Obstacles and facilitators to communicating with children about their parents’ mental illness: A qualitative study in a sub-district of Mpumalanga, South Africa

Lucy Dean, Hadassah Buechner, Bianca Moffett, Meriam Maritze, Louise Dalton, Jeff Hanna, Elizabeth Rapa, Alan Stein, Stephen Tollman, Kathleen Kahn

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Abstract

Background
Given that common mental disorders are one of the leading causes of disease burden worldwide, it is likely that many children are growing up with a parent or other adult within their family who has anxiety or depression. Parents with a mental illness may not consider it appropriate to discuss their illness with their child, and consequently an absence of communication may lead to stigmatization, shame, misunderstanding their parents’ symptoms, and even blaming themselves. There is a scarcity of research exploring the experiences and perceptions of healthcare professionals about communication with children of parents with mental illness in low-resource and African contexts.

Methods
A qualitative study using semi-structured interviews with healthcare professionals (n = 15) was conducted within the Bushbuckridge sub-district of Mpumalanga Province, South Africa. Data were analysed using Thematic Analysis.

Results
Four themes were identified relating to the obstacles around communication with children. These included: (1) finding an appropriate language to describe mental illness, as well as the prevailing cultural explanations of mental illness (2) the stigma associated with mental illness (3) the perceived role of children in society and (4) mental health services and staff skills. Two themes that addressed facilitators of communication about parental mental illness were identified: (1) the potential to increase mental health awareness amongst the broader community through social media, the internet, and general psychoeducation (2) healthcare professionals’ concerns for the wellbeing and future mental health of patients’ children, as well as their hopes for increased mental health awareness amongst future generations.

Conclusions
This study provides insight into healthcare professionals’ attitudes and perceptions about talking to patients and families within their community about mental illness. The results provide recommendations about possible ways to promote sharing information about a parent’s mental illness with children at an individual and community level. Future research should focus on the collaborative creation of culturally sensitive psychoeducational resources and evidence-based guidelines. This must be supported by systemic and organisational change in order for professionals to successfully facilitate conversations with patients who are parents, and their children.
Original languageEnglish
Article number78
Number of pages11
JournalBMC Psychiatry
Volume23
Issue number1
Early online date27 Jan 2023
DOIs
Publication statusPublished online - 27 Jan 2023

Bibliographical note

Funding Information:
The study was funded by Research England GCRF QR fund (HQ02.01/HQ0B.01). The funder body had no role in the design of the study and collection, analysis, and interpretation of data, nor in writing the manuscript.

Funding Information:
The authors would like to express their gratitude to all of the healthcare professionals who took part in the study. The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa.

Publisher Copyright:
© 2023, The Author(s).

Keywords

  • Communication
  • Children
  • Parental Depression
  • healthcare professionals
  • Parental depression
  • Healthcare professionals
  • Parents/psychology
  • Humans
  • Mental Health
  • Mental Disorders/psychology
  • Adult
  • South Africa
  • Qualitative Research
  • Child

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