Exploring the experiences of having a child who regularly does not attend school on parental mental health and wellbeing in the United Kingdom

PurposeTo ascertain to what extent parental and children's mental health wellbeing are inter-related over time. MethodsWe used a birth cohort study of 5,217 children in Scotland followed up from birth to adolescence. We fitted a Random Intercept Cross-lagged Panel Model for parental mental health and children's conduct problems and emotional symptoms. We included longitudinal patterns of poverty as the main covariate and some demographic control variables. ResultsThe effects of parental mental health and child conduct problems and emotional symptoms on one another are roughly equal in early childhood. At younger ages, parents with poorer mental health tend to negatively affect their children's conduct and the conduct problems of a child seem to impact negatively on their parents' mental health. At older ages, it is children's emotional symptoms, but not conduct problems, that tend to have a reciprocal effect on parental mental health. Regarding structural inequalities, the effect of poverty on parents' and children's mental health is categorically the largest and continues to accrue throughout the whole period, intensifying mental health problems for both parents and children over time. DiscussionChildren’s and parents' wellbeing is a bidirectional process. This interdependency needs to be acknowledged and addressed in policy. To foster children's wellbeing, we also need to foster parents' wellbeing. Furthermore, all interventions that address mental health and wellbeing in parents and children and that do not also tackle structural inequalities, such as poverty, will have limited success.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

Child Protection and Mental Health

Editor's evaluation: Investigating the relationship of COVID-19 related stress and media consumption with schizotypy, depression, and anxiety in cross-sectional surveys repeated throughout the pandemic in Germany and the UK

Decision letter: Investigating the relationship of COVID-19 related stress and media consumption with schizotypy, depression, and anxiety in cross-sectional surveys repeated throughout the pandemic in Germany and the UK

Background: The first 1000 days (conception to 2 years postnatal) are crucial for parent and infant health. Visual art-based interventions are used to promote positive parental mental health, but currently, there are no comprehensive insights into how these interventions can support new parents during this critical perinatal period. Aims: To synthesise research on visual art-based interventions designed to promote parents’ mental well-being during the first 1000 days to understand if and how these interventions made a difference and to identify any barriers or facilitators to parents’ engagement. Method: A keyword search of five databases (CINAHL, Embase, Medline, PsychInfo and Scopus), searches via Google Scholar and backward and forward chaining were undertaken. Quality appraisal was conducted using design appropriate tools, and a narrative thematic approach was used. Results: 4417 hits were identified, and 10 studies met eligibility criteria and were included. Interventions were classified as art therapy (n = 8) or creative arts (n = 2), and overall, a lack of robust evidence was highlighted. Six themes were constructed that describe the psychosocial impacts and experiences of the interventions and relational and contextual factors that influenced parents’ engagement. While both types of interventions had benefits, art therapy had the most profound impacts. Challenges regarding sustainability of impacts and facilitator skills were noted for creative arts, rather than art therapy interventions. Conclusion: While art therapy interventions promote positive parental mental health and well-being, high-quality evidence is needed. Implications for future research: More robust evaluation designs to identify mechanisms of effectiveness in art therapy interventions are needed.

The benefits of physical activity for mental health and well-being and the associations between parental mental health and children's mental health have been well established. These important issues tend to be examined separately however, and there is limited research on the associations between parent and child physical activity and mental health when all considered together. While family focused practice is recommended to provide support for parents who have mental health problems and their families and includes various components (such as psychoeducation, support for mental health and parenting), promoting physical activity for parents and children is not usually a core component of these interventions. The Northern Ireland Youth Wellbeing Survey aimed to provide estimates of the prevalence of mental health problems among children and young people. The survey also included questions about parental physical activity, parental mental health, and children's physical activity (for those aged 11-19 years). The main aim of the analysis reported in this article was to explore possible bivariate associations between parent and child physical activity and mental health and also explore these associations when all considered together. Participants were included in the analysis where there were completed interviews for the young person and one of their parents, and both young person and parent provided responses in relation to questions on weekly physical activity (n = 882). The findings highlight the positive associations between parental physical activity and parental mental health, and between children's physical activity and children's mental health. They also explore some of the more complex interactions between these four variables, which suggest that gender may also be an important consideration. There were significant associations between father's physical activity and son's mental health, and son's physical activity and father's mental health. These findings suggest that including support for parental physical activity and children's physical activity should be a routine component of family focused mental health interventions. It is important to acknowledge that there may be additional barriers to engaging in physical activity for families where a parent is experiencing mental health problems, and these should also be explored and addressed.

