| 1. |
- Afzelius, Maria, et al.
(författare)
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Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
- 2018
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.
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| 2. |
- Afzelius, Maria, et al.
(författare)
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Children of parents with serious mental illness : the perspective of social workers
- 2017
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Ingår i: Practice. - : Taylor & Francis. - 0950-3153 .- 1742-4909. ; 29:4, s. 293-310
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to describe the experiences of children’s social workers in Sweden who work with families in which a parent suffers from serious mental illness, and how a child in such a family receives support. Data were collected through individual interviews and focus groups discussions with 13 professionals in 2 minor municipalities in southern Sweden. Interviewees stated that parental serious mental illness was not a main focus for children’s social workers. When parental serious mental illness became a barrier to caring for their children, the children’s social workers sought to collaborate with psychiatric services, but in many cases it did not turn out well. Providing support to the parent was one way of aiding the family, although at the price of setting the child’s perspective aside. Being faced with responsibility for the parent and the child left children’s social workers feeling they were the last outpost for the families. Children’s social workers require greater knowledge of how to handle parental serious mental illness, and more interagency collaboration with psychiatric services is needed to adequately support children of parents with a serious mental illness. Keywords: children of parents with serious mental illness; parental serious mental illness; children’s social workers; psychiatric services
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| 3. |
- Afzelius, Maria, et al.
(författare)
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Families living with parental mental illness and their experiences of family interventions
- 2018
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : John Wiley & Sons. - 1351-0126 .- 1365-2850. ; 25:2, s. 69-77
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim: This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method: Five families with children aged 10–12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both family and individual interviews were performed. Results: In striving to lead an ordinary life while coping with the parental mental illness, these families sought the support of the psychiatric services, especially in order to inform their children about the mental illness. Despite different family interventions, the family members felt supported and reported that the number of conflicts in the family had decreased. The parents were appreciative of help with child-rearing questions, and the children experienced a calmer family atmosphere. However, the partner of the person with mental illness experienced being left without support. Implications for practice: Our study shows that psychiatric services, and especially mental health nurses, are in a position to more regularly offer family interventions in supporting the children and the healthy partners.
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| 4. |
- Afzelius, Maria
(författare)
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Families with parental mental illness : supporting children in psychiatric and social services
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children living with a parent with a mental illness can face difficulties. Parentalmental illness may influence the parents’ ability to cope with family life, where theparents’ awareness of their illness plays an important role. Family interventionsprovided by psychiatric and children’s social care services can be a way to supportthese children, making them feel less burdened, and improving the relationshipswithin the family. The aim of this thesis was to illuminate how children infamilies with a parent with a mental illness are supported in psychiatric and socialservices, especially by means of family interventions, and how families experiencethe support. Study I explored how professionals in adult psychiatric outpatient servicesdeal with children and families when a parent has a mental illness. The findingsshowed that professionals balanced between establishing, and maintaining,a relationship with the patient and fulfilling the legal obligations towards thepatient’s children. Asking the patient about their children could be experiencedas intrusive, and involving the patient’s family in the treatment could be seen asa dilemma, in relation to the patient. Efforts were made to enhance the familyperspective, and when the patient’s family and children joined the treatment thisrequired flexibility from the professional. Study II examined how professionals in children’s social care services experienceworking with children and families when a parent has a mental illness. The socialworkers’ objective was to identify the needs of the children. No specific attentionwas paid to families with parental mental illness; they were supported in thesame way as other families. When the parental mental illness became difficult tohandle both for the parent and the social worker, the latter had to set the child’sneeds aside in order to support the parent. Interagency collaboration seemed likea successful way to support these families, but difficult to achieve. Study III investigated if patients in psychiatric services that are also parentsof underage children, are provided with child-focused interventions or involvedin interagency collaboration between psychiatric and social services and childand adolescent psychiatry. The findings showed that only 12.9% of the patientsregistered as parents in Psykiatri Skåne had registered children under the ageof 18 years. One fourth of these patients had been provided with child-focusedinterventions in psychiatric service, and 13% of them were involved in interagencycollaboration. If a patient received child-focused interventions from the psychiatricservices, the likelihood of being involved in interagency collaboration was fivetimes greater as compared to patients receiving no child-focused intervention.Study IV explored how parents and their underage children who were supportedwith family interventions experienced these interventions. The results showedthat parents experiencing mental illness were eager to find support in explainingto and talking with their children about their mental illness, although the supportfrom the psychiatric service varied. Both children and other family membersappreciated being invited to family interventions. After such an intervention, theyexperienced the atmosphere in the family as less strained and found it easier tocommunicate with each other about difficulties. Unfortunately, the participatingpartners felt that they were left without support specifically targeted at them. The thesis showed that there is a gap between how professionals deal withquestions concerning these families and their support, and the parents’ and thefamilies’ needs to receive support in handling the parental mental illness in thefamily. The psychiatric and social services need to expand their approach andwork with the whole family, in order to meet the needs of the child and otherfamily members involved.
