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. 2023 Sep;96(3):697-715.
doi: 10.1111/papt.12464. Epub 2023 Apr 5.

What about the children? Adult mental health practitioners' experiences and views of family-focused practice in Early Intervention Services

Molly Tuck  1   2 , Anja Wittkowski  1   2 , Rory Allott  2 , Lynsey Gregg  1
Affiliations

What about the children? Adult mental health practitioners' experiences and views of family-focused practice in Early Intervention Services

Molly Tuck et al. Psychol Psychother. 2023 Sep.

Abstract

Background: There is a significant risk of negative outcomes for families when a parent experiences serious mental illness. Family-focused practice (FFP) emphasises the "whole family" as the unit of care and has been found to improve outcomes for service users and their families. Despite its benefits, FFP is not routinely implemented in UK adult mental health services. This study explores adult mental health practitioners' experiences and views of FFP within Early Intervention Psychosis Services in the UK.

Methods: Sixteen adult mental health practitioners employed in three Early Intervention Psychosis teams in the Northwest of England were interviewed. Interview data were analysed using thematic analysis.

Results: Five core themes were generated: (1) A limited understanding of FFP, (2) Our practitioners, (3) Our approach, (4) Our families and (5) Our services. Practitioners' understanding of FFP was limited and typically excluded dependent children. Practitioners' age, professional and personal experience, and preconceptions of families influenced delivery, and in turn, the engagement approach they adopted impacted families' responsiveness. The diversity and dynamics of service user families such as age, socioeconomic status, culture and stigma impacted FFP. An operational context characterised by insufficient resources reduced FFP; however, organisational structures such as leadership, clinical supervision and multi-disciplinary teams facilitated FFP.

Conclusions: FFP is not yet embedded within Early Intervention Services. Practice recommendations include agreeing on a formal definition of FFP and its scope; the development of FFP policy; clarity in relation to staff responsibilities and identities; the adoption of a collaborative approach which encourages service user choice and for time to be ring-fenced to prioritise FFP. Future research should ascertain service user and family views on the facilitators and barriers to engaging with FFP in Early Intervention Services.

Keywords: children of parents with mental illness; health care professionals; psychosis; qualitative; serious mental illness.

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