and how are the kids? Integrated family-focused care for adult patients with depressive and/or anxiety disorders: a pilot study

Transcription

1 Mallorca Global Consortium for Prevention of Depression conference October 25 th -26 th 2018 and how are the kids? Integrated family-focused care for adult patients with depressive and/or anxiety disorders: a pilot study

2 Marieke Potijk Petra Havinga Robert Schoevers Louisa Drost Catharina Hartman Team at UCP/UMCG Groningen studying offspring of depressed and anxious patients in close collaboration with professionals and patients 2

3 Parental mental illness and outcomes for children Psychiatric disorders - ± 30 % no psychiatric problems (resilient) - ± 30% transient psychiatric problems - ± 30% persistent disorder Other negative outcomes E.g. Social, cognitive, education (a.o. Reupert et al., 2015) 3

4 Cumulative proportion of offspring with a mood and/or anxiety disorder Outcomes in offspring of depressed/anxious patients in particular Cumulative proportion of offspring with a mood and/or anxiety disorder Age % Age of onset (years) 95% CI Failure function Havinga et al.,

5 Limited reach interventions for children with parents who have a mental illness (Charles et al., 2016; Dijkstra et al., 2012; Romijn et al., 2010) 5

6 Get the offspring in the picture Mental health agencies are the most common source of referrals to preventive programs for offspring of parents with a mental illness. Van Doesum et al. (2016) 6

7 Research Question* Is it possible to permanently embed a preventive, childaware approach in routine treatment of adult care? * This project was financially supported by the Healthy Ageing fund, UMCG Groningen 7

8 Aims of the pilot (Nearly) all practitioners and/or nurses mention patient s role as a parent at least once during routine treatment and motivate parents to attend the group psychoeducation parenting and a mental illness. 20 % of patients who are parents have attended the group psycho-education at least once after one year. Possibilities to permanently embed this preventive approach in the organization and management structures have been presented to the department management. 8

9 Review of Accomplishments pre phase Identify common barriers for parents to participate in preventive interventions Make a plan to address these barriers Identify existing routines in adult care to build on them Adopt an iterative approach Make sure that the management supports the plans 9

10 Review of Accomplishments phase 1 : creating awareness phase 2: adoption of the intervention Create awareness of the impact of mental illness on parenting among parents and professionals via various ways including presentations, flyers, and an infographic: Identify attitudes of professionals by means of an online survey Organize meetings with the client council, social workers, residents, secretaries, and the managers of the department Organize group psycho-education at predictable times: every first Thursday evening of the month 10

11 Parenting and Mental illness 11

12 Review of Accomplishment phase 3 : implementation; phase 4: evaluation Ask feed back from parents via contact forms and interviews; outcomes among other: timing is important Ask feedback from professionals both individually and in focus groups; outcomes among other: need for education Keep adjusting the original plan to the actual situation in clinical practice Publish an update of the project in the department s newsletter at least every 3 months Registration of patients who are parents and of participants at the monthly group 12

13 Barriers to Achieving Outcomes Two (!) new electronic patient registration systems had to be introduced. Education plans needed to be postponed. Interviews with professionals showed that opinions differed between disciplines whether talking about parenthood was part of their job. Responsibilities should be laid down in the department policy. 13

14 Conclusions 19% of patients who are parents participated in the monthly group. An improvement, but not enough Half of them applied via the special web page. Direct online communication seems promising Satisfaction of participants was great. One of the suggestions: make this obligatory Most professionals acknowledge the need for a child aware approach. They need training and guidelines 14

15 Next Steps Potijk et al., submitted Report with recommendations for the subsidy provider and the department of Psychiatry (UCP/UMCG) Grant application for research into the effect of psychoeducation on parents Share our experiences and results 15

16 Thank you for your (child aware) attention! 16