Diaz-Caneja Angeles, Johnson Sonia
St Mary's Dept. of Child & Adolescent Psychiatry, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2004 Jun;39(6):472-82. doi: 10.1007/s00127-004-0772-2.
The majority of women with severe mental illness are mothers. Little is known about their experiences and the extent to which their needs are met.
Semi-structured interviews were carried out with 22 women with schizophrenia, bipolar affective disorder or severe depression with psychotic symptoms in Inner London. Participants' experiences, views about services and needs for support in parenting were discussed. Interviews were transcribed verbatim and qualitative thematic analysis carried out.
Most participants who looked after their children described motherhood as rewarding and central to their lives. However, they described the demands associated with parenting and at the same time coping with severe mental illness as considerable, and some feared that their children would be adversely affected by their illnesses. Parenting responsibilities created practical impediments to engaging with mental health services. Fear of losing custody or access to children dominated interactions with mental health and social services, making most participants reluctant to disclose difficulties in parenting to professionals. A widespread assumption that mentally ill women are inherently poor parents, regardless of the facts of individual cases, was described, and stigma was seen as affecting children as well as mothers. Services were perceived as offering little continuing support in relation to parenting, intervening only in crises.
Little attention has so far been paid in research and service development to the fact that the majority of mentally ill women are mothers. Strategies for assessing and meeting the resulting unmet needs should be developed and evaluated.
大多数患有严重精神疾病的女性是母亲。对于她们的经历以及其需求得到满足的程度,人们了解甚少。
对伦敦市中心22名患有精神分裂症、双相情感障碍或伴有精神病症状的重度抑郁症的女性进行了半结构式访谈。讨论了参与者的经历、对服务的看法以及育儿方面的支持需求。访谈内容逐字转录,并进行了定性主题分析。
大多数照顾孩子的参与者将母亲身份描述为有意义的,且是她们生活的核心。然而,她们表示育儿的需求以及同时应对严重精神疾病的需求相当大,一些人担心自己的疾病会对孩子产生不利影响。育儿责任给参与心理健康服务造成了实际障碍。对失去孩子监护权或探视权的恐惧主导了与心理健康和社会服务机构的互动,这使得大多数参与者不愿向专业人员透露育儿方面的困难。人们描述了一种普遍的假设,即无论个别情况如何,患有精神疾病的女性天生就是不称职的父母,而且污名化被认为既影响母亲也影响孩子。人们认为服务机构在育儿方面几乎没有提供持续的支持,仅在危机时进行干预。
迄今为止,研究和服务发展很少关注大多数患有精神疾病的女性是母亲这一事实。应该制定并评估评估和满足由此产生的未得到满足的需求的策略。