Raising a child with autism has been linked to mental health difficulties. Poor parental mental health is likely influenced by various factors - including child-, parent-, and family/socioeconomic characteristics. However, little is known about what influences and promotes well-being (as opposed to mental health) among parents of young, newly diagnosed autistic children who may be particularly vulnerable. We examined child-, parent-, and family/socioeconomic factors associated with each of mental health and well-being in a sample of 136 parents of pre-school-aged children. Parental mental health was linked to both child- (i.e. autism symptom severity) and parent-related factors (i.e. personality traits reflecting a tendency to experience negative emotions). By contrast, in additional to mental health difficulties, which were linked to well-being, only other parent-related characteristics (and not child characteristics) were related to well-being. These included personality traits reflecting a tendency to be more extraverted/sociable, and also mindfulness. Other child-related and family/socioeconomic context factors (including household income, parental education level) were not linked to parental mental health or well-being in this sample. These results support the idea that poorer mental health and well-being are not simply the opposite of one another. That is, while these two factors were related, they were linked to different personal characteristics. Perhaps most importantly, the link between well-being and mindfulness - a personal characteristic that parents can improve - suggests mindfulness-based interventions may be helpful in directly supporting parental well-being in the context of raising a young child with autism.

Parent mental health and wellbeing may have implications for understanding attachment transmission. In this systematic review, we synthesise the published literature to determine the nature of the relationship between parent mental health and wellbeing and the intergenerational transmission of attachment and to provide recommendations for future research, clinical practice and intervention. Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, five electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on adult attachment, child attachment, and a domain of parent mental health/wellbeing. No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42020157247). Eleven studies examining the impact on parent mental health and wellbeing on the intergenerational transmission of attachment were identified for inclusion in this review. Our review found preliminary evidence that parent mental health and wellbeing play a role in the intergenerational transmission of attachment. Other key findings from the review were: evidence quality is mixed due to variable measurement of attachment and mental health; studies have mostly included correlational analysis or do not utilise contemporary methodological approaches to testing mediating or moderating relationships; and literature is largely focused on psychopathology and negative factors of mental health. The limited scope of parent mental health and wellbeing constructs examined in the literature, the sparse use of robust statistical analyses, and the lack of literature in general makes it difficult to draw conclusions on how and why parent mental health impacts attachment transmission. Addressing these limitations will further progress attachment-related literature and may have particular implications for attachment-informed interventions with clinical populations.

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Paternity leave has the potential to help parents by enabling new fathers to spend time with their families. However, existing evidence about its association with parental mental health and wellbeing is mixed. This study used data from Understanding Society, a national UK household survey, to examine uptake of paternity leave and its association with measures of mental health and wellbeing for fathers (n=1385) and mothers (n=1384) of infants born 2009-2019. We used logistic regression to explore paternity leave uptake and inverse probability weighted regression adjustment (IPWRA) to estimate the association between paternity leave uptake and the mental wellbeing (Short Form-12 Mental Component Score (SF-12 MCS)) and mental health (General Health Questionnaire-12 (GHQ-12) caseness) of fathers and mothers in the months after the birth of their child. Odds of taking paternity leave were higher for more educated fathers and those born in the UK. After adjusting for potential confounders, we found no strong evidence of association between paternity leave and mental wellbeing or mental health of mothers or fathers in our overall sample. This finding was robust to a range of sensitivity analyses including alternative model specifications, imputation of missing data, and weighting. However, subgroup analysis showed that fathers with above median household incomes had better mental wellbeing if they took paternity leave (1.43-point difference in SF-12 MCS; 95% CI 0.25,2.62; p=0.02). Improved policies are needed to ensure parental leave reduces inequalities in mental health and wellbeing.

