At a glance 9: Think child, think parent, think family

Published: May 2012

Key messages

  • Think child, think parent, think family in order to develop new solutions to improve outcomes for parents with mental health problems and their families.
  • Take a multi-agency approach, with senior level commitment to implement a think family strategy.
  • Review whether criteria for access to adult mental health and to children’s services take into account the individual and combined needs of children, parents and carers.
  • Ensure screening systems in adult mental health and children’s services routinely and reliably identify and record information about adults with mental health problems who are also parents.
  • Listen to parents and children – most want support that is flexible, based on a relationship with a key worker and takes account of their practical priorities.
  • Build resilience and manage risk – ensure ready access to specialist mental health and children’s safeguarding services when needed and that staff know who makes what decision in what circumstances.
  • Be creative – consider allocating an individual budget to provide flexibility and tackle stigma by developing non-traditional ways of providing services.
  • Increase every family member’s understanding of a parent’s mental health problem – this can strengthen their ability to cop

Introduction

Parents with mental health problems and their families are one of the four groups most likely to be excluded from health and social care provision (SEU 2004). Changing this requires a new way of working – think child, think parent, think family – across adult mental health and children’s services. This approach is described in SCIE’s guide on working with parents with mental health problems and their children.This At a glance summary presents the recommendations from the guide. It identifies what needs to change to improve service planning, delivery and practice and so help to improve the health, wellbeing and life chances of families affected by parental mental ill health.The guide also provides some examples of how this can be implemented in practice.

The current context

Policy

In recent years there has been a shift in children’s and adult social care policy and guidance which is now placing greater emphasis on supporting adults in their parenting role.This is reflected in the main policy drivers in England: No Health without Mental Health, the Troubled Families Initiative, Community Budgets,Think Local Act Personal, and Putting People First. Every Child Matters and the updated Working Together guidance provide the framework for children’s services to support the child and the family. In Northern Ireland, support for parents is covered in the Regional Family and Parenting Strategy and the 10-year strategy for children and young people Our Children andYoung People – Our Pledge.The think family approach is also outlined in the Service Framework for Mental Health and Wellbeing, which explicitly sets out how the family model should be embedded in practice.

Organisations

Research has shown that adult mental health and children’s social care services need to work together to better meet the needs of families. However, there are currently many barriers to effective joint working characterised by separate legal frameworks, policy and practice guidance.

The challenges for staff

Staff need advice and support on how to change their practice and how to make change. Most staff seem to be aware of the issues, but state they need more effective leadership and guidance to help them overcome the barriers.

The views of families

Families want good quality, practical support in looking after their children and freedom from the fear of losing parental responsibility. Children and young people say they want relevant information about their parent’s illness, someone to talk to about their experiences and a chance to make and see friends.

SCIE’s guide says Think child, think parent, think family. It encourages the development of services that:

What makes a successful service?

Based on the findings from this review, a successful service for families with a parent with a mental health problem will:

A high-quality service that incorporates a ‘think child, think parent, think family’ approach will:

Key recommendations

These recommendations summarise the changes that need to be made at every stage of the care pathway to improve services for families where a parent has a mental health problem.

Screening

Practitioners need to:

Organisations need to:

Managers need to:

Assessment

Assessment processes need to take account of the whole family and their individual and collective needs.

Practitioners need to:

Organisations need to:

Managers need to:

Planning care

Care planning needs to take a holistic approach to include appropriate care plans for each individual family member as well as the family as a whole. These plans should aim to increase resilience, reduce stressors and respond appropriately to risks.

Practitioners need to:

Providing care

Commissioning, funding and management processes need to ensure that services meet the full spectrum of needs of parents with mental health problems and their children.

Practitioners need to implement interventions that will:

Organisations need to:

Review of care plans

Reviews need to consider changes in family circumstances over time, include both individual and family goals and involve children and carers in the process.

Practitioners need to:

Taking a strategic approach

Based on these recommendations, it is clear that changes are needed at every level and across all agencies.

Such systemic and fundamental change requires a more strategic approach. This should involve:

Carrying out a multi-agency-led review of services to:

Ensuring senior level commitment

Supporting workforce development

In order to support managers and practitioners in putting these recommendations into action, those responsible for professional education, training and workforce development should introduce a think child, think parent, think family perspective.

Provision should be made for joint training for staff in adult mental health and children and family services as well as other professional groups.

A new leadership programme for adult and children’s social work supervisors and managers should be developed.

Putting it into practice

This guidance was the first step in taking forward a long process of change. SCIE supported this process by working with partner agencies and families to implement and evaluate these recommendations.This work included:

Those responsible for professional education, training and workforce development should introduce a think child, think parent, think family perspective.

Further information

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