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      Supporting children who have a parent with a mental illness in Tyrol: a situational analysis for informing co-development and implementation of practice changes

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          Abstract

          Background

          A research project, which aims to improve the situation of children of parents with a mental illness (COPMI) is currently underway in the Austrian region of Tyrol. The project aims to strengthen formal and informal support structures around the child, through enhancing their village of collaborative support. Understanding the current situation in the region is vital for implementing practice change. This paper aims to gain knowledge regarding the Tyrolean societal and service provision context.

          Methods

          We collected qualitative (17 interviews among stakeholder and people with lived experience) and quantitative data (e.g. health insurance data) regarding overall societal characteristics, epidemiology of mental illness, currently existing services, uptake of services, and current practices and challenges of identifying and supporting COPMIs. We analysed data along eight external context dimensions: 1) professional influences, 2) political support, 3) social climate, 4) local infrastructure, 5) policy and legal climate, 6) relational climate, 7) target population, and 8) funding and economic climate.

          Results

          We identified that there is awareness of potential challenges related to COPMIs at both a professional and planning level. Additionally, there is a lack of installed support processes and standards to meet these children’s needs across Tyrol. A variety of services are available both for unwell parents, as well as for families and individual family members. Yet, only one small service addresses COPMIs directly. Services fall into different sectors (education, health, social affairs) and are funded from different sources, making coordination difficult. Access varies from universal to rather restricted (i.e. through referral). The potential number of parents which could be reached in order to identify their children via adult mental health, differs considerably by setting. Societal structures indicate that the informal and voluntary sector may be a realistic source for supporting COPMIs.

          Conclusions

          The societal structures and the current services provide a rich resource for improving identification and support of COPMIs, however considerable coordination and behaviour change efforts will be required due to the fragmentation of the system and professional cultures. The insights into the context of supporting COPMIs have been of high value for developing and implementing practice changes in the local organizations.

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          Most cited references18

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          Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: I. The scientific basis to a comprehensive approach

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            Do preventive interventions for children of mentally ill parents work? Results of a systematic review and meta-analysis.

            The transgenerational transmission of mental disorders is one of the most significant causes of psychiatric morbidity. Several risk factors for children of parents with mental illness (COPMI) have been identified in numerous studies and meta-analyses.
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              The number of parents who are patients attending adult psychiatric services

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                Author and article information

                Contributors
                jean.paul@i-med.ac.at
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                19 April 2020
                19 April 2020
                2020
                : 20
                : 326
                Affiliations
                [1 ]GRID grid.416150.7, ISNI 0000 0001 0414 9599, Ludwig Boltzmann Institute for Health Technology Assessment, ; Garnisongasse 7/20, 1090 Vienna, Austria
                [2 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, School of Rural Health, , Monash University Melbourne, ; Wellington Rd, Clayton, Victoria 3800 Australia
                [3 ]GRID grid.419350.a, ISNI 0000 0001 0860 6806, Mental Health Research Group Programme, , The Village, Ludwig Boltzmann Gesellschaft, ; c/o MedUni Innsbruck, Tirol Kliniken GmbH, Schöpfstraße 23a, 6020 Innsbruck, Austria
                [4 ]GRID grid.5361.1, ISNI 0000 0000 8853 2677, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, , Medical University of Innsbruck, ; Anichstraße 35, 6020 Innsbruck, Austria
                Article
                5184
                10.1186/s12913-020-05184-8
                7168853
                32306960
                429b5c83-41bb-48de-b134-684f9fa6674b
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 August 2019
                : 2 April 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003413, Bundesministerium für Wissenschaft, Forschung und Wirtschaft;
                Award ID: not applicaple
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                mental illness,children,situational analysis,context analysis,implementation science

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