During the preschool years (3–5 years), children living with parental mental illness are more at risk of various adverse developmental outcomes, compared to other children. Early childhood services are opportune settings for prevention and early intervention strategies that may support preschool children living with parental mental illness. However, there is limited research examining how the early childhood sector supports the child, parent and family. The aim of the study was to explore family focused practices within the early childhood sector in terms of the level of self-perceived knowledge, skill and confidence; and compare the self-perceived knowledge, skill and confidence between preschool teachers and childcare workers. A sample of 40 preschool teachers and 39 childcare providers rated themselves across eight domains that describe their knowledge, confidence and skill using the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Overall, the sample rated themselves positively across all domains. In a cross-sectional analysis, a t-statistic comparison of preschool teachers and childcare providers showed that childcare providers scored significantly higher than preschool teachers in parenting support, referrals and assessing the impact of parental illness on the child. Future studies might identify the barriers and enablers for Family Focus Practice (FFP) across different groups of workers in the early childhood sector.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
ACECQA. (2014). Australian children’s education and care quality authority. http://www.acecqa.gov.au/, Accessed 27 Jan 2015
AICAFMHA. (2001). Children of parents affected by mental illness-scoping project. http://www.aicafmha.net.au/projects/scoping/children.htm, Accessed 26 Sept 2016.
AIHW. (2015). Literature review of the impact of early childhood education and care on learning and development. http://www.aihw.gov.au/publication-detail/?id=60129552947. Accessed 26 Sept 2016
Baker-Henningham, H. (2014). The role of early childhood education programmes in the promotion of child and adolescent mental health in low-and middle-income countries. International Journal of Epidemiology, 43, 407–433.
Bakulski, K. M., & Fallin, M. D. (2014). Epigenetic epidemiology: Promises for public health research. Environmental and Molecular Mutagenesis, 55(3), 171–183.
Bassett, H., Lampe, J., & Lloyd, C. (1999). Parenting: Experiences and feelings of parents with a mental illness. Journal of Mental Health, 8(6), 597–604.
Beardslee, W., Ayoub, C., Avery, M. W., Watts, C., & O’Carroll, K. (2010). Family connections: An approach for strengthening early care systems in facing depression and adversity. American Journal of Orthopsychiatry, 80(4), 482–495. https://doi.org/10.1111/j.1939-0025.2010.01051.x.
Bayer, J. K., Hiscock, H., Ukoumunne, O. C., Price, A., & Wake, M. (2008). Early childhood aetiology of mental health problems: A longitudinal population-based study. Journal of Child Psychology and Psychiatry, 49(11), 1166–1174. https://doi.org/10.1111/j.1469-7610.2008.01943.x.
Berman, E., & Heru, A. M. (2005). Family systems training in psychiatric residencies. Family Process, 44(3), 321–335. https://doi.org/10.1111/j.1545-5300.2005.00062.x.
Bibou-Nikou, I. (2004). Parental mental health and children’s well-being. Clinical Child Psychology and Psychiatry, 9(2), 309–312.
Biebel, K., Nicholson, J., & Woolsey, K. (2014). Implementing an intervention for parents with mental illness: Building workforce capacity. Psychiatric Rehabilitation Journal, 37(3), 209.
Bruder, M. B. (2000). Family-centered early intervention:Clarifying our values for the new millennium. Topics in Early Childhood Special Education, 20(2), 105–115. https://doi.org/10.1177/027112140002000206.
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(01), 11–27. https://doi.org/10.1017/S0033291714000129.
Davis, E., Young, D., Corr, L., & Cook, K. (2012). Organizational capacity building in childcare: Promoting children’s mental health. International Journal of Mental Health Promotion, 14(5), 264–275. https://doi.org/10.1080/14623730.2013.784595.
DECS. (2006). Healthy minds/healthy futures: Child mental health and wellbeing study. Predicting and improving mental health resilience in early childhood. Summary of research findings from 2005 for educators. http://www.decd.sa.gov.au/speced2/files/pages/chess/hsp/Research/final_2005_teacher_results.pdf.
Falkov, A. (2012). The family model handbook: An integrated approach to supporting mentally ill parents and their children. London: Pavilion.
