Browsing by Author "Gatsou, Lina"

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    The Challenges Presented by Parental Mental Illness and the Potential of a Whole Family Intervention to Improve Outcomes for Families
    (Wiley, 2015) Yates, Scott; Goodrich, Nigel; Pearson, Dan; Gatsou, Lina
    Parental mental illness (PMI) can negatively affect the lives of all family members, and there is an acknowledged need to work attentively with family and social contexts to promote recovery. However, programmes undertaking such work remain rare and knowledge concerning mechanisms through which PMI impacts families and through which recovery might be achieved is underdeveloped. This paper outlines a family intervention programme and presents evidence from focus groups with 16 professionals into their experiences of work with families with PMI. Evidence suggests that interactional effects of PMI, family communication and family relationships are key to understanding its impacts, but professionals are liable to struggle to engage with these due to concerns over stigma and low confidence. Positive impacts on professionals’ practice were achieved primarily through raising awareness of the whole family context in relation to PMI, building of confidence to raise and engage with PMI and the provision of structured tools for use with families. Positive impacts on the lives of family members were then achieved by professionals in relation to symptoms for the ill parent, the burden on children and overall family wellbeing, strongly mediated through improved family communication, understanding and relationships. Implications for policy and practice are considered.
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    Constrained sense-making in families with parental mental illness and the importance of intra-family communication for positive outcomes
    (Oxford University Press, 2022-12-28) Yates, Scott; Gatsou, Lina
    Recent work in parental mental illness has focused attention on mechanisms by which it impacts the lives of family members and is transmitted intergenerationally. This includes arguments for attending to how recovery and experiences of the illness in families are shaped relationally. In this paper we contribute to this area through presenting the results of in-depth qualitative research studying how family communication around parental mental illness shapes families’ experiences of illness and recovery. This comprises thematic analysis of 36 semi-structured interviews and eight focus groups with families and multi-agency professionals who worked with them. Findings demonstrate a complex interplay of drivers of lack of communication and of the impacts of this on family relationships and wellbeing. Notably, families found it difficult to communicate around mental health due to guilt and shame felt by the unwell parent, a belief that concealing the illness will protect children, and lack of capacity in families for communication in general. This lack of communication affects how families make sense of one another’s experiences and behaviours and impacts individual coping and family relationships. Fostering positive communication around the illness in social work settings has potential to improve relationships, reduce perceived burdens of illness and aid recovery.
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    Enhancing Family Communication in Families Where a Parent has a Mental Illness
    (University of Massachusetts Medical School, 2017-12-05) Yates, Scott; Gatsou, Lina
    In this brief we will discuss the Think Family-Whole Family Programme, which differs from other interventions by putting a central focus on fostering effective communication within families. This can enhance families’ understanding of parental mental illness (PMI) and how it affects behavior and relationships, help families jointly set goals for recovery, and enable more supportive interactions among family members.
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    Parental mental illness: incidence, assessment and practice
    (RCN Publishing, 2016-02-10) Gatsou, Lina; Yates, Scott; Hussain, S.; Barrett, M.; Gangavati, S.; Ghafoor, R.
    Background: Parental Mental Illness (PMI) increases risk of mental illness and other negative outcomes in children. Work on the family impacts of PMI can protect children’s mental health, but little is known about current assessment and practice. Methods: An audit of mental health service case notes was undertaken in one NHS Trust. A template was designed to code information on family mental health, assessment and referral for comparative analysis. Results: 60% CAMHS cases with data were children of parents with mental illness and 40% AMHS cases were parents of dependent children. Presence of PMI was poorly assessed: 32% CAMHS cases, 38% AMHS cases and 44% LD cases showed no evidence of assessment. Assessment of impacts of PMI on children and rates of referral to support services were very low. Conclusions: Mental health services should review practice in assessing, recording and treating cases where PMI might impact children’s mental health.
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    Prato Research Collaborative for Change in Parent and Child Mental Health: Principles and recommendations for working with children and parents living with parental mental illness
    (Wiley, 2021) Yates, Scott; Reupert, A.; Bee, P.; Hosman, C.; van Doesum. K.; Drost, L.M.; Falkov, A.; Foster, K.; Gatsou, Lina; Gladstone, B.; Goodyear, M.; Grant, M.; Grove, C.; Isobel, S.; Kowalenko, N.; Lauritzen, C.; Maybery, D.; Mordoch, E.; Nicholson, J.; Reedtz, C.; Solantaus, T.; Stavnes, K.; Weimand, B.M.; Ruud, T.
