Current Practices and Barriers of Family-focused Care of Patients with Severe Mental Illness and Their Children: A Survey Among Czech Psychologists and Psychiatrists.

Abstract

Background: Children of parents with mental illness are known to be at risk of developing mental illnesses due to hereditary and socio-economic factors. The family-focused practice in the treatment of adult patients with severe mental illness benefits patients and their children, and can help prevent mental health problems in children of parents with mental illness. Therefore, professionals caring for adult patients must contribute to the early identification of families at risk and initiate the necessary care.

Objective: This study aimed to determine the current practices of psychologists and psychiatrists in the Czech Republic-the extent to which they include parental issues and their patients' children in their treatment, how informed they are about the available support, their attitudes toward a family-focused practice, potential barriers to family-focused practice, and recommendations for improvements in care for children of parents with mental illness.

Methods: A structured online questionnaire completed by 193 professionals (51.8% psychiatrists, 48.2% psychologists) working with adults with severe mental illness in various healthcare settings.

Results: A large majority (95.9%) of respondents regularly asked about the parenting status of their patients and 75.1% had a positive attitude toward involving children more in treatment. Although most respondents were comfortable discussing parenting (91.2%), they only discussed parenting topics if the patients themselves brought them up. Minors were rarely invited to treatment (26.4%), usually on a one-off basis. Major barriers cited include a lack of set procedures for working with families, lack of coherence of services, lack of time, shortage of professionals to refer to, and perceived lack of training and experience.

Conclusion: Although most professionals know that their patients have children and believe that children of parents with mental illness are at risk of developing problems, they are hindered by a variety of organizational and systemic barriers in implementing the family-focused approach more frequently in practice. Subject to wider expert discourse, the findings may contribute to informed policy formulation.