Ways of working with families where a parent has a psychiatric disability

Many people who are clients of adult mental health services are parents of dependent children yet little is known about what happens in clinical practice in relation to either them or their children. The purpose of this study is to develop an understanding of clinical practice in an outpatient/community based mental health service in relation to clients who are parents. Four focus groups with clinicians from a Community Mental Health Service in Christchurch, Aotearoa New Zealand were utilised as the principal method of data generation. A fifth focus group was unde1iaken with clients of the CMHS who were parents, the purpose of which was to establish a client context and reference point for the clinician focus groups. A thematic analysis was used to interrogate the qualitative data generated. Firstly, the findings reveal that whereas clinicians have a good understanding of the issues faced by parents who have a severe mental illness they are much less knowledgeable about the risks faced by children in these families and about how to decrease the likelihood that negative outcomes will occur. Secondly, the groups provide a description of the practice of clinicians with clients who are parents and their children. Thirdly, they illuminate a wide range of factors that affect and impact on practice including: the organisational context, a range of constraints, multi­ disciplinary roles, variation and inconsistency in practice and team process and function. Finally, the professional focus groups reveal three issues that arise from clinical practice which clinicians must grapple with: care and protection issues whether to be 'adult' or 'parent' focused in their practice, and the complexity of the clinical situations encountered. The discussion also focuses on implications for the mental health service system, training and workforce development and further research is discussed