Home > Patients. parents. people. Towards integrated supports and services for families experiencing mental health difficulties.

Barnardos. (2014) Patients. parents. people. Towards integrated supports and services for families experiencing mental health difficulties. Dublin: Barnardos.

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In recent years pressures on parents have increased, with austerity budgets cutting child support payments and increasing costs. Barnardos has more than 40 services across the country and staff are reporting that poor mental health among parents is increasing in prevalence. Barnardos staff are also finding that when a parent experiences a mental health difficulty and they are not adequately supported or are receiving inappropriate treatment, their children can be affected.

These reports prompted Barnardos to examine the issue of mental health specifically in relation to parents to try and identify ways in which approaches and supports can be improved. In the majority of cases Barnardos encounters, parents are experiencing feelings of anxiety, stress and hopelessness. There is a proven link between poverty and poor mental health and often the parent’s life circumstances are at the root of these feelings and exacerbating them. Staff also found that very few parents have adequate support for their mental health difficulty.

It is not possible to generalise the effects of parental mental health difficulties on families as it can depend on the severity and duration of the difficulty. In addition, other factors are frequently present such as poverty, addiction, overcrowding in housing, bereavement and domestic violence, all of which can have a huge impact on family life. It is important to note research has indicated that parental mental health difficulties alone present little risk of significant harm to children1. But the absence of supports for both parents and children can compromise the child’s ability to cope. This can result in children’s social and emotional development and their educational attainment being adversely affected. The impact can include inconsistency in parenting capacity, resulting in poor routines and sometimes patchy school attendance, lack of boundaries and children presenting with poor hygiene and / or hungry.

Key Recommendations:
Challenge mental health prejudice and discrimination: While some efforts are already being undertaken, more needs to be done to challenge public perceptions and promote the message that mental health difficulties can affect anyone and people can and do recover, given the right supports. In particular, parents must know they can access support without judgement on their parenting capacity.

Adopt a family model approach: Promote policies and improve practice across adult and children’s systems that consider the needs of the whole family instead of seeing their service users in isolation. This would be a shift from the current siloed system, towards more holistic user focused services. Far greater intra and interagency co-ordination between inpatient mental health services and primary care services and between community mental health teams and primary care services are desperately needed. Likewise improved information sharing involving community based services is required. Practical changes to improving service delivery across adult mental health and children’s services interface can include co-ordinating workforce development training, having common questions about family life in screening and assessment templates, and considering whole family needs in care plans and identifying crossover with different agencies needed to implement the plan.

Talk to children: Children living with a parent experiencing mental health difficulties need to be informed and reassured in an age appropriate manner about what is happening to their parent and what to expect. All professionals working with the parent must understand the importance of talking to the children and be skilled accordingly. Likewise parents should be given the appropriate support so they can talk to their children about what they are experiencing and reassure them in an age appropriate manner.

Expedite the roll out of community based services: The ongoing delays in recruitment and service provision for fully staffed, multi-disciplinary community services as outlined in A Vision for Change are unacceptable. Their widespread availability will help challenge the dominance of the medical model and act as a preventative factor stemming some problems from escalating. Consult with parents affected by poor mental health: Identify parents’ preferred community based services that would make a positive difference to their lives and to their children. These services could include peer support groups (for parents and children), counselling services and family support services. The widespread availability of such practical supports would ease pressure on parents and reassure them they are not alone and can seek support without fear their parenting ability is being judged.


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