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| 5. |
- Afzelius, Maria, et al.
(författare)
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How Adult Psychiatry Professional's View Children
- 2015
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Ingår i: Austin Journal of Psychiatry and Behavioral Science. - : Austin Publishing. - 2381-9006. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Children of parents with a mental illness need support from adult psychiatric services. Efforts have been made to enhance the knowledge of practitioners in this field so that they may work in a more family- oriented manner and to include children in the therapeutic services they provide. Aim: This study investigates how adult psychiatry services works with families and children when a parent has a mental illness. Method: Twenty-four Swedish professional care providers were interviewed individually or in focus groups. Data was analyzed using an inductive content method. Results: Although the professionals knew that their patients had minor children, they still prioritized the individual relationship they had with the parent. Few efforts were made to include both children and families in the treatment offered, and when this happened it was done at the professional’s own discretion. Conclusion: Despite the mandatory Swedish obligation to pay attention to a patient’s children, our study showed that professionals tend to fall short in this regard. Adult psychiatry services needs to strengthen family -oriented work in order to provide support to such children. Keywords: Minor children; Parents with mental illness; Adult psychiatric services; Family therapy
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| 6. |
- Axberg, Ulf, 1961, et al.
(författare)
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Barn till föräldrar som har kontakt med vuxenpsykiatrin – hur har de det? Rapport från en nationell studie
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Psykisk ohälsa hos vuxna som depression, ångest eller bipolär sjukdom är idag ett be-tydande folkhälsoproblem. Många av de drabbade är föräldrar till minderåriga barn. Psykisk ohälsa hos föräldern påverkar barnens utveckling och välmående, men sam-bandet medieras av föräldraförmågan och relationen mellan barnet och föräldern. Sammantaget finns på gruppnivå en ökad risk att barnen också utvecklar psykiska problem, även om det inte behöver vara så i varje enskilt fall. Barns behov av information, råd och stöd ska enligt Hälso- och sjukvårdslagen beak-tas när en förälder lider av psykisk ohälsa. Det finns idag ett flertal interventioner som kan användas för att tillgodose detta behov. Samtidigt behöver man utvärdera hur dessa interventioner fungerar i Sverige. Denna rapport handlar om en kartläggning av hur barn vars föräldrar är patienter inom den specialiserade vuxenpsykiatrin har det med avseende på psykisk hälsa och generell familjesituation. Kartläggningen ingår i ett större forskningsprojekt vars syfte är att göra en utvärdering av interventioner (Beardslees familjeintervention, Föra barn på tal och reguljär behandling/övriga insatser) för stöd till barn i åldern 8 till 17 år med föräldrar med depression, dystymi, ångeststörning och/eller bipolär sjukdom. Totalt ingår föräldrar, både patienter och deras partners, till 88 barn i studien och 19 barn har gjort egna skattningar. De fick fylla i ett antal frågeformulär, där föräldrarna skattade barnens psykiska hälsa, sitt eget psykiska mående, sin generella livssituation, sin relation till eventuell nuvarande partner, sin upplevelse av att kunna hantera bar-nens beteende och olika aspekter av klimat och funktion i familjen. Barnen skattade sin egen psykiska hälsa samt vissa aspekter av klimat och funktion i familjen. Resultaten visar att föräldrar i vår studie rapporterar signifikant högre nivåer av psy-kisk ohälsa hos barnen än föräldrar i en normgrupp i den vanliga befolkningen. Barn rapporterar större symptombelastning än föräldrarna när det gäller emotionella pro-blem, hyperaktivitet/ouppmärksamhet och total problembelastning. De föräldrar som är patienter rapporterar som väntat lägre psykiskt välmående än sina partners, men även i partnergruppen finns det flera som uppger en egen psykisk problematik på klinisk nivå. Patienter och deras partner ger en samstämmig bedömning av sin re-lation; betydligt fler än i en normalgrupp anger bekymmersamt höga nivåer av stress i relationen. Insatser för barn som anhöriga ses ofta som indikerade preventioner i syfte att minska risken för psykisk ohälsa i vuxenåldern, men det finns utifrån studiens resultat mycket som talar för att det istället kan finnas behov av tidig behandling. Studien pekar på vikten av att man som professionell inom vuxenpsykiatrin i enlighet med lagstiftningen tar reda på om det finns barn i familjen, även ställer frågor om hur patienten upplever att barnet mår psykisk och fysiskt, vilka övriga personer som finns omkring barnet och hur tillgängliga de är som stöd för barnet, hur relationerna mellan olika familjemedlemmar är, samt hur föräldraskapet upplevs.
