Using the Person-based Approach to Develop a Resource for Health and Social Care Professionals to Facilitate Family-Centred Conversations when an Adult Patient has a Mental Illness

Mental health problems affect 1 in 6 adults in England. Over half of those with a mental illness are parents and a quarter of adults admitted to UK psychiatric inpatient units have dependent children. The children of parents with mental illness have an increased risk of developing mental health disorders themselves. Honest communication about parental illness is associated with better psychological outcomes and enhanced family functioning. However, parents try to shield their children from distress and want professional guidance in how to navigate these discussions. Many professionals report lacking the specific training and skills to effectively guide family-centred conversations. Aims:to develop a resource to improve mental health and social care professionals (MHSCPs ) knowledge, skills and confidence about initiating family-centered conversations about parental mental illness. Methods: Using the Person-Based Approach (PBA) with key stakeholders and PPI contributors in a collaborative and iterative fashion, ensuring inclusivity and diversity throughout the research lifecycle. Phase 1 Planning:Individual interviews with Advisory panel of MHSCPs (n=6) who have responsibility for professional training. Inductive thematic analysis of data. Findings will inform resource format, length and strategies to overcome identified barriers. Phase 2A Resource Development:Workshops to identify resource content with i) adults with lived-childhood experience of parental mental illness (n=10); ii) parents with lived-experience of mental illness and partners (n=10); iii) Children (aged 8-11; 12-14; 15-18 years) with lived-experience of parental mental illness (n=6/group). Inductive thematic analysis of data. Outputs presented to a workshop with MHSCPs (n=12) to explore their ideas about how these requirements could be incorporated into a resource for MHSCPs. Published research and outputs from Phase 1 and Phase 2A will be used to generate Guiding Principles and a Logic Model. These will be used to create the resource. Phase 2B Resource Testing:Think-Aloud individual interviews to iteratively test and modify the resource with i) MHSCPs (n=6); ii) parents and partners with lived-experience of mental illness (n=6); iii) children and young people (n=6) with lived-experience of parental mental illness. After every 2-3 interviews, data critically discussed with co-applicants and PPI representatives to modify the resource. This process of iterative development and testing (anticipated 3 rounds) will be used to reach the final version of the resource. Phase 3 Formative Evaluation:Online survey of MHSCPs pre-and-post accessing the resource (n=200), including Likert-style questions assessing knowledge and perceptions of family-centred care, Self-Efficacy questionnaire (SE-12) and Theoretical Framework of Acceptability Questionnaire. After three months, individual semi-structured interviews with MHSCPs (n=20) will explore their use, engagement and acceptability of the resource. Inductive thematic analysis of data. Anticipated Impact and Dissemination:Resource dissemination via scientific publications, podcasts and Advisory panel, applicants and collaborators professional and personal networks and social media. The impact of the resource will be to break the cycle of poor mental health by promoting honest and empathic communication about parental mental illness. The resource will upskill professionals by enhancing their knowledge and understanding of family-centred communication. This will directly benefit patients and their families by giving them the confidence and tools to talk with children about mental illness.