Family intervention in mental health care
31 October 2019
Not all mental illness in children can be prevented, but for those that can, the responsibility for prevention is shared by families, teachers, health professionals and the community. For mental illnesses that cannot be prevented, that responsibility shifts to one-off support. In the same way that physical health is a concern for family, friends and employers, mental health must be seen as equally important for the whole community.
Increased awareness and understanding of things that influence coping strategies and resilience can improve the lived experience of people with mental health disorders. In the case of children with mental illness, families that receive early and effective support can reduce the current impact on the child while improving their future outcomes. In the case of parents with a mental illness, that support can reduce the risk of their children developing mental health problems as they grow up.
When mental illness is recognised in children and family engagement is established early, two things become possible. The risk of further conduct disorder and their susceptibility to substance dependence later in life are both reduced. Early and sustained family engagement can have a positive and lasting impact on children’s mental health.
Current mental health statistics
According to the 2015 Young Minds Matter survey, almost one in every seven Australian children aged between four and 17 has experienced a mental disorder in the past year. That statistic is equivalent to 560,000 individuals. This particular survey has been conducted since 1998, during which time the overall prevalence of mental disorders has not changed.
However, over the past two decades there have been changes in specific mental disorders experienced by children in this age group. The occurrence of major depressive disorder in six to 17-year-olds has increased from 2.1 per cent to 3.1 per cent. That includes a jump from 2.9 per cent to 5 per cent in children aged between 12 and 17.
Over the same period, the incidence of ADHD has reduced from 9.8 per cent to 7.8 per cent. In younger children aged between six and 11, there was an even greater reduction from 12.6 per cent to 9.2 per cent.
A significant outcome for children who experience a mental disorder is that many will continue to experience that mental disorder as an adult. Professor George Patton is a medically qualified epidemiologist with a clinical background in child and adolescent psychiatry. He highlights that “around 50 per cent of all adult mental disorders begin by the age of 14 years, and mostly between the ages of seven and 14”.
The Adverse Childhood Experiences (ACE) study demonstrates a link between adverse childhood experiences, or childhood trauma, and health and social problems across the lifespan. Prolonged stress and trauma experienced in childhood can disrupt brain development and undermine functions in the immune and nervous systems. ACEs can also lead to behavioural problems such as eating disorders and alcoholism.
One of the best ways to prevent the emergence of mental illness is to ensure that children have the best possible environment while they are developing physically, mentally and emotionally. Caregivers can utilise the Circle of Security attachment intervention - a relationship-based early intervention program designed to enhance attachment security between parents and children. Decades of university-based research confirms that children who feel secure have greater self-esteem, better relationships and an increased capacity to deal with their emotions.
Ensuring the best possible environment also includes in-utero, i.e. a stress-free pregnancy. Evidence from in-utero fetal brain scans shows that a mother’s stress during pregnancy can change neural connectivity in the foetus’s brain.
Mental health issues commonly associated with family intervention
There are stigmas associated with mental health problems and children are often reluctant to participate in mental health treatment. Even a simple visit to a health practitioner for a child – which is something they don’t see other children doing – can be enough to cause anxiety. Family intervention can help to reduce the number of health appointments and bring more of the required mental healthcare into the home.
- behavioural problems
- emotional problems
- substance misuse
- antisocial behaviour; and
- participation in delinquent activities
The aim of the family intervention is to provide children with a more predictable, stable, nurturing and responsive family environment. So, improving these elements is likely to impede or prevent the development of depression, anxiety and serious conduct problems.
The importance of family engagement and retention
To highlight the importance of family engagement in child mental health care, it’s helpful to start by looking at what can happen with no engagement. A parent may see things in their child, or hear things, that cause them to worry and express their concerns. If they don’t know why their child is behaving in a particular way or how to respond to that behaviour, then their response may create stress for the child and more stress for the parent. It creates a feedback loop that can impact on the social and emotional development of the child – as well as their future mental health.
Family engagement in child mental health care can do much more than just reduce that feedback loop. It gives mental health professionals a deeper understanding of the parents’ life situation, values, beliefs and attitudes towards parenting and childhood. This information provides much more context and highlights areas in need of education and support in the family. With effective communication, mental health professionals can work more closely with the family to support the child.
The value of community partnerships
Children who have experienced family violence, sexual abuse and other traumas are more likely to develop mental health problems. Those who come into contact with homelessness services, drug and alcohol services, child protection, out of home care and youth justice, are highly vulnerable to severe mental injury. Community partnerships that address the mental health problems these children experience is an essential component of an integrated response that can improve their lives.
An effective community partnership demands mutual cooperation from multiple parties. While respecting the privacy of individuals and families, it’s essential for mental health professionals, social services and community services to cooperate. Only then can intervention programs have a chance of sustainable success in supporting vulnerable children.
This cooperation can also assist the engagement and retention of families in child mental health care. As the child grows, and the family accesses other services, different members of the community partnership can step up. By providing support and seeking feedback, they can bolster family engagement and keep them engaged for longer.
If you’re working in mental health, community services or social services, you can improve your ability to build and sustain community partnerships with SCU Online’s Master of Mental Health. This qualification will also equip you with the skills to increase family engagement and retention in child mental health care.
Learn more about our online Master of Mental Health. Get in touch with our Enrolment team on 1300 589 882.