    Children whose parents have mental illnesses are among the most vulnerable in our communities. There is however, much that can be done to prevent or mitigate the impact of a parent’s illness on children. Notwithstanding the availability of several evidence-based interventions, efforts to support these children have been limited by a lack of adequate support structures. Major service reorientation is required to better meet the needs of these children and their families. This editorial provides recommendations for practice, organisational and systems change.
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    Supporting families with parental mental health challenges: A guide for social workers
    (Community Care Inform, 2022-10) Yates, Scott; Gatsou, Lina
    There has been an increased recognition of the high prevalence ofparental mental illness, and it is now seen as a specific public healthissue. Children of parents with mental illness are at an increased risk ofnegative experiences and outcomes and are more likely to experiencemental health issues themselves. Parental mental illness is associated with between 10% and 42% of childprotection cases in Western countries, however, it is important to keepin mind that many parents cope and parent well despite significantmental health problems and without involvement of services. Supportneeds exist on a continuum or spectrum. Families experiencing parental mental illness are more likely thanothers to experience additional social and economic challenges that canaffect quality of life. The relationship between social and economicproblems and parental mental illness is complex; both can exacerbatethe other. There are three categories of stigma around parental mental illness:public stigma (the attitudes and beliefs of others in society), self-stigma(parents’ internalisation of negative stereotypes and beliefs aboutmental illness), and courtesy-stigma (the prejudice and discriminationchildren and family members experience through their ‘association’with the parent); all can result in a range of negative consequences forparents and whole families. Lack of communication around mental illness in families can lead tomisconceptions in children and can increase anxiety or worry that theywill also experience the same illness or blame themselves for theirparent’s illness. Family-focused work can help promote non-judgemental, open communication in families and betterunderstanding of behaviours. It is important that interventions with families experiencing parentalmental illness are voluntary and family-led, however, professionals alsoneed to balance potential safeguarding and child protection concernsthat may arise. Professionals should note that any additional riskfactors such as violence within a household, or alcohol or substancemisuse, that might exist alongside parental mental illness, can increasesrisk of abuse or neglect to children. Recent work exploring the integenerational ‘transmission risk’ of mentalillness has found that focusing on the relational experiences of illnessand recovery (ie ensuring family relationships are considered as centralcomponent) rather than framing these individualistically is beneficial.These approaches emphasise the importance of strengtheningrelationships between family members to help in the recovery process;helping them to identify what recovery means to them and how toachieve it. Family-focused practice focuses on the wider family and caregivingsystem rather than focusing solely on the adult as the mental health‘consumer’. The key features include psychoeducation, assessment offamily, family care planning, joint working between family and services,and instrumental and emotional support. Direct work sessions with families may also include building trust and openness, and anti-stigmamessaging. Services working with families with parental mental illness need to havea holistic system in place, and family-focused practice should be valuedby service managers and available to families across a range of settings 8 Family-focused practice focuses on the wider family and caregivingsystem rather than focusing solely on the adult as the mental health‘consumer’. The key features include psychoeducation, assessment offamily, family care planning, joint working between family and services,and instrumental and emotional support. Direct work sessions with
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    Undertaking family-focused interventions when a parent has a mental illness - possibilities and challenges
    (Taylor and Francis, 2020-05-18) Yates, Scott; Gatsou, Lina
    Parental mental illness (PMI) is a public health issue associated with risks of negative outcomes for children and families. Effective whole family interventions with families with PMI are still not well implemented across mental health, social work and multi-agency workforces. This paper presents research with professionals trained in a new programme, the Think Family-Whole Family Programme, to strengthen family-focused work around PMI. It examines professionals’ practice and understanding of PMI and identifies enablers of effective practice. Findings indicate that participants identify having appropriate knowledge of how PMI can affect families and the confidence to address it as important factors enabling effective work with them. They also had concerns around how to discuss mental health due to issues of stigma and management support of whole-family work. Results indicate potential for training to achieve positive outcomes in improving professionals’ knowledge and confidence and encouraging whole-family work around PMI. Possibilities and challenges for future work with families with PMI are discussed.