The autistic community have called for an increase in autism research exploring the lifespan experiences of autistic people. Researchers have notably neglected the parenting experiences of autistic adults. We aimed to study the factors that impact the mental health of autistic parents. We also explored the possible influence of childhood trauma. Nine autistic parents took part in remote semi-structured interviews. We used participants' chosen communication modalities during interviews to facilitate accessibility. We carried out data analysis using the principles of Iterative Phenomenological Analysis, a qualitative approach where meaning is co-constructed by both the participant's interpretation of their personal experience and the researcher's subjective interpretation. We identified three superordinate themes: Identity and Purpose; Looking Through a Lens of Trauma; and External Factors. Our participants described intimate connections with their children, who were sources of love and joy. Their childhood trauma influenced their parenting experiences. They experienced extreme empathy, perfectionism, and a drive to protect their children from the same trauma. We found that professionals' acceptance and awareness of autism was essential for positive outcomes during interactions with participants. Participants also experienced pervasive sensory overload from their environments, related to a loss of trusted coping mechanisms when they became parents. Our study draws attention to the influence of childhood trauma on the parenting experience of autistic adults. We reveal an unexplored long-term impact of childhood trauma resulting from a lack of support and othering of autistic children. Professionals should consider that autistic parents may be parenting through a lens of historical trauma. Professionals should be trained in trauma-informed approaches for providing support. Researchers should investigate this phenomenon to explore how this knowledge can be used to inform practise. Researchers should also investigate wider systemic and societal issues that have an impact on the mental health of autistic parents.

BackgroundChildren’s social-emotional development and mental well-being are critical to adult mental health. However, little is known about the mechanisms or factors that contribute to poor child mental health in low- and middle-income countries. Given the lack of child mental health research to guide interventions or social-emotional learning programs and policy planning, the present study aimed to address these knowledge gaps by examining the psychopathology mechanism involved in the development of childhood mental health problems.MethodsThis cross-sectional study recruited parents (N = 393) whose children attended preschool to primary classes in the Arghakhanchi district of Nepal. Data were gathered through parent interviews. Structural Equation Modeling was used to examine the pathways of the mediational mechanism that examined the influence of parental well-being on parenting and children’s mental health outcomes.ResultsApproximately 22% of the parents were at risk for moderate to severe mental health problems (anxiety: 24%, depression:19%). Parental mental health problems were higher in families who reported food insecurity, among female parents, less educated parents, and those who perceived themselves on a lower social ladder. Parental mental health, social support, and perceived class were associated with parent-child conflict. Greater parent-child conflict was associated with decreased social competence and increased anger, anxiety, and depression in children.ConclusionThe results partially support the mediational model that Nepali parents’ well-being (especially in mental health symptoms, social support, and perception of family’s social class domains) is associated with less optimal parenting and, in turn, greater child mental health problems and lower social competence. This study provides new evidence of cross-cultural consistency in child psychopathology and guides the development of evidence-based programs to prevent and promote mental health among Nepali children and families.

BackgroundParent mental health and wellbeing may have implications for understanding attachment transmission. In this systematic review, we synthesise the published literature to determine the nature of the relationship between parent mental health and wellbeing and the intergenerational transmission of attachment and to provide recommendations for future research, clinical practice and intervention.MethodUsing the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, five electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on adult attachment, child attachment, and a domain of parent mental health/wellbeing. No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42020157247).ResultsEleven studies examining the impact on parent mental health and wellbeing on the intergenerational transmission of attachment were identified for inclusion in this review. Our review found preliminary evidence that parent mental health and wellbeing play a role in the intergenerational transmission of attachment. Other key findings from the review were: evidence quality is mixed due to variable measurement of attachment and mental health; studies have mostly included correlational analysis or do not utilise contemporary methodological approaches to testing mediating or moderating relationships; and literature is largely focused on psychopathology and negative factors of mental health.ConclusionsThe limited scope of parent mental health and wellbeing constructs examined in the literature, the sparse use of robust statistical analyses, and the lack of literature in general makes it difficult to draw conclusions on how and why parent mental health impacts attachment transmission. Addressing these limitations will further progress attachment-related literature and may have particular implications for attachment-informed interventions with clinical populations.

Effects of Coronavirus Disease 2019 (COVID-19) on Family Functioning