Farrell, P., & Travers, T. (2005). A healthy start: Mental health promotion in early childhood settings. Australian e-Journal for the Advancement of Mental Health, 4(2), 98–107. https://doi.org/10.5172/jamh.4.2.98.
Field, A. (2013). Discovering statistics using IBM SPSS statistics. London, England: Sage.
Fordham, L., Gibson, F., & Bowes, J. (2012). Information and professional support: Key factors in the provision of family-centred early childhood intervention services. Child: Care, Health and Development, 38(5), 647–653. https://doi.org/10.1111/j.1365-2214.2011.01324.x.
Foster, K., Maybery, D., Reupert, A., Gladstone, B., Grant, A., Ruud, T., & Kowalenko, N. (2016). Family-focused practice in mental health care: An integrative review. Child & Youth Services, 37(2), 129–155. https://doi.org/10.1080/0145935X.2016.1104048.
Fudge, E., Falkov, A., Kowalenko, N., & Robinson, P. (2004). Parenting is a mental health issue. Australasian Psychiatry, 12(2), 166–171.
Furlong, M. A. (2001). Constraints on family-sensitive mental health practices. Journal of Family Studies, 7(2), 217–231. https://doi.org/10.5172/jfs.7.2.217.
Giannakopoulos, G., Agapidaki, E., Dimitrakaki, C., Oikonomidou, D., Petanidou, D., Tsermidou, L., & Papadopoulou, K. (2014). Early childhood educators’ perceptions of preschoolers’ mental health problems: A qualitative analysis. Annals of General Psychiatry, 13(1), 1–6. https://doi.org/10.1186/1744-859X-13-1.
Gladstone, B. M., Boydell, K. M., Seeman, M. V., & McKeever, P. D. (2011). Children’s experiences of parental mental illness: A literature review. Early Intervention in Psychiatry, 5(4), 271–289. https://doi.org/10.1111/j.1751-7893.2011.00287.x.
Goodman, S. H. (2014). Commentary: The multifaceted nature of maternal depression as a risk factor for child psychopathology—reflections on Sellers et al. (2014). Journal of Child Psychology and Psychiatry, 55(2), 121–123. https://doi.org/10.1111/jcpp.12202.
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.
Goodyear, M., Obradovic, A., Allchin, B., Cuff, R., McCormick, F., & Cosgriff, C. (2015). Building capacity for cross-sectorial approaches to the care of families where a parent has a mental illness. Advances in Mental Health, 13(2), 153–164. https://doi.org/10.1080/18387357.2015.1063972.
Grant, A., Goodyear, M., Maybery, D., & Reupert, A. (2015). Differences between Irish and Australian psychiatric nurses’ family-focused practice in adult mental health services. Archives of Psychiatric Nursing. https://doi.org/10.1016/j.apnu.2015.07.005.
Heckman, J. J. (2006). Skill formation and the economics of investing in disadvantaged children. Science, 312(5782), 1900–1902. https://doi.org/10.1126/science.1128898.
Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: Developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, 46(7), 714–734. https://doi.org/10.1111/j.1469-7610.2005.01456.x.
Hosman, C. M., van Doesum, K. T., & van Santvoort, F. (2009). Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the netherlands: I. The scientific basis to a comprehensive approach. Australian e-Journal for the Advancement of Mental Health, 8(3), 250–263.
Howard, L. M., & Underdown, H. (2011). The needs of mentally ill parents-a review of the literature. Psychiatrische Praxis, 38(1), 8–15.
Howe, D., Batchelor, S., & Bochynska, K. (2009). Estimating consumer parenthood within mental health services: A census approach. Australian e-Journal for the Advancement of Mental Health, 8(3), 231–241.
Kay-Lambkin, F., Kemp, E., Stafford, K., & Hazell, T. (2007). Mental health promotion and early intervention in early childhood and primary school settings: A review. The Journal of Student Wellbeing, 1(1), 31–56.
Kelly, C., Jorm, A., & Wright, A. (2007). Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Medical Journal of Australia, 187(7), S26.
Laletas, S., Reupert, A., & Goodyear, M. (2017). “What do we do? This is not our area”. Childcare providers’ experiences when working with families and preschool children living with parental mental illness. Children and Youth Services Review, 74, 71–79. https://doi.org/10.1016/j.childyouth.2017.01.024.
