According to the Mental Health Foundation’s website, between 50% and 66% of parents with a severe and enduring mental illness live with one or more children under 18. That’s over half of families in the UK. Team this with the fact that adult and children’s services are struggling to understand and deliver support to parents with mental health problems and their children and we have a problem that needs to be addressed.
Parental mental health - learning from success
But rather than looking back on where services have failed, Pavilion’s new Learning from Success series of conferences and annual volumes are asking the question of how parents with mental health difficulties and their children can be supported successfully.
To illustrate this, here’s an extract from the guest editorial by Adrian Falkov from the upcoming Parental Mental Health and Child Welfare Work Volume 1: A Pavilion Annual 2016.
Working Together: Parental mental health and working with families
By Adrian Falkov
It is almost 50 years since Michael Rutter’s Maudsley monograph, Children of Sick Parents, was published (Rutter, 1966); 17 years since Crossing Bridges (Mayes et al, 1998); and about eight years since the inaugural international COPMI conference in Adelaide, Australia.
Parental mental illness has indeed come some considerable distance and there is now much greater awareness of the needs of parents with mental health problems and their children.
In England, the Think Family Guidance has provided some support for practitioners in the field to address mental health needs of individuals within their families, and it remains to be seen what specific impacts the recently introduced Care Act (2014), the Children & Families Act (2014) and Closing the Gap: Priorities for essential change in mental health (DoH, 2014) will have for this group of families.
Parental mental health has indeed shown itself to have relevance for individuals and families, across the lifespan and generations, and across professional disciplines, service settings, agencies, localities, regions and countries – family mental health is a truly global issue.
However, progress has been slow and many barriers remain. The need for good quality information is crucial to support ongoing awareness raising and advocacy, as well as education and training to achieve the necessary acceptance, design and delivery of evidence-informed, family-focused approaches in mental health and social care services.
Strength in practice
A paper about eliciting positive attributes in individuals – young people in mental health services (Vidal-Ribas, 2015) – recently caught my eye. It is surprising how long it has taken for the ‘pursuit of resilience’ (strengths-based approaches) to become accepted and incorporated into clinical practice. Clinicians will, of course, be aware of the potent validation that comes from a realistic endorsement of someone’s efforts, especially in the face of adversity. We all like (and need!) praise and encouragement. My question to children, young people and their parents is: ‘what gets you through?’ (the bleakest, darkest times). I have yet to meet a parent, child or young person who does not struggle with this question. It sits behind the more obvious ‘what are your strengths/things you are good at/successes/achievements?’ (which of course those with significant adversity also struggle to answer).
I find it worth persisting and encourage exploration of both why it is a difficult question to answer and why it is such a central question to address. Of course treatment is important. But often it is controlling not curing symptoms, and the combination of good treatments (psychological, pharmacological and lifestyle) in conjunction with those innate, often hidden, qualities in the individual, is a way of tapping into a rich vein of capability that can enhance our joint efforts. It’s the best form of collaboration and likely to play a considerable role in sustaining recovery and preventing relapse. The upcoming one day conference Parental Mental Health and Child Welfare: Sharing what works from the perspective of children, parents, professionals and research and its accompanying publication Parental Mental Health and Child Welfare Work Volume 1: A Pavilion Annual 2016 share the important role in promoting best practice by spanning the crucial gap between research and practice.
About Adrian Falkov
Dr Adrian Falkov is a child and adolescent psychiatrist who trained and practised in London before moving to Sydney. He has extensive experience in the field. He is the author of The Family Model: An integrated approach to supporting mentally ill parents and their children and managed the development of the Crossing Bridges programme. He has worked in frontline clinical practice, research and policy development.
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