Lauritzen Camilla, Reedtz Charlotte
Regional Centre for Child and Youth Mental Health and Child Welfare, RKBU-Nord, UiT-Arctic University of Norway, 9037 Tromsø, Norway.
Int J Ment Health Syst. 2016 Oct 5;10:64. doi: 10.1186/s13033-016-0098-y. eCollection 2016.
Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics. Additionally, to describe the characteristics of child responsible staff in terms of gender and educational background, their competence, clinical practice and knowledge about parental mental illness. A final aim was to study whether or not the clinics had established collaboration with other services concerning follow-up for the children of parents with mental illness.
Participants in this study are the staff at psychiatric clinics in a large university hospital in Norway. Practitioners were asked to answer a questionnaire prior to the initial process of implementing the new legislation in 2010 (N = 219). After a three-year period of implementing routines to adopt the new law in the clinic, the same survey was sent out to the staff in 2013 (N = 185) to monitor if changes were taking place. To study if the changes were sustained within the clinics, we conducted a two-year follow up in 2015 (N = 108).
The results indicated that the systematic work to change clinical practice in the participating hospital had made a difference. Routines to follow up children's patients after the new legislation had to some extent been implemented. The child responsible personnel had more knowledge and awareness about the consequences of parental mental illness for children.
The results of this study suggested that the systems change of establishing child responsible personnel within adult mental health services may be a tool contributing to safeguarding children of mentally ill parents. However, the role of being a child responsible should be further developed and defined.
父母患有精神健康问题的儿童是弱势群体。早期干预以支持患有精神疾病的父母有助于改善儿童的结局。在病房指定儿童责任人员,以此对成人精神健康系统进行调整,是一种系统解决家庭需求的策略。自2010年起,挪威医院必须在所有病房任命此类人员。本研究旨在调查一家设有当地诊所的地区医院在成人精神健康服务中儿童责任人员的任命情况。此外,描述儿童责任人员在性别和教育背景、能力、临床实践以及对父母精神疾病的了解方面的特征。最后一个目的是研究诊所是否就患有精神疾病父母的子女后续跟进事宜与其他服务机构建立了合作关系。
本研究的参与者为挪威一家大型大学医院精神科诊所的工作人员。在2010年新法规初步实施之前,从业者被要求回答一份问卷(N = 219)。在诊所实施新法律的常规程序三年后,2013年向工作人员再次发送相同的调查问卷(N = 185),以监测是否发生了变化。为研究这些变化在诊所内是否持续存在,我们在2015年进行了为期两年的随访(N = 108)。
结果表明,参与研究的医院为改变临床实践所做的系统性工作产生了影响。新法规实施后对儿童患者进行随访的常规程序已在一定程度上得到执行。儿童责任人员对父母精神疾病对子女的影响有了更多的了解和认识。
本研究结果表明,在成人精神健康服务中设立儿童责任人员的系统变革可能是保护患有精神疾病父母的子女的一种手段。然而,儿童责任人员的角色应进一步发展和明确。