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Grant, A, Lagdon, S, Devaney, J, Davidson, G, Duffy, J, Galway, K, Perra, O & Leavey, G 2018, A Study of Health and Social Care Professionals’ Family Focused Practice with Parents who have Mental Illness, their Children and Families in Northern Ireland MAIN REPORT . |
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Introduction Parental mental illness (PMI) and, or substance use problems, are major public health issues as they may negatively impact children. Conversely, childrens’ experiences and difficulties may impact parents’ mental health. Consequently, family relationships should be an important focus for clinicians, managers, researchers and policy makers (Beardslee, Solantus, Morgan, Gladstone & Kowalenko, 2012). There is increasing evidence, within the past 15 years, that Family Focused Practice (FFP) can be beneficial for families, including children, when parents have mental illness and, or substance use problems (Beardslee et al., 2012; Cooper & Reupert, 2017; Siegenthaler, Munder & Egger, 2012). For the purpose of this report, FFP refers to interventions which attempt to identify and address the needs of parents and children in relation to child welfare and parental mental health and, or substance use problems. Early intervention to promote family functioning is also key. These interventions may not necessarily be provided to the whole family. In some cases they may be provided to just one person in the family, but the focus has to be on both parental mental health and, or substance use problems AND child welfare issues. Since the commencement of the Think Family NI programme in 2009 a wide range of initiatives have been developed and implemented, across Northern Ireland (NI), to promote Health and Social Care (HSC) professionals’ FFP, in response to families when parents have mental illness and, or substance use problems (See p.37 - 39 of this report for overview of key initiatives). While there is limited information internationally about extent of FFP (Grant, Goodyear, Maybery & Reupert, 2016) and inter disciplinary differences in FFP (Maybery et al., 2014), there is an absence of studies that directly compare FFP across services including adult mental health and children’s services. There has also been limited evaluation of Think Family NI initiatives to date. In 2016 the Health and Social Care Board (HSCB) commissioned Queen’s University Belfast (QUB), in conjunction with Ulster University, to conduct a two-year baseline study with three parts. The first part entailed a systematic review of the literature and development of a logic model. A logic model is a graphical representation of the relationships between the resources, activities, outputs and outcomes of a program of work. A mixed methods study was then conducted in the second and third parts to examine FFP in adult mental health and children’s services from multiple perspectives (i.e. HSC professionals and service users). Our findings provide evidence on the current state of Think Family NI initiatives and will inform ongoing and future development and evaluation of FFP within the five HSC Trusts. This report has three aims, 1) to present contextual information underpinning the wider study as well as key findings from the systematic review, 2) to outline the logic model underpinning Think Family NI and 3) to outline the research design underpinning the HSC commissioned study and to present and discuss key findings. Each of these aims is addressed in three distinct parts of the report. The first part of the report addresses the first aim and presents the context of the wider project and findings of the systematic review. The first section commences by highlighting the prevalence of parental mental illness (PMI) and substance use problems and their impact on service users and their families, including dependent children. The remaining background sections detail the underlying context to the study including benefits of FFP and related policy and practice developments to promote FFP internationally and in NI. Barriers and enablers of FFP are also detailed. Following on from this, the second part of the report presents the logic model. The process of establishing the logic model entailed scoping out and recording Think Family NI initiatives that have occurred since 2009 to the present day (2017). This information was then used to support the formulation of anticipated outcomes of Think Family NI initiatives and assist with the evaluation of effectiveness and development of refocused aims and future Think Family NI work. Finally, the third part of the report addresses the third aim and discusses key findings of the mixed methods study. This final part of the report will commence by discussing the research design and methodology. Following on from this, the quantitative survey findings with HSC professionals will be reported. The qualitative findings from semi-structured interviews with HSC professionals and parents who are service users will then be reported. Key findings from the quantitative and qualitative component of the study will then be discussed. The report concludes with a discussion of the implications of the findings from the study in relation to the future direction of Think Family NI and the steps necessary to consolidate and further develop the progress made to date. |
