Think child, think parent, think family: Parental mental health and child welfare

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

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

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

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

5. 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)

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

7. 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

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

9. Think Child, Think Parent, Think Family Guide • Full guide • At-a-glance • SCTV www.scie.org.uk/children/thinkchildthinkparentthinkfamily/index.asp

10. 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

11. 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

12. 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).

13. The sites North Somerset Northern Ireland Southwark • Birmingham • Lewisham • Liverpool

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

15. Early learning • Senior sign-up • Safeguarding children’s boards • Family strategy boards • Parenting boards • Think Family project boards • Steering group membership • Adult mental health • Children’s social care • Users and carers, or representatives • Training, communications

16. 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

17. 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

18. 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

19. 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

20. 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?