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| 7. |
- Axberg, Ulf, et al.
(författare)
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Barn till föräldrar som har kontakt med vuxenpsykiatrin - hur har de det? : Rapport från en nationell studie
- 2020
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Ingår i: Nationellt kompetenscentrum anhöriga. - 9789187731631
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Mental illness in adults such as depression, anxiety or bipolar disorder are nowadays a significant public health problem. Many of those with mental illness are parents of underage children. A parents’ mental illness affects children’s development and wellbeing, but this association is mediated by parental skills and the relation between child and parent. In summary, at a group level there is an increased risk that the children also develop mental illness, even if it does not need to be so in every individual case.Children’s need for information, advice and support has to be considered according to the Swedish Health Care Act if a parent is mentally ill. A number of different interventions are available that can be used in order to meet this need. At the same time, it has to be evaluated how these interventions work in a Swedish context.This report is about a study on how children with parents who are patients in adult psychiatry do with regard to mental health and general family situation. The study is part of a larger research project with the aim to evaluate interventions (Beardslee Family Intervention, Let’s talk about children and treatment as usual/other interventions) for support to children at 8 to 17 years of age who have parents with depression, dysthymia, anxiety and/or bipolar disease. In total, parents, both patients and their partners, of 88 children are included in the study and 19 children have also participated. They answered a number of questionnaires. Parents estimated their children’s mental health, their own psychological wellbeing, their life situation in general, their relation to their current partner, their experience of control of their child’s behavior and different aspects of family climate and function. Children reported their own mental health and some aspects of family climate and function.The results show that parents in our study report significantly higher levels of mental ill-health in their children than parents in a non-clinical norm group. Children report higher symptom load than parents concerning emotional problems, hyperactivity/inattention and total problem score. Those parents who are psychiatric patients report as expected lower psychological wellbeing than their partners, but also several partners indicate own psychological problems on a clinical level. Patients and their partners give a consistent estimation of their relation. Considerably more participants as compared to a normal group report concerning high stress levels in their relation.Interventions for children as next of kin are often regarded as indicated preventions that aim to decrease the risk for mental illness in adulthood, but the results of this study indicate that there may be need for early treatment instead.The study points out the importance that practitioners in adult psychiatry in agreement with the law find out if there are children in the family and even ask about how the patients perceive their child’s psychological and physical wellbeing, if there are other significant persons around the child and how available they are as a support for the child, how relations between other family members are and how parenthood is experienced.
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| 8. |
- Hansson, Kristofer, et al.
(författare)
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Stärk det socialvetenskapliga perspektivet i vården
- 2022
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Ingår i: Dagens Medicin. - : Dagens medicin. - 1104-7488 .- 1402-1943. ; :25-33/22, s. 26-26
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Hälso- och sjukvårdskuratorernas legitimation infördes 1 juli 2019. Legitimationen har skapat en ny riktning för de socionomutbildade och samtidigt tydliggjort vikten av att placera hälso- och sjukvårdens hälsobegrepp i en samhällelig kontext. Därmed sätter förändringen ljus på viktiga frågor som hälso- och sjukvården brottats med under lång tid och som nu skulle kunna debatterats på allvar med kuratorn i centrum.
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| 9. |
- Priebe, Gisela, et al.
(författare)
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Barns behov av information, råd och stöd när en förälder får vuxenpsykiatrisk vård - Hur efterföljs lagen i den kliniska vardagen?
