WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders

World psychiatry: official journal of the World Psychiatric Association (WPA) (Impact Factor: 14.23). 06/2011; 10(2):93-102. DOI: 10.1002/j.2051-5545.2011.tb00023.x
Source: PubMed


This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide.

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    • "These two different types of adverse developmental experience may see the child's inchoate affect regulatory capacities being overwhelmed again and again, possibly leading to long-standing psychological difficulties (Brown & Roberts, 2000; Winnicott, 1953, 1960; Zeitz, 1995). Maternal psychosis is typically associated with erratic parenting through dysfunctional cognition and diminished sensitivity to, and involvement with, the child (Brockington et al., 2011; Polkki et al., 2004; Wan & Green, 2009). However, maternal psychotic illness might also lead to hospitalisation and mother–child separation, exceedingly difficult experiences for children, especially very young children (Case, 2005). "
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    ABSTRACT: This qualitative research project explored the recollections and reflections of women who were raised by mothers suffering with psychosis. Existing research has documented the mostly negative effects of maternal psychopathology on offspring; they are exposed to both the genetic and environmental effects of such illness. Very few qualitative studies exist in this research area. The mother-daughter perspective was taken to explore the ways that daughters felt maternal psychosis might have affected this primary relationship. Five participants comprised the purposive, snowball sample. The semi-structured interview method was used for data collection. The data was analysed using thematic content analysis. Nine themes and two sub-themes emerged from the interview data; these were (1) resilience and survival (with two sub-themes: (1.1) extreme self-sufficiency and (1.2) low self-esteem and the need for approval); (2) memories of maternal psychotic episodes; (3) mother-daughter bond; (4) importance of father; (5) sibling sounding boards and responsibilities; (6) silent family storms; (7) significant others; (8) stigma, shame, and secrecy; and (9) maternal psychosis, motherhood, and feminine identity. All participants believe that maternal psychosis had affected them profoundly, both in childhood and adulthood. They felt that it had influenced their personality development in various ways, including the formation of feminine identity.
    South African journal of psychology = Suid-Afrikaanse tydskrif vir sielkunde 04/2015; DOI:10.1177/0081246315581565 · 0.46 Impact Factor
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    • "( i ) identification of parenting status and dependent chil - dren among adult clients ; ( ii ) a needs and well - being assessment of parents and family members , including children ; and ( iii ) the provision of support to address those needs , including referral to support services ( AICAFMHA 2004 ; Bannerman 2009 ; Brady 2009 ; Brockington et al . 2011 ; Evans & Fowler 2008 ; Foster 2010 ; Foster et al . 2005 ; 2012 ; Fudge et al . 2004 ; Heriot 2009 ; Liangas & Falkov 2014 ; Maybery & Reupert 2009 ; Mottaghipour & Bickerton 2005 ; Mowbray et al . 2001 ; Mullen 2009 ; Nicholson 2010 ; Nicholson & Biebel 2002 ; RCP 2011 ; Wan et al . 2008"
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    ABSTRACT: This article outlines the development of practice standards for the adult mental health workforce for addressing the needs of families where a parent has a mental illness (FaPMI). The practice standards recommended here were formulated using a modified cooperative inquiry process with a group of senior clinical leaders in adult mental health services in Australia, following consultation with the available literature and policy documents. The aim of the project was to generate, align, and operationalize family-inclusive practice standards within the core activities of the adult mental health workforce and integrate into the continuum of care and recovery for service users who are parents of dependent children. As part of a modified Delphi method, the standards were also ranked by the senior clinical leaders to determine what they believe to be essential and recommended practices for the adult mental health workforce they manage. We argue that developing practice standards that provide practical and realistic expectations of the adult mental health service workforce enable services and workers to better adapt practice to respond to FaPMI. © 2015 Australian College of Mental Health Nurses Inc.
    International journal of mental health nursing 01/2015; 24(2). DOI:10.1111/inm.12120 · 1.95 Impact Factor
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    • "correlates and risk factors for anxiety disorders during pregnancy and after delivery are less well studied (for review see: Goodman et al., 2014; Grekin and O'Hara, 2014). Given the evidence that peripartum mental disorders bear potential risks for the (expectant) mother and the offspring (Brockington et al., 2011) more research is warranted to examine the course of pre-existing anxiety and depressive disorders and to investigate how many previously healthy women experience an anxiety or depressive disorder for the first time during peripartum time. Several authors reported rates of DSM-IV anxiety and depressive disorders at particular time points during pregnancy and postpartum period (e.g. "
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    ABSTRACT: Peripartum anxiety and depressive disorders are associated with adverse consequences for mother and child. Thus, it is important to examine risk factors, correlates and course patterns of anxiety and depressive disorders during pregnancy and after delivery. In the prospective-longitudinal Maternal Anxiety in Relation to Infant Development (MARI) Study, n=306 expectant mothers were recruited from gynaecological outpatient settings in Germany and completed up to seven waves of assessment from early pregnancy until 16 months postpartum. Anxiety and depressive disorders and potential risk factors/correlates were assessed with the Composite International Diagnostic Interview for Women (CIDI-V), medical records and additional questionnaires. Although peripartum anxiety and depressive disorders appeared to be persistent in some women, others reported major changes with heterogeneous courses and shifts between diagnoses and contents. There was a considerable amount of incident disorders. Strongest predictors for peripartum anxiety and depressive disorders were anxiety and depressive disorders prior to pregnancy, but psychosocial (e.g. maternal education), individual (e.g. low self-esteem), and interpersonal (e.g. partnership satisfaction, social support) factors were also related. Knowing the aims of the study, some participants may have been more encouraged to report particular symptoms, but if so, this points to the importance of a comprehensive assessment in perinatal care. Peripartum time is a sensitive period for a considerable incidence or persistence/recurrence of anxiety and depressive disorders albeit the course may be rather heterogeneous. Interventional studies are needed to examine whether an alteration of associated factors could help to prevent peripartum anxiety and depressive disorders. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 01/2015; 175C:385-395. DOI:10.1016/j.jad.2015.01.012 · 3.38 Impact Factor
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