen formal and informal support structures around the child, through enhancing their village of collaborative support. Understanding the current situation in the region is vital for implementing practice change. This paper aims to gain knowledge on the Tyrolean societal and service provision context. Methods: We collected qualitative (e.g. interviews) and quantitative data (e.g. administrative data from the health insurance) on overall societal characteristics, epidemiology of mental illness in Tyrol, current services within adult mental healthcare and for supporting children, parents and families, uptake of services, and current practices and challenges of identifying and supporting COPMIs. We analysed data along several external context dimensions: 1) professional influences, 2) political support, 3) social climate, 4) local infrastructure, 5) policy and legal climate, 6) relational climate, 7) target population, and 8) funding and economic climate. Results: We identified that there is awareness of challenges related to COPMIs at professional and planning level, however there is a lack of installed support processes and standards to meet these children’s needs across Tyrol. A variety of services are available both for unwell parents, and families and individual family members. Yet, only one small service addresses COPMIs directly. Services fall into different sectors (education, health, social affairs) and are funded from different sources, making coordination difficult. Access varies from universal to rather restricted (i.e. through referral). The potential number of parents which could be reached in order to identify their children via adult mental health differs considerably by setting. Societal structures indicate that the informal and voluntary sector may be a realistic source for supporting COPMIs in Tyrol. Conclusions: Societal structures and current services provide a rich resource for improving identification and supporting of COPMIs, however considerable coordination and behaviour change effort will be required due to the fragmentation of the system and professional cultures. Insights into the context of supporting COPMIs have been of high value for developing and implementing practice changes in local organizations.