Family focus in mental health and social services for adults: Supporting minor children of parents in challenging life situations

Abstract

Parental mental illness, parents’ loss of ability to work and family poverty affect children and put them at risk for adverse life outcomes. Support for and attendance to minor children and parenting in adult mental health and social services should therefore be an incorporated practice. The main aim of this thesis was to investigate the extent and quality of a family focus in these adult services. Paper 1 investigates self-reported levels of parenting sense of competence among parents with a mental illness. The findings were that parents with a mental illness did not report lower on their parenting sense of competence scores compared to samples from the general population. The paper discusses whether parents felt sufficiently safe to convey any difficulties in parenting they might experience. Paper 2 evaluates the performance of the Child Talks intervention in mental health services using both qualitative and qualitative methods. Results were that few patients, and even fewer children of patients, participated in Child Talks. The quality of the support and follow-up that professionals provided to children and families was inadequate. Paper 3 explores the level of child focus in practices and the level of knowledge and use of the UN CRC among counselors in social services for adults. The main result of the paper was that thematizing children’s situation was not a part of common practice in social services for adults. In conclusion, findings from the three papers suggest that children and parenting is not an incorporated focus among professionals in mental health and social services for adults. The extent and the quality of the family focus in these adult services is insufficient to enable prevention of adverse life outcomes for children and to enable direction of further support of families.

Foreldre som mottar behandling i psykiske helsetjenester eller rådgivning i NAV er i livssituasjoner som påvirker barna deres. Denne avhandlingen handler om ivaretakelse og støtte av mindreårige barn av foreldre som mottar hjelp fra helse og sosialtjenestene for voksne. Artikkel 1 handler om pasientenes rapporterte opplevelse av tilfredshet og mestring av foreldrerollen. Artikkel 2 handler om helsepersonells informasjon og støtte til barn av pasienter i psykisk helsevern for voksne med bruk av tiltaket Barneperspektivsamtalen. Artikkel 3 handler om veiledere i NAV sitt fokus på klientenes mindreårige barn. Hovedresultatet i denne avhandlingen er at barn og foreldrerollen adresseres i for liten grad i tjenester for voksne hvor foreldre er i utfordrende livssituasjoner. Få barn inkluderes i samtaler, barnas situasjon tas i for liten grad hensyn til, barn og foreldrerollen er i for liten grad et tema, og kvaliteten på oppfølgingen barna og familien får av profesjonelle i tjenestene er for lav. Et familiefokus er ikke en integrert del av praksisen i sosial- og psykisk helsetjenester for voksne. Et avgrenset fokus på brukeren eller pasienten i utdanning, praksis, organiseringen av tjenestene, overordnede retningslinjer og systemer, i politikken og i bevilgninger diskuteres som faktorer som bidrar til å opprettholde et manglede barneperspektiv.