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Prevention and early intervention critical for children of parents living with mental illness

ACU mental health expert Professor Kim Foster is part of an international group of researchers who developed a series of prevention and early intervention recommendations for mental health services to help children of parents living with mental illness.

In a new position paper, published in the Journal of Child Psychology and Psychiatry, 24 international parental mental illness research experts outlined a series of principles and recommendations for  child and adult mental health services to better meet the needs of these children and families.

Children whose parents have mental illness are between two to 13 times more likely to develop a mental illness themselves, to be less school-ready, to present with higher rates of physical injury, more likely to be taken into care, and more likely to develop health conditions such as asthma.

The paper recommends mental health services deliver support for the whole family in addition to supporting individual clients. 

Research shows that 23 per cent of children have at least one parent who has experienced mental illness.

“Our paper directly addresses recommendations from the National Mental Health Productivity Commission Report and the Royal Commission into Victoria’s Mental Health System, to provide child and adult mental health services that better meet the needs of these children and families,” Professor Foster said.

“Applying the principles and recommendations from the paper will help services improve the quality of life and outcomes for children and families living with parental mental illness.”

Representing seven countries, the 24 authors of the position paper are research experts in the field of parental mental illness.

They are part of the Prato Collaborative for Change in Parent and Child Mental Health, which aims to contribute to the evidence base for these children and families and promote change at clinician, workforce, and systems levels. 

Lead author Professor Andrea Reupert, from the School of Educational Psychology and Counselling at Monash University, said children whose parents have mental illnesses are among the most vulnerable in our communities. 

“Currently the delivery of evidence-based interventions to support these children have been limited by a lack of adequate support structures,” she said.

“We believe a major service reorientation is required to better meet the needs of these vulnerable children and their families. Accordingly, we’ve outlined a number of recommendations for practice, organisational and systems change to enable this.”

Key recommendations include:

• Child and adolescent orientated services need to ask whether parents of clients have mental health concerns, ascertain the impact of the parent’s illness on the child, engage with parents to identify, and respond to, their needs and/or initiate and coordinate agency referrals
• Adult services should identify parenting status, engage with clients in their parenting role and responsibilities, engage with clients’ children to identify, and respond appropriately to their needs and/or initiate and coordinate agency referrals for children
• Child, adolescent, and adult services need to assess family strengths and needs, including quality and quantity of family supports, parenting strengths and vulnerabilities, to provide age-appropriate information about the parent’s mental illness to children, parents and other family members. They should consult with children and other family members if the parent is hospitalised and follow up at key developmental milestones.

Professor Darryl Maybery from Monash University said current practices needed to be overhauled so mental health support services are based on family needs rather than individual models of care.

Although there are evidence-based interventions available for these children and families, these have largely not been picked up by services.

The position paper said it was critical that appropriate prevention and early intervention initiatives are provided to both children and parents living with parental mental illness.

“Current practice paradigms are based on individualistic models of practice, particularly in mental health services. This must change.”