Supporting Adolescents with Mental Health Problems in Secondary Education: Feasibility of a Supported Education Intervention.

Mental health problems in adolescence can have a profound influence on school functioning, educational attainment and thus future societal participation. Supported education (SEd) is a potentially useful method for educational professionals to help adolescents with mental health problems in secondary school improve their functioning by stimulating collaboration, ownership, and participation. In this study, we examined the feasibility of SEd in secondary education by examining its acceptability, implementation, and preliminary effectiveness. We performed a mixed-methods study using quantitative data (questionnaires) and qualitative data (interviews) from educational professionals (EP) and adolescents, aged 13-17, about their experiences with a SEd intervention. Regarding the acceptability of the intervention, three main themes emerged: (a) structure, (b) autonomy, and (c) applicability of the intervention. Themes regarding the implementation were: (a) lack of time, (b) personal attitude, (c) mastery, and (d) complexity of the school environment. The findings show that, for those that followed the intervention, SEd is a promising approach to support adolescents with mental health problems to improve their functioning and participation in school. Further research is needed on the effectiveness of the intervention.

Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking.

Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12-16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.

Strategies for parenting by mothers and fathers with a mental illness.

UNLABELLED: WHAT IS KNOWN ON THE SUBJECT?: The combination of coping with their mental health problems and caring for children makes parents vulnerable. Family-centred practice can help to maintain and strengthen important family relationships, and to identify and enhance the strengths of a parent with a mental illness, all contributing to the recovery of the person with the mental illness. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE?: Taking the strength and the opportunities formulated by parents themselves as a starting point is fairly new. Parents with severe mental illness find strength for parenting in several ways. They feel responsible, and this helps them to stay alert while parenting, whereas parenthood also offers a basis for social participation through school contacts and the child's friendships. Dedication to the parent role provides a focus; parents develop strengths and skills as they find a balance between attending to their own lives and caring for their children; and parenting prompts them to find adequate sources of social support. In this study these strategies were found to be the fundamentals of recovery related to parenting. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can support and coach patients who are identified as parents, and self-chosen parenting related goals are set and addressed. A family-focused approach by nurses can be used to prevent problems for children and their families, identify their strengths as well as vulnerabilities, and address the challenges to build resilience. INTRODUCTION: Understanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new. QUESTION: What are the strategies of parents with a mental illness to be successful? METHOD: Experiences of 19 mothers and eight fathers with a mental illness were explored with in-depth interviews. Data were content analysed, using qualitative methods. RESULTS: Next to feelings of inadequacy, interviewees also describe how children enrich and structure their lives and are not only a burden but serve as distraction from problems. Developing activities that interest both child and parent provides avenues for emerging strength. Mental illness constrains fathers, but also gives opportunities to develop a meaningful relation with their children. DISCUSSION: Strategies like being fully dedicated to the parental role, finding a balance between attention for one's own life and parenting and finding adequate sources of support are found to be fundamental for recovery in the parent role. Implications for practice Peer groups can be of valuable help and mental health workers can support parents to set self-chosen parenting related goals.

[Parents with severe mental illness. Epidemiological data]. / Ouders met ernstige psychische aandoeningen; epidemiologische gegevens.

BACKGROUND: It is becoming increasingly clear that people with severe mental illness (SMI) are in need of support with parenting. So far, however, little is known about how many persons fall into this category. AIM: To estimate how many SMI patients aged 18 to 65 are parents with children and how many need help with parenting. METHOD: We based our estimate on epidemiological studies and on official records and data relating to SMI patients for the year 2009. RESULTS: We estimated that 48% of patients with smi had children. The total number of such patients for the year 2009 was 68,000; this figure represents 0.9% of the Dutch population in the 18-64 age-group. CONCLUSION: Health professionals and carers need to be alerted to the fact that almost 50%of the patients with SMI require possibly help in fulfilling their parental role. Potential problems in the parent-child relationship need to be registered in greater details so that more adequate care can be provided both at individual level and national level.