Interventions to Prevent the Trans-Generational Transmission of Mental Health Problems for Children of Mentally Ill Parents

In Scandinavia, there have been ongoing efforts the past decade to increase knowledge and awareness about the risk factors of having parents with mental health problems. These risk factors have been thoroughly documented internationally and studies have concluded that children of parents with a mental illness are at risk of developing social and mental health problems themselves. Subsequently, Norway has changed health legislation and routines in order to make sure these children are identified and given necessary support, as a national effort to prevent the transmission of mental health problems from one generation to the next.

However, studies have shown that there is a gap between what is known about consequences of parental mental illness and what is done in the field of practice. The aim of the current study was to explore the challenges of filling this gap in the Norwegian context.

This study is a part of a large implementation study that evaluates the process of implementing the interventions Family Assessment and Child Talks for children of patients in the adult mental health care. The participants in this study are staff and leaders at wards that are implementing the new interventions. The project is designed to evaluate the process of change in clinical practice, and a mixed methods approach was chosen. The data was collected via web-based questionnaires for all staff (n = 219), which generated both quantitative and qualitative data. This part of the study reports on the qualitative data (n = 183, n = 58), and the data was analysed using a Framework Analysis approach. Furthermore, the study included register data from the electronic patient journals for all patients admitted to the participating clinic (n= 5258).

Results showed that the implementation of a child perspective into adult mental health care is coming along extremely slowly, and that there are several barriers within the adult mental health services related to including a child perspective in the treatment of mentally ill parents. In order to achieve changes in skills, organizational capacity and culture; the health care services need to integrate long-term multilevel implementation strategies. The results of this study also showed that even though health legislation has been changed in order to safeguard children of mentally ill parents, there is still a need for clear and effective strategies to fully incorporate efforts to prevent the trans-generational transmission of mental health problems within families.