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.

[Contributions to the quality of care in homes for the aged from a psychogeriatric nursing home]. / Bijdragen aan de kwaliteit van zorg in verzorgingshuizen vanuit een psychogeriatrisch verpleeghuis.

The knowledge and experiences of the staff of a psychogeriatric nursing home can be used to improve the care for residents with psychogeriatric problems of a home for the aged. Staff members of the nursing home Nieuw Toutenburg in Noordbergum taught psychogeriatrics in eleven homes for the aged. Subsequently a psychologist and a nurse provided additional support during eight months. The use of care-schemes and staff meetings concerning the care-planning for the residents were introduced. In the homes for the aged knowledge about psychogeriatrics tested by 89 course participants increased and remained stable over a period of at least three months. The care organization in the homes had changed: systematic reports about the residents with psychogeriatric problems were made and staff meetings for care-planning were regularly held. These changes persisted over at least three months after the staff of the nursing home had withdrawn.

The development of a care-giving burden scale.

A burden scale is described that is conceptually specific by concentrating on an assessment of different aspects of distress of care-giving burden and conceptually sensitive by distinguishing two dimensions: the relationship of the carer and the care-receiver and the limitations in the personal life of the carer. To develop a burden scale an analysis was carried out on a database of an intervention study in which 89 informal caregivers of psychogeriatric patients were interviewed twice. A principal components analysis was carried out showing two main factors that could be interpreted as the two dimensions mentioned above. Reliability analysis showed a Cronbach's alpha of 0.84 for the total care-giving burden scale (13 items) and 0.77 for both subscales (7 and 6 items), confirmed in an independent sample. An analysis of the hierarchy of items (Mokken Scale Analysis) showed a strong and moderate hierarchy for the subscales and the total scale, respectively. Finally, an analysis of construct validity showed strong correlations of care-giving burden with depression of the carer and deviant behaviour of the patient.