- 2015
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Ingår i: Att se barn som anhöriga : Om relationer, interventioner och omsorgsansvar - Om relationer, interventioner och omsorgsansvar. - 9789187731266 ; , s. 155-177
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Bokkapitel (refereegranskat)abstract
- Omfattande forskning pekar på att en förälders psykiska ohälsa kan utgöra enriskfaktor för barnens psykiska utveckling och hälsa, inte minst när den psykiska ohälsan gör det svårt för föräldern att fullt ut fungera som förälder. Sedan år2010 finns ett tillägg i hälso- och sjukvårdslagen om att vården ska beakta barnensbehov av information, råd och stöd och det finns idag ett flertal insatser att väljabland. Detta kapitel redovisar resultat från en studie som undersöker hur lagenefterföljs inom vuxenpsykiatrin, med Psykiatri Skåne som exempel.
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| 10. |
- Priebe, Gisela, et al.
(författare)
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Barns behov av information, råd och stöd när en förälder är psykiskt sjuk - Hur efterföljs lagen? En utvärdering av implementeringen i Psykiatri Skåne
- 2015
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Rapport (populärvet., debatt m.m.)abstract
- Omfattande forskning pekar på att en förälders psykiska ohälsa kan utgöra en riskfaktor för barnens psykiska utveckling och hälsa. Man räknar med att cirka 30 procent av patienterna i vuxenpsykiatrisk vård har minderåriga barn. Under ett år får cirka 30 000 patienter vuxenpsykiatrisk vård i Skåne. Sedan år 2010 finns ett tillägg i hälso- och sjukvårdslagen som slår fast att vården ska beakta barnens behov av information, råd och stöd (HSL § 2g). Region Skåne/Division Psykiatri utarbetade redan år 2010 ”Riktlinjer för att beakta behov hos barn till psykiskt sjuka föräldrar” för att möta lagens krav. Bland annat föreskrivs att barnen och insatser som görs för barnen och deras föräldrar ska registreras i patientdatabasen. Syftet med denna studie är att med utgångspunkt i riktlinjerna undersöka hur lagens intentioner efterlevs i den kliniska vardagen i Psykiatri Skåne och på så sätt bidra till att vidareutveckla arbetet för dessa familjer. Med utgångspunkt i Region Skånes patientdatabas undersöktes hur många barn som hade registerats, vilka insatser barnen och deras familjer hade fått och hur fördelningen såg ut i olika grupper. Två mätningar genomfördes, år 2013 och år 2014, under en period då satsningar för att implementera lagen i det kliniska arbetet gjordes, t.ex. genom Interreg-projektet. Vid varje mätning ingick cirka 30 000 patienter i analysen. Dessutom genomfördes fyra kvalitativa intervjuer med nyckelpersoner för att få en mer nyanserad bild ur några medarbetares perspektiv. År 2013 hade barn registrerats för 12,5 procent av patienterna och år 2014 var det 12,9 procent. År 2013 hade för 28,3 procent av patienterna med registrerade barn minst en insats dokumenterats i patientdatabasen medan motsvarande siffra år 2014 var 29,6 procent. Det innebär att tre fjärdedelar av patienterna med registrerade barn inte hade fått någon insats registrerad. Den vanligaste insatsen var information – en femtedel av patientfamiljerna hade fått det. Hos en tiondel av patienterna hade registrerats att kontakt med socialtjänsten fanns eller hade initierats. År 2013 hade för 5,3 procent av patientfamiljerna metoden Föra barnen på tal registrerats (år 2014: 6,4 procent) och för 1,4 procent av patientfamiljerna hade Beardslee familjeintervention registrerats (år 2014: 1,8 procent). I intervjuerna med medarbetarna pekades mot flera hinder för registreringen, men också på den betydelse det har för barnen, när deras behov uppmärksammas. Vår studie visar att det finns en betydande underrapportering av patienternas barn och att få insatser registreras för barnen och deras familjer. Ökningen mellan år 2013 och år 2014 var marginell trots satsningar på implementering av lagen. Det finns också stora variationer mellan olika verksamheter. Rapporten avslutas med rekommendationer inför det fortsatta arbetet för att uppmärksamma barnens behov. Rapporten vänder sig i första hand till personal inom vuxenpsykiatrin, barnpsykiatrin och socialtjänsten men också till beslutsfattare, politiker och brukarorganisationer samt till intresserad allmänhet.
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