Constrained sense-making in families with parental mental illness and the importance of intra-family communication for positive outcomes

Abstract

Abstract Recent work in parental mental illness (PMI) has focused attention on mechanisms by which it impacts the lives of family members and is transmitted intergenerationally. This includes arguments for attending to how recovery and experiences of the illness in families are shaped relationally. In this article, we contribute to this area through presenting the results of in-depth qualitative research studying how family communication around PMI shapes families’ experiences of illness and recovery. This comprises thematic analysis of thirty-six semi-structured interviews and eight focus groups with families and multi-agency professionals who worked with them. Findings demonstrate a complex interplay of drivers of lack of communication and of the impacts of this on family relationships and well-being. Notably, families found it difficult to communicate around mental health