ADULT MENTAL HEALTH PARENTING SUPPORT

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ADULT MENTAL HEALTH / PARENTING SUPPORT

• Strengthening Links

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WHY IMPROVE LINKS?
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PARENTING SUPPORT CONTEXT
BACKGROUND FACTORS Family Structure Age of
Mother Income/ Poverty Occupation /
Employment Education
KEY FAMILY FEATURES Parental Cognition Physical
Health Mental Health / Well Being Resources
FAMILY PROCESSES Parenting Quality Home
Learning Parental Advice
OUTCOMES Child Development
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(No Transcript)
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MULTIPLE DISADVANTAGE
Percentage of families with children experiencing
5 or more disadvantages
2.2
2.1
2
2
1.9

2001
2002
2003
2004
2005
The consistency of this figure over 2001 to 2004
suggests that improvements such as the reduction
in child poverty may not be reaching such
families

• Basket of indicators of disadvantages includes
• No parent in the family is in work
• Family lives in poor quality or overcrowded
  housing
• No parent has any qualifications
• Mother has mental health problems
• At least one parent has a long-standing illness/
  disability
• Family has low income (below 60 median)
• Family cannot afford a number of food and
  clothing items

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POLICY BACKGROUND

• Every Child Matters
• Every Parent Matters
• Think Family

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THINK FAMILY

• Tailored, flexible, holistic approaches needed
  no wrong door
• Progressive universalism
• Early intervention

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SERVICE RESPONSE

• Single person / single problem
• Complex and fragmented
• Deficit models
• Reactive not early intervention
• Random element to who gets service

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THINK FAMILY MODEL
Better systems for identifying and engaging
families at risk (those with multiple and complex
problems putting their children at risk of poor
outcomes)
Identification
Whole family assessment
Building on the CAF, which looks at the needs,
strengths and interrelation of problems of the
whole family
Multi agency support plan
Managed by lead workers who case work families,
working directly with them and co-ordinating
other service involvement
Improved information sharing
To enable early identification and interventions
To ensure the full range of evidence based
programmes and interventions to meet family needs
Joined up planning commissioning
Integration between adult and childrens
services
At all levels of local services such as clear
accountability for families through joined-up
governance to and a common vision and agreed
outcomes for families across services as part of
the LAA process.
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NEW DEVELOPMENTS

• Family intervention projects
• Family pathfinder projects
• Family nurse partnership
• Family group conferencing
• Multi systemic / family therapy

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MENTAL HEALTH -RISK FACTOR

• 450,000 parents have MH problems
• Poor parental MH linked to child MH difficulties
• 175,000 children acting as carers, around 30 in
  relation to parent with MH difficulties
• Transmission genetic and environmental
• Particular influence of mothers mental health

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MENTAL HEALTH ACT 2007

• 1. Single Definition of Mental Disorder
• 2. Criteria for the use of Compulsion
• 3. Age Appropriate Services
• 4. Widening Professional Groups
• 5. Nearest Relative
• 6. Independent Mental Health Advocacy Service
• 7. Patients and ECT
• 8. Supervised Community Treatment
• 9. Referral to the MHRT

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Care Programme Approach

• The needs of parents, child and family as a whole
  should be assessed routinely at each stage of the
  care pathway from referral to review.
• Guidance states
• An intervention intended to provide safety and
  support during a time of acute distress, can fail
  to promote recovery if the effects on the whole
  family are not taken into account.

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SCIE /NICE GUIDANCE

• To conduct a systematic review of evidence and
  existing practice by health and social care
  services in parenting needs, including meeting
  the needs of ethnic minority parents to publish
  new guidelines

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EMERGING FINDINGS

• Change is required in both childrens and adult
  services
• Key information is not routinely collected
• Some interagency protocols in place but few
  resources to embed
• CAF/ Integrated Childrens System CPA interface
  crucial
• Separate eligibility criteria prevent
  identification of compounding difficulties
• Limited robust evidence of what works for parents
  with MH problems
• Training does not address complexity of cross
  working

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BUILDING BRIDGES

• Where parents have profound and enduring mental
  health problems
• Starting point is families perceptions of their
  needs
• Flexible and holistic
• Utilises unqualified family support workers
• Help with practical issues as well as providing
  emotional support

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COVENTRY - ISSUES

• Gap in skills and awareness of impact on children
  of parents with MH issues
• Need for training around referral routes/pathways
  and awareness of issues for childrens and
  adults services in working together
• Duplication of assessments and meetings
• Asking the right questions on initial referral
  forms and encouraging a Think Family approach
  in all agencies/organisations

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COVENTRY continued

• Understanding thresholds for mental
  health/illness and identifying levels and
  availability of interventions for both parents
  and CYP
• Need for joint budgets/commissioning to enable
  joint working
• Concern about capacity to introduce new
  initiatives

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COVENTRY - OPPORTUNITIES

• Protocol for adults with a disability, (MH
  included) who are also parents, being written by
  Adult Services
• PEIP CEDAR starting an evaluation which looks
  at long-term effects of parenting on both parents
  and their CYP
• Family Action (FWA) awarded an intensive family
  support project in Coventry (Jan 09)
• FIP, SPP, DVA project, FGC

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OPPORTUNITIES continued

• Multi-Agency Teams being set up in
  neighbourhoods/clusters weekly case meetings
  involving a holistic, whole family approach
• Early Intervention Team at CAMHS working with
  families
• New Senior Parenting Practitioner post part of
  remit will be working with families with MH issues

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BIRMINGHAM ISSUES

• Limited overall policy/protocols
• Sporadic joint training
• Access difficult / pathways unclear
• Good initiatives but not linked
• Some holistic approaches finding barriers
• Young carers services uncoordinated
• Tensions between health and local authority
  perspectives

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BHAM OPPORTUNITIES

• FIP
• Young carers initiatives
• Family group conferencing
• Domestic violence pilot
• Links with parents with disabilities group
• Pilot site for SCIE /NICE guidelines

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EXERCISE

• 1) Discuss your experiences of MH / parenting
  support links in pairs / threes.
• 2) On pro forma provided identify barriers and
  drivers to developing links further.
• 3) Summarise any initiatives / innovations you
  are aware of that have tried to address the above
  issues.

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RESOURCES

• www.pmhcwn.org.uk (Parental Mental Health
  Child Welfare Network)
• www.scie.org.uk
• www.barnardos.org.uk
• www.suffolk.gov.uk/careandhealth/childrenandfamili
  es/ACCORD (protocol)
• www.nspcc.org.uk
• www.rcpsych.ac.uk

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RESOURCES

• www.youngcarers.net
• www.mind.org.uk
• www.nsfscot.org.uk (National Schizophrenia
  Fellowship Scotland)
• www.family-action.co.uk (was FWA)