An estimated one in four psychiatric inpatients are parents, yet most hospital wards offer no systematic support for their parenting role. This matters because parental hospitalisation typically follows a period of illness where the parent already struggled to care for their children, and admission itself severs the parent-child connection. Despite parents wanting their parenthood to be acknowledged during treatment, there is a knowledge gap about how many inpatients have parental responsibilities and what support currently exists. The research will first determine the prevalence of parents in inpatient services and map existing family-focused provision across English psychiatric wards. It will then identify barriers and facilitators to staff engaging with patients as parents, co-create an intervention to support these families, and test its feasibility on six wards. If successful, this work could produce a low-cost, scalable intervention that helps maintain parent-child connection during hospitalisation. That would improve psychosocial outcomes for both parents and children, and could shift routine inpatient care toward recognising and supporting the parenting role—a change that affects family wellbeing long after discharge.
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Research Questions The programme of research will address the following questions: How many psychiatric inpatients have parental responsibilities? What support for the parenting role and parent-child connection is offered to inpatient parents in English psychiatric inpatient settings? What are the barriers to/facilitators of family-focused practice in English psychiatric inpatient settings? Is it feasible to deliver an intervention to support psychiatric inpatients who are parents? Background An estimated 25% of the 16,500 adults receiving psychiatric inpatient care are parents. Mental illness in parents is associated with impaired parent and child outcomes, including the intergenerational transmission of psychopathology. Parental hospitalisation typically follows a period of illness in which the parent may have struggled to care for their children, and treatment in hospital involves further rupture to this relationship. Despite challenges faced by parents and their children during hospitalisation, there is a knowledge gap related to the prevalence of parents within these services and a lack of targeted provision to support them during this period of specific vulnerability. Evidence from parents indicates that they want their parenthood to be engaged with during hospitalisation and help to limit the negative impact of hospitalisation and their mental illness on their parenting. Supporting parent-child connection and parental functioning of parents who are hospitalised will improve parent and child psychosocial outcomes. Aims/objectives The fellowship will support research focused on developing an evidence-based intervention and test feasibility of delivery in the NHS. It is focused on delivering the following four objectives: 1) Determine the number of parents accessing inpatient psychiatric services and the relationship between parenthood and service-use. 2) Understand family-focused facilities and care within English psychiatric inpatient settings. 3) Co-create an intervention to support inpatients who are parents and their children. 4) Conduct a feasibility trial of six wards optimised to use this intervention. Methods Varied research methods deployed across four related work packages: WP1) Secondary data analysis of national health datasets. WP2) Online survey of current inpatient provision and qualitative follow-up interviews will generate mixed-methods analysis of barriers/facilitators to staff engagement with parenthood, informed by the Consolidated Framework for Implementation Research v2. WP3) Co-creation of materials to support parents on wards and improve service provision. WP4) Pragmatic eight-month feasibility trial of six wards (mixed and single gender) for which outcomes related to intervention delivery and acceptability, patient service usage and staff practice will be reported. This programme of work will be delivered over 6-years. Anticipated impact and dissemination The programme of work will generate much-needed evidence around the prevalence of inpatient parents and the current provision of support for them. The delivery of a co-produced intervention programme designed to be a low-cost and scalable will benefit the health and wellbeing of inpatient parents and their children. Findings will be disseminated to academic, clinical, and non-expert audiences using methods including peer-reviewed publications, webinars and media promotion. Results will be used to engage at a practice, policy and commissioning level, and inform local, regional and national practice in inpatient care, with the aim of improving provision for patients.
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