A Narrative Inquiry into the Experiences of Adult Children of Parents with Serious Mental Illness

Abstract

Children of parents with mental illness (COPMI) are a substantial, yet until quite recently, marginalised group within society. Whilst extensive empirical research has been conducted into their risk for adverse psychosocial outcomes as well as potential for resilience, there has been relatively little focus on their personal experiences and understandings of such experiences. In recent years, national and international mental health service policies and guidelines for service provision have been developed to address the specific needs of families and children where parents have mental illness, including serious mental illnesses such as schizophrenia and bipolar disorder. These policies and related service provision guidelines have appropriately focused health professionals' attention on the needs and importance of prevention and early intervention for COPMI. There has not, however, been an associated focus on the needs and experiences of adult children of parents with mental illness (ACOPMI), who have remained significantly marginalised in respect to policy and mental health service provision whilst also demonstrating an increased risk for psychosocial adversity yet potential for resilience. Thus, there has been a gap in knowledge of the experiences of adult children with parents who have mental illness, and their needs have not been served adequately. This narrative inquiry set out to extend the limited understandings of the needs and experiences of adult children of parents with serious mental illnesses (ACOPSMI) such as schizophrenia and major depression. These illnesses have been recognised through research as having potential for long-term and often adverse impacts on children. A lengthy unstructured narrative interview and member check process was conducted with nine ACOPSMI in Australia over a nine month period. The inclusion of the researcher's experience through the use of auto-ethnography resulted in a total of ten participants in the study. Postmodern assumptions have provided a framework for this inquiry and so in this thesis multiplicity, diversity and attending to the voices of those on the margins have been privileged. In order to identify the concerns of ACOPSMI using methods that allowed their voices and stories to be heard from multiple perspectives, a dual analytic process was developed. As per Lather's (1997) recommendation of doing a 'double science', a conventional or realist interpretation of participants' experiences was initially performed. Field texts were analysed according to van Manen's (1990) interpretive phenomenological thematic approach. This initial analytic phase sought to develop and build upon the existing literature which had used similar approaches. In order to thicken interpretations and add a fresh dimension to conventional understandings, the postmodern or alternate story of their experiences was then illuminated through a postmodern narrative analysis. This approach employed an analytic framework developed from the work of several other postmodern and/or narrative writers. From the initial analysis, four phenomenological themes of participants' experiences were uncovered. Consistent with previous literature, these adult children experienced a number of difficulties in growing up with parents with serious mental illness, including assuming responsibility for their parent and family, experiencing negative emotional impacts and developing their own mental health problems, and finding it challenging to connect emotionally with their parents and others. They also, however, demonstrated considerable resilience and effective ways of coping with their experience which assisted many of them to forge productive lives and overcome negative impacts of their past. This thesis discusses these participants' experiences from both conventional and alternate perspectives, as well as addressing the inter-textuality of meanings that may be found between the spaces of such findings. In the light of participants' experiences, recommendations have been developed for health professionals' practice which seek to inform and guide them in working with adult children and families where parents have serious mental illness.