Laletas, S., Reupert, A., Goodyear, M., & Morgan, B. (2015). Pathways of care: Targeting the early childhood sector for early intervention. Advances in Mental Health, 13(2), 139–152. https://doi.org/10.1080/18387357.2015.1066293.
Lauritzen, C., Reedtz, C., Van Doesum, K. T.. & Martinussen, M. (2014). Implementing new routines in adult mental health care to identify and support children of mentally ill parents. BMC Health Services Research, 14(1), 58.
Madsen, W. C. (2009). Collaborative helping: A practice framework for family‐centered services. Family Process, 48(1), 103–116.
Mann, C. (2003). Observational research methods. Research design ii: Cohort, cross sectional, and case-control studies. Emergency Medicine Journal, 20(1), 54–60.
Maybery, D., Goodyear, M., O’Hanlon, B., Cuff, R., & Reupert, A. (2014). Profession differences in family focused practice in the adult mental health system. Family Process, 53(4), 608–617.
Maybery, D., Goodyear, M., & Reupert, A. (2012). The family-focused mental health practice questionnaire. Archives of Psychiatric Nursing, 26(2), 135–144. https://doi.org/10.1016/j.apnu.2011.09.001.
Maybery, D., & Reupert, A. (2006). Workforce capacity to respond to children whose parents have a mental illness. Australian and New Zealand Journal of Psychiatry, 40(8), 657–664.
Maybery, D., & Reupert, A. (2009). Parental mental illness: A review of barriers and issues for working with families and children. Journal of Psychiatric and Mental Health Nursing, 16(9), 784–791. https://doi.org/10.1111/j.1365-2850.2009.01456.x.
Maybery, D., Reupert, A., Patrick, K., Goodyear, M., & Crase, L. (2009). Prevalence of children whose parents have a mental illness. Psychiatric Bulletin, 33(1), 22–26.
Meaney, M. J. (2010). Epigenetics and the biological definition of gene × environment interactions. Child Development, 81(1), 41–79.
Monds-Watson, A., Manktelow, R., & McColgan, M. (2010). Social work with children when parents have mental health difficulties: Acknowledging vulnerability and maintaining the “rights of the child”. Child Care in Practice, 16(1), 35–55.
Mordoch, E., & Hall, W. A. (2002). Children living with a parent who has a mental illness: A critical analysis of the literature and research implications. Archives of Psychiatric Nursing, 16(5), 208–216. https://doi.org/10.1053/apnu.2002.36231.
Mowbray, C., Lewandowski, L., Bybee, D., & Oyserman, D. (2004). Children of mothers diagnosed with serious mental illness: Patterns and predictors of service use. Mental Health Services Research, 6(3), 167–183.
Neil, A. L. (2007). Australian school-based prevention and early intervention programs for anxiety and depression: A systematic review. Medical Journal of Australia, 186(6), 305.
Nicholson, J., & Henry, A. D. (2003). Achieving the goal of evidence-based psychiatric rehabilitation practices for mothers with mental illnesses. Psychiatric Rehabilitation Journal, 27(2), 122.
Nicholson, J., Sweeney, E. M., & Geller, J. L. (1998). Mothers with mental illness: Family relationships and the context of parenting. Psychiatric Services, 49(5), 643–649.
O'Brien, L., Brady, P., Anand, M., & Gillies, D. (2011). Children of parents with a mental illness visiting psychiatric facilities: Perceptions of staff. International Journal of Mental Health Nursing, 20(5), 358–363.
O’Donnell, M., Anderson, D., Morgan, V. A., Nassar, N., Leonard, H. M., & Stanley, F. J. (2013). Trends in pre-existing mental health disorders among parents of infants born in Western Australia from 1990 to 2005. Medical Journal of Australia, 198(9), 485–488.
Oyserman, D., Mowbray, C. T., Meares, P. A., & Firminger, K. B. (2000). Parenting among mothers with a serious mental illness. American Journal of Orthopsychiatry, 70(3), 296–315. https://doi.org/10.1037/h0087733.
Reupert, A., Cuff, R., Drost, L., Foster, K., van Doesum, K., & van Santvoort, F. (2012). Intervention programs for children whose parents have a mental illness: A review. Medical Journal of Australia Opening, 1(1), 18–22.
