Academic journal article Social Work

Parents with Serious and Persistent Mental Illness: Issues in Assessment and Services

Academic journal article Social Work

Parents with Serious and Persistent Mental Illness: Issues in Assessment and Services

Article excerpt

Parenting is one of the most highly valued social roles in all human societies and cultures. Therefore, it is not surprising that there is extensive literature on parenting and development of parenting skills. Most of the social work literature has taken a negative view of parenthood by people with serious mental illness because of concerns about possible detrimental effects on children. Recent laws and policies, such as the Adoption and Safe Families Act of 1997 (P.L. 105-89), speed up the process for termination of parental rights for children in out-of-home care (Genty, 1998; Hollingsworth, 2000), and some states specifically target parents with a persistent mental illness (Jacobsen & Miller, 1998). Incompetent parenting as a result of mental illness is one of the most common grounds on which courts terminate parental rights (Sackett, 1991).

However, first-person accounts and exploratory research have confirmed that parenting is very important to mothers who have a mental illness (Fox, 1999; Mowbray, Oyserman, & Ross, 1995; Sands, 1995). This issue affects social workers in child welfare and mental health settings, but little research has addressed assessment and development of parenting skills for adults with serious and persistent mental illness. Parenting is not typically considered a mental health issue, and parenting skills are typically assessed only when children are deemed at risk of out-of home placement rather than as part of a comprehensive psychosocial rehabilitation plan for the parent (Blanch, Nicholson, & Purcell, 1994). The social work profession should adopt a broader approach toward working with parents who have a serious and persistent mental illness. To accomplish this we need to develop specific assessment tools and interventions to improve these parents' competence to perform this important social role.

Focus on Parental Pathology

Literature on parents with mental illness has focused on parental pathology and its detrimental effects on children. Some researchers focus specifically on parents with serious and persistent mental illnesses, such as schizophrenia and major depression, whereas other studies include substance abuse and other moderate disorders, such as anxiety and dysthymia. A comprehensive literature review of major databases in the field, including Social Work Abstracts Plus and PsycINFO, found surprisingly few articles that address assessment and development of competent parenting in parents who have a serious mental illness. Most of the literature on assessment is related to child welfare, which is primarily concerned with determining when children should be removed from the home and when parental rights should be terminated. The mental health literature has little research on assessment of parental competence and what constitutes competent parenting by people with serious mental illness.

Historically, the mental health literature has focused on the negative aspects of parenting by people with serious mental illness. Most of the literature tends to be pathology focused and fails to address the strengths and capabilities of these parents. Researchers have understandably been concerned about the well-being of children who live with a mentally ill parent, but they have viewed the parent's mental disorder as an immutable problem that inevitably undermines the ability to be an effective parent. Most of the discussion is related to determining when children should be taken away from a parent and the possible damage to children who remain in these situations (Orvaschel, Walsh-Allis, & Ye, 1988; Stiffman, Jung, & Feldman, 1988; Thomas, Forehand, & Neighbors, 1995). In addition, the negative effect that separation and loss of the parental home may have on children who are removed from their biological parent has received insufficient attention.

Parents who have a serious and persistent mental illness are victimized twice. …

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