Furlong Mairead, McGuinness Colm, Mulligan Christine Marie, McGarr Sharon Lisa, McGilloway Sinead
Centre for Mental Health and Community Research, Maynooth University Department of Psychology and Social Sciences Institute, Maynooth, Ireland.
Technological University Dublin, Dublin, Ireland.
Front Psychiatry. 2024 Mar 28;15:1287378. doi: 10.3389/fpsyt.2024.1287378. eCollection 2024.
Parental mental illness (PMI) is common and places children at high risk of developing psychological disorders. (FT) is a well-known, whole-family, 7-session intervention designed to reduce the risk of transgenerational psychopathology. However, very few larger-scale evaluations of FT (across only a limited number of settings) have been conducted to date while there have been no cost analyses. This study aimed to assess the effectiveness and costs of delivering FT in improving child and family psychosocial functioning in families with PMI within routine mental health settings.
A total of 83 families with PMI, with children aged 5-18 years, were randomly assigned on a 2:1 ratio to receive either the FT intervention (n=55 families) or usual services (n=28 families) across 10 adult, child and primary care mental health sites in Ireland. Parental disorders included anxiety/depression (57%), Bipolar Disorder (20%), Borderline Personality Disorder (12%), Post-Traumatic Stress Disorder (8%) and psychosis (2%). Detailed assessments with parents were conducted at baseline and 6-month follow up.
FT led to significant improvements in family functioning and child behaviour at 6-month follow up when compared to usual services, with medium effect sizes indicated. Parent participants with lower mental health literacy at baseline also showed significant post-intervention improvements. Those parents with less severe mental illness at baseline, and families with more partner and economic supports, reported additional significant post-intervention improvements in child depression/anxiety and parental mental health symptoms. The cost of FT amounted to €761.50 per family, although this decreased to €415.31 when recurring costs only were included.
The findings from this study, which was conducted within the context of a national programme to introduce family-focused practice in Ireland, demonstrate that FT is a low-cost intervention that improved child and family psychosocial functioning across different mental health disorders within routine adult, child and primary care mental health services. The findings contribute to the growing evidence base for FT, and provide a robust basis to inform practice and policy development for families with parental mental illness both in Ireland and elsewhere.
https://www.isrctn.com/ISRCTN13365858, identifier ISRCTN13365858.
父母精神疾病（PMI）很常见，会使孩子患心理障碍的风险增加。家庭治疗（FT）是一种著名的、针对整个家庭的、为期7节的干预措施，旨在降低代际精神病理学的风险。然而，迄今为止，很少有对家庭治疗进行的大规模评估（仅在有限数量的环境中），也没有成本分析。本研究旨在评估在常规心理健康环境中，提供家庭治疗对改善患有父母精神疾病的家庭中儿童和家庭心理社会功能的有效性和成本。
共有83个患有父母精神疾病的家庭，其孩子年龄在5至18岁之间，以2:1的比例被随机分配，在爱尔兰的10个成人、儿童和初级保健心理健康场所接受家庭治疗干预（n = 55个家庭）或常规服务（n = 28个家庭）。父母的疾病包括焦虑/抑郁（57%）、双相情感障碍（20%）、边缘型人格障碍（12%）、创伤后应激障碍（8%）和精神病（2%）。在基线和6个月随访时对父母进行了详细评估。
与常规服务相比，在6个月随访时，家庭治疗导致家庭功能和儿童行为有显著改善，显示出中等效应量。基线时心理健康素养较低的父母参与者在干预后也有显著改善。那些基线时精神疾病不太严重的父母，以及有更多伴侣和经济支持的家庭，报告在干预后儿童抑郁/焦虑和父母心理健康症状有额外的显著改善。家庭治疗的成本为每个家庭761.50欧元，不过仅计入经常性成本时，这一数字降至415.31欧元。
这项在爱尔兰一项引入以家庭为中心实践的国家计划背景下进行的研究结果表明，家庭治疗是一种低成本干预措施，可改善常规成人、儿童和初级保健心理健康服务中不同精神疾病患者家庭的儿童和家庭心理社会功能。这些发现为家庭治疗不断增长的证据基础做出了贡献，并为爱尔兰和其他地方患有父母精神疾病的家庭的实践和政策制定提供了有力依据。
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