Primary prevention for children of mentally ill parents: the Kanu-program

Abstract

Aim

The objective of the study is to develop, implement and evaluate a program of primary prevention for children of mentally ill parents. The main aim of the program is to reduce the burden on children and to improve their skills.

Subject and methods

Study findings lead to the assumption that children of mentally ill parents are at a higher risk of developing mental disorders and behavioural problems themselves (Niemi et al. in Br J Psychiatry 186:108–114, 2005; Nomura et al. in J Am Acad Child Adolesc Psychiatr 41:402–409, 2002; Beardslee et al. in J Am Acad Child Adolesc Psychiatr 37:1134–1141, 1998; Lieb et al. in Arch Gen Psychiatry 59:365–374, 2002). Although there is a high need for prevention targeting this high-risk population, evidence-based preventive programs for children of mentally ill parents hardly exist (Foster et al. in Contemp Nurse 1–2:67–81, 2005; Heitmann and Bauer in Zeitschrift Pflegewissenschaft psychische Gesundheit 1:5–16, 2007). Therefore a primary preventive program was developed and implemented as a part of adult psychiatric care.

Results

The preventive program consists of five elements: (1) a family-focused communicative intervention in order to improve the children’s comprehension of the parental mental disorder (Beardslee 2009; Wiegand-Grefe in Analyt Kinder- Jugendlichen-Psychotherapie 1:81–96, 2008); (2) a godparent for children in order to avoid children being admitted into foster care while the parents are receiving therapy as inpatients (Trepte 2008; Beckmann and Szylowicki 2008); (3) a parenting program that will improve parenting skills as well as parent–child communication (Kühn and Petkov 2005); (4) a group program for affected children whose aim is to improve the children’s social and communicative skills (Hipp and Staets in Soz Psychiatr 3:27–30, 2003); and (5) a module for networking and training of professionals. The evaluation mainly addresses children’s burden, the parent–child interaction, quality of life, children’s self-esteem and self-efficacy.

Conclusion

Adequate support according to the needs of children with mentally ill parents is still difficult to predict. Many of the preventive options and projects are regionally limited as well as time-limited. A transfer to a national standard care system is desirable, as in reality the options often are unstable because they are limited, financially insecure and non transparent.