Think child, think parent, think family: Parental mental health and child welfare Hugh Constant, Practice Development Manager Hannah Roscoe, Research Analyst

Developing the Think Child, Think Parent, Think Family guide June 2006 Systematic map of evidence 2006 – 2008 Practice inquiries in five local authorities April 2009 Consultation : practitioners, academics, children and parents July 2009 Think Child, Think Parent, Think Family guide 2006 – 2008 Literature reviews: Incidence and detection Acceptability and effectiveness Professional education Policy

Developing the Think Child, Think Parent, Think Family guide June 2006 Systematic map of evidence 2006 – 2008 Practice inquiries in five local authorities 2006 – 2008 Literature reviews: Incidence and detection Acceptability and effectiveness Professional education Policy Parker et al. (2009) SPRU Stanley & Cox (2009) UCLan SCIE Bates & Coren (2006) SCIE with consultancy from EPPI Centre

Parents with mental health problems Those with dependent children All adults with MH problems Those with MH problems All adults with dependent children All adults Approach 1 Approach 2

Parents with mental health problems In a population of non-elderly adults, at any given time, around 9 to 10 per cent of women and 5 to 6 per cent of men in Great Britain will be parents with mental health problems (Meltzer et al. 1995; Singleton et al. 2001). One in four children aged 5-16 have mothers who would be classed as at risk for common mental health problems (Meltzer et al. 2000)

Why think family in mental health services? 3. Parenting and the parent – child relationship 4. Risks, stressors and vulnerability factors 4. Protective factors and resources 1. Child mental health and development 2. Adult mental health The Family Model (Falkov, 1998)

Why think family in mental health services? Most parents with mental health problems parent their children effectively However, in some cases parental mental ill health can be a factor in: Significant harm to children Impaired health and development of children Increased likelihood of mental ill health in children of parents with MH problems

Barriers to thinking family 3. Parenting and the parent – child relationship 4. Risks, stressors and vulnerability factors 4. Protective factors and resources 1. Child mental health and development 2. Adult mental health

Think Child, Think Parent, Think Family Guide Full guide At-a-glance SCTV inkfamily/index.asp

Key messages from the guidance A no wrong door approach Whole family approach to the care pathway Build on family strengths Communications strategy Workforce development Think Family strategy

Key messages Listen to parents and children Manage crises and risk Be creative Increase every family member´s understanding of a parent´s mental health problem

Why implementation?...in the past much policy and guidance has relied on exhortations to collaborate rather than offering constructive mechanisms for doing so. (Stanley & Cox, 2009, p.5).

The sites Birmingham Lewisham Liverpool North Somerset Northern Ireland Southwark

Early learning Senior sign-up Steering group Progress User and carer involvement

Early learning Senior sign-up Safeguarding childrens boards Family strategy boards Parenting boards Think Family project boards Steering group membership Adult mental health Childrens social care Users and carers, or representatives Training, communications

Early learning Getting to Know You Colleagues meeting for the first time Can add to time needed to get started Trust and working relationships need to be developed Joint training is useful in breaking down barriers

Early learning Northern Ireland benefits from a whole systems approach Professional education IT systems Regulation North Somerset – champions group; tackling challenge of parental involvement Southwark – strong strategic approach; focus on training

Early learning Liverpool – lunchtime learning Birmingham – piloting in one area of the city; employing project worker Lewisham – learning from drug & alcohol policy; effective consultation event

Early learning This is a guide – albeit a very robust and credible one Local areas need to use it to inform their work, as shaped by local drivers and priorities The evidence base is strong, but situations differ

Questions for discussion Thoughts or reflections (10 minutes) on the evidence base on the messages on the implementation Changing practice (15 minutes) what might you do differently in your work? what changes need to take place in your organisation?