Parental mental ill-health: experiences of navigating multiple services, a systematic review conducted by learnt and lived experience researchers

Background. Families in which a parent experiences mental ill-health often face complex and evolving challenges, with individual family members’ needs impacting one another across generations. Accessing appropriate support frequently requires the navigation of multiple services and systems, which can be overwhelming for both families and professionals, potentially leading to barriers in care. To address the challenges inherent with navigating complex systems of care it is imperative that the experiences of individuals using these services are understood. The aim of this paper is to review qualitative studies of family members' experiences of accessing multiple services.
Methods. A multidisciplinary research team with both learnt and lived experience of parental mental illness conducted a systematic review using PsycINFO, Academic Search Ultimate, Complementary index, Medline Ultimate, CINAHL, ERIC and Scopus databases. Studies were screened according to predefined inclusion criteria. Quality assessment was undertaken using an expanded version of the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist. Findings were thematically synthesized using a reflexive thematic analysis approach.
Results. While no studies were found that directly addressed the navigation of complex support systems, sixteen papers were identified that explored experiences related to receiving or engaging with multiple services (N = 417). Inhibiting and enabling factors were identified at an individual and systemic level highlighting key considerations for service design and delivery
Conclusion. The limited research in this area indicates a pressing need to understand the experiences of individuals, families and professionals navigating complex and often contradictory systems of care. This review highlights a critical gap in the literature and emphasizes the value of lived experience in research. Future work must centre the voices of all family members to develop coordinated, responsive and effective systems of care. Integrating insights from those directly affected can lead to more family-centred care models, ultimately improving health outcomes and service delivery for all family members.