Steps Towards Evidence-Based Practice in Supporting Families with Parental Mental Illness
Steps Towards Evidence-Based Practice in Supporting Families with Parental Mental Illness (pdf format report)
Findings from a forum held December 2004
Executive Summary(for full report please click the link above)
I. Introduction
This report contains the findings from the forum, “Steps Towards Evidence-Based Practice in Supporting Families with Parental Mental Illness” that was held on December 3, 2004. This forum was planned with the purpose of gathering an in-depth look at where we are as a Province in terms of policy, practice, programs and protocol regarding families with parental mental illness. The forum also provided an opportunity for participants to discuss their vision for these British Columbian families. The ultimate goal of the 2004 forum was to bring together a collective voice and community to support families with parental mental illness.
To this end, this document includes voices from across BC. Key stakeholders were interviewed before the Forum to gather their thoughts and ideas. The forum’s invitation list was developed carefully to ensure that a wide variety of participants would lend their rich experience and ideas to the proceedings. Participants at the Forum included policy makers, service providers and consumers. Representatives were present from all parts of our province including Northern BC, the Interior, Vancouver Island and the Lower Mainland. In all, over 100 people participated in this process.
This paper demonstrates that we are engaged in similar work that is currently being done in other parts of the world. Australia recently had a major initiative to produce a scoping project that identified current evidence-based initiatives for families with parental mental illness and created a plan for work in this area. Their project outlined major activities, identified gaps and made recommendations regarding future work. This paper is the British Columbian version; it is our step toward effectively addressing the needs of our families with parental mental illness. The findings presented in this report indicate that simply put, in British Columbia we have taken a number of important steps in our quest for best practice and we still have a fair distance to travel. Many of the findings have to do with practices in the Ministry for Child and Family Development (MCFD) and services in the Regional Mental Health Authorities of British Columbia. Most points, however, will be relevant to any service provider working with a family with parental mental illness.
II. Policy: Summary of Findings
There is currently no Provincial data on the frequency of parental mental illness in families. It is hoped that this information can be collected starting with the families with parental mental illness who are receiving support from the Ministries in the Province of British Columbia. Acquiring this information will assist in making decisions about services, programs, funding and research. The goal is to look at both Adult Mental Health and MCFD case files, and collect information on diagnosed parental mental illness, substance misuse, whether or not this adult has dependent children, the ages of children and who has custody of them.
Currently, MCFD’s goal is to keep families together through initiatives such as Service Transformation Plan and Family Development Response. It has been shown that advance planning, interministerial communication and integrated case management will also support families in their desire to remain intact.
III. Practices: Summary of Findings
These findings show the importance of having a family focus in treatment with families with parental mental illness across the Province, with the goal of treatment being optimal family functioning. Research findings also indicate that a strengths-based approach allows a therapeutic alliance to grow, sprouting trust and a positive working relationship between families and service providers. In the future it is hoped that innovative ways are found to overcome the stigma of mental illness and to create a culture of understanding and tolerance. Service Providers need ongoing training about mental illness in general as well as about families with parental mental illness in particular, and this training needs to occur from the beginning – in University and College courses. Service Providers also need to examine their use of labels, understanding how labels help and how they hinder practice.
IV. Programs: Summary of Findings
Another vision that came from this forum is the need for evidence-based research in our Province, and for that research to be used effectively in planning programs. Programs could be built with the expectation of assessment to determine good practice Steps Towards Evidence-Based Practice in Supporting Families with Parental Mental Illness 2 Executive Summary principles and guidelines for services and workers as well as complementary resource materials. It is also important to recognize the value of early intervention and prevention. As service providers work toward best practice in programs, it is imperative to consider the diversity of the families with parental mental illness and determine the best ways to address their unique needs. Another hope is that the first responders, often doctors and hospitals, have current knowledge of mental illness, assessment practices and shared care practices. Finally in this chapter, participants mention the programs and services they felt were beneficial in supporting families with parental mental illness.
V. Protocol: Summary of Findings
The chapter on protocol reviews the concerns participants and interviewees had regarding funding. Their hope is to determine the numbers of families with parental mental illness in our province and be able to assess whether or not funding is adequate. If categorical funding existed for families with parental mental illness, stakeholders would be able to make decisions and prioritize spending for this population as a group. In the current system, funding is provided for adults and for children, but there are no specific funds for family-focused treatment and programs. Participants also stated their desire that programs would be funded for longevity as in the United States where some programs have been operating for more than 20 years. This would ensure that the good work that is started could last longer than a year or two. Participants gave specific ways that these families could be supported in their daily lives, which would create optimal family functioning. These simple requests for support included: shelter, food, transportation, recreation, respite, medication, tax breaks and legal aid.
VI. The Children: Summary of Findings
It is important to ensure that in British Columbia, children in families with parental mental illness are not invisible. Currently there are few direct services for children. Research has shown that children are affected by their parent’s mental illness and thus the desire is to optimize healthy family functioning through supporting the parents when needed. Parents need support to ensure that they are providing a healthy environment for their children. Research has also shown us that children are resilient and resiliency can be encouraged in children. It is crucial that children from these families receive support and education not only about their parent’s illness but also about the possibility of developing a mental illness themselves.
The hope of the Provincial Working Group is that significant changes continue to occur in British Columbia because of stakeholders coming together to collaborate and commit to the best ways of supporting families with parental mental illness.
Désirée Blume, MA, MEd Child and Family Therapist On behalf of the Provincial Working Group May 2005
