title: How to support patients with severe mental illness in their parenting role with children aged over 1 year? A systematic review of interventions.
abstract: OBJECTIVE
  There are well-established risks for parents with severe mental illness (i.e. psychotic and bipolar disorders), both for their children and themselves. Interventions to help parents fulfil their role should therefore be a public health objective, but their implementation needs to be underpinned by research evidence. This systematic review determines what is known about the nature and effectiveness of interventions for parents with severe mental illness.
  
  
  METHODS
  We conducted a narrative synthesis of controlled and uncontrolled studies reporting interventions for this patient group after the post-natal period (i.e. after the child has turned 1 year old).
  
  
  RESULTS
  Eighteen publications reported data from 15 studies. All but two studies were rated as low quality studies. Interventions included home visiting programmes, complex community programmes, residential treatments, and online interventions. Interventions targeted diverse areas, with parenting skills and understanding the impact of mental illness on parenting most frequently addressed. Both parent and child-related outcomes improved, but children were only assessed via observers and follow-up times were short.
  
  
  CONCLUSIONS
  Interventions were diverse with respect to their nature and effectiveness. Future interventions should combine different intervention strategies to target multiple areas in a flexible manner. The addition of positively focussed and resource-oriented components should be investigated. Trials should include direct assessments of both parents and children, outcomes that are relevant from a public health perspective, and establish the long-term effects ideally until children have reached 18 years of age.
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. beate.schrank@kcl.ac.uk.|Department of Psychiatry and Psychotherapy, Medical University Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria. beate.schrank@kcl.ac.uk.
authors.forename: Beate
authors.initials: B
authors.lastname: Schrank
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Moran
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012944:Social Support
keywords: Bipolar; Children; Parents; Schizophrenia; Support