Parental Mental Illness: Cross-Sectional Analysis Of Family Focused Practice within the Early Childhood Sector

Abstract

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.

References

  1. ACECQA. (2014). Australian children’s education and care quality authority. http://www.acecqa.gov.au/, Accessed 27 Jan 2015

  2. AICAFMHA. (2001). Children of parents affected by mental illness-scoping project. http://www.aicafmha.net.au/projects/scoping/children.htm, Accessed 26 Sept 2016.

  3. 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

  4. 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.

    PubMed  Article  Google Scholar 

  5. Bakulski, K. M., & Fallin, M. D. (2014). Epigenetic epidemiology: Promises for public health research. Environmental and Molecular Mutagenesis, 55(3), 171–183.

    PubMed  PubMed Central  Article  Google Scholar 

  6. 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.

    Article  Google Scholar 

  7. 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.

    PubMed  Article  Google Scholar 

  8. 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.

    PubMed  Google Scholar 

  9. 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.

    PubMed  Article  Google Scholar 

  10. Bibou-Nikou, I. (2004). Parental mental health and children’s well-being. Clinical Child Psychology and Psychiatry, 9(2), 309–312.

    Article  Google Scholar 

  11. Biebel, K., Nicholson, J., & Woolsey, K. (2014). Implementing an intervention for parents with mental illness: Building workforce capacity. Psychiatric Rehabilitation Journal, 37(3), 209.

    PubMed  Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. 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.

    PubMed  Article  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. 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.

  16. Falkov, A. (2012). The family model handbook: An integrated approach to supporting mentally ill parents and their children. London: Pavilion.

    Google Scholar 

  17. 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.

    Article  Google Scholar 

  18. Field, A. (2013). Discovering statistics using IBM SPSS statistics. London, England: Sage.

    Google Scholar 

  19. 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.

    Google Scholar 

  20. 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.

    Article  Google Scholar 

  21. Fudge, E., Falkov, A., Kowalenko, N., & Robinson, P. (2004). Parenting is a mental health issue. Australasian Psychiatry, 12(2), 166–171.

    PubMed  Article  Google Scholar 

  22. 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.

    Article  Google Scholar 

  23. 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.

    PubMed  PubMed Central  Article  Google Scholar 

  24. 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.

    PubMed  Article  Google Scholar 

  25. 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.

    PubMed  Article  Google Scholar 

  26. 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.

    PubMed  Article  Google Scholar 

  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.

    Article  Google Scholar 

  28. 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.

  29. 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.

    PubMed  Article  Google Scholar 

  30. 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.

    PubMed  Article  Google Scholar 

  31. 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.

    Article  Google Scholar 

  32. Howard, L. M., & Underdown, H. (2011). The needs of mentally ill parents-a review of the literature. Psychiatrische Praxis, 38(1), 8–15.

    PubMed  Article  Google Scholar 

  33. 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.

    Article  Google Scholar 

  34. 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.

    Article  Google Scholar 

  35. 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.

    PubMed  Google Scholar 

  36. 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.

    Article  Google Scholar 

  37. 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.

    Article  Google Scholar 

  38. 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.

    PubMed  PubMed Central  Article  Google Scholar 

  39. Madsen, W. C. (2009). Collaborative helping: A practice framework for family‐centered services. Family Process, 48(1), 103–116.

    PubMed  Article  Google Scholar 

  40. Mann, C. (2003). Observational research methods. Research design ii: Cohort, cross sectional, and case-control studies. Emergency Medicine Journal, 20(1), 54–60.

    PubMed  PubMed Central  Article  Google Scholar 

  41. 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.

    PubMed  Google Scholar 

  42. 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.

    PubMed  Article  Google Scholar 

  43. 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.

    PubMed  Article  Google Scholar 

  44. 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.

    PubMed  Article  Google Scholar 

  45. 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.

    Article  Google Scholar 

  46. Meaney, M. J. (2010). Epigenetics and the biological definition of gene × environment interactions. Child Development, 81(1), 41–79.

    PubMed  Article  Google Scholar 

  47. 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.

    Article  Google Scholar 

  48. 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.

    PubMed  Article  Google Scholar 

  49. 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.

    PubMed  Article  Google Scholar 

  50. 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.

    PubMed  Google Scholar 

  51. 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.

    PubMed  Article  Google Scholar 

  52. 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.

    PubMed  Article  Google Scholar 

  53. 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.

    PubMed  Article  Google Scholar 

  54. 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.

    PubMed  Article  Google Scholar 

  55. 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.

    PubMed  Article  Google Scholar 

  56. 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.

    Google Scholar 

  57. 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.

    Article  Google Scholar 

  58. 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.

    PubMed  PubMed Central  Google Scholar 

  59. 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.

    Google Scholar 

  60. 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.

    Google Scholar 

  61. Satcher, D. (2004). School-based mental health services. Pediatrics, 113(6), 1839.

    Article  Google Scholar 

  62. 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.

    Article  Google Scholar 

  63. 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.

    Article  Google Scholar 

  64. 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.

    Article  Google Scholar 

  65. 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.

    PubMed  Article  Google Scholar 

  66. 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.

    Article  Google Scholar 

  67. 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.

    Article  Google Scholar 

  68. 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.

    Article  Google Scholar 

  69. 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.

    PubMed  Article  Google Scholar 

  70. 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.

    Article  Google Scholar 

  71. 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.

    Article  Google Scholar 

Download references

Author Contributions

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Stella Laletas.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

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.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

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

Download citation

Keywords

  • Parental Mental Illness (PMI)
  • Preschool Teachers
  • Childcare Providers
  • Family Focus
  • Early Childhood Education And Care (ECEC)