Reupert, A., & Maybery, D. (2007). Strategies and issues in supporting children whose parents have a mental illness within the school system. School Psychology International, 28(2), 195–205. https://doi.org/10.1177/0143034307078098.
Rishel, C. W. (2012). Pathways to prevention for children of depressed mothers: A review of the literature and recommendations for practice. Depression Research and Treatment. https://doi.org/10.1155/2012/313689.
Roberts, W. (2015). Enabling change through education for children and their families experiencing vulnerability and disadvantage: The understandings of early childhood professionals. Australasian Journal of Early Childhood, 40, 49–56.
Sanden, S., Ernst, J. C. D., Hamann, K., Quesenberry, A., Latham, N. I., Christianson, D., & Smyrniotis, A. (2016). Supporting early childhood workforce development and pathways: Developing a competency-based assessment system in illinois. In S. A. Bernoteit, J. C. D. Ernst & N. I. Latham (Eds.), Voices from the field (pp. 201) Springfield, Illinois: Illinois Education Research Council and Illinois Board of Higher Education.
Satcher, D. (2004). School-based mental health services. Pediatrics, 113(6), 1839.
Sims, M., Davis, E., Davies, B., Nicholson, J., Harrison, L., Herrman, H., & Priest, N. (2012). Mental health promotion in childcare centres: Childcare educators’ understanding of child and parental mental health. Advances in Mental Health, 10(2), 138–148.
Solantaus, T., Toikka, S., Alasuutari, M., Beardslee, W., & Paavonen, J. (2009). Safety, feasibility and family experiences of preventive interventions for children and families with parental depression. International Journal of Mental Health Promotion, 11(4), 15–24.
Steer, S., Reupert, A., & Maybery, D. (2011). Programs for children of parents who have a mental illness: Referral and assessment practices. “One size fits all. Australian Social Work, 64(4), 502–514. https://doi.org/10.1080/0312407x.2011.594901.
Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., & Levine, M. D. (2012). Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders, 3(1), 76–91. https://doi.org/10.1037/a0023081.
Swafford, M. D., Wingate, K. O., Zagumny, L., & Richey, D. (2015). Families living in poverty: Perceptions of family-centered practices. Journal of Early Intervention, 37(2), 138–154. https://doi.org/10.1177/1053815115602880.
Tchernegovski, P., Reupert, A., & Maybery, D. (2015). “Let’s talk about children”: A pilot evaluation of an e‐learning resource for mental health clinicians. Clinical Psychologist, 19(1), 49–58.
van Doesum, K. T., & Hosman, C. M. (2009). Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands:II. Interventions. Australian e-Journal for the Advancement of Mental Health, 8(3), 264–276.
Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., & Egger, M. (2014). Strengthening the reporting of observational studies in epidemiology (strobe): Explanation and elaboration. International Journal of Surgery, 12(12), 1500–1524. https://doi.org/10.1016/j.ijsu.2014.07.014.
Wells, J., Barlow, J., & Stewart-Brown, S. (2003). A systematic review of universal approaches to mental health promotion in schools. Health Education, 103(4), 197–220.
Whitley, J., Smith, J. D., & Vaillancourt, T. (2013). Promoting mental health literacy among educators: Critical in school-based prevention and intervention. Canadian Journal of School Psychology, 28(1), 56–70.
In the case of Manuscript JCFS-D-16-00526, the nature and extent of the author contribution to the work was the following: S.L.: Designed and executed the study, conducted the data analysis and wrote the paper. M.G.: collaborated with the design, assisted with the data analysis and wrote part of the results. A.R.: collaborated with the design and writing and editing of the final manuscript.
Conflict of Interest
The authors declare that they have no competing interests.
Informed consent was obtained from all individual participants included in the study.
Ethical approval was provided by the Monash University Human Ethics Committee. Reasearch involving human participants: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
About this article
Cite this article
Laletas, S., Goodyear, M. & Reupert, A. Parental Mental Illness: Cross-Sectional Analysis Of Family Focused Practice within the Early Childhood Sector. J Child Fam Stud 27, 1650–1660 (2018). https://doi.org/10.1007/s10826-017-0992-1
- Parental Mental Illness (PMI)
- Preschool Teachers
- Childcare Providers
- Family Focus
- Early Childhood Education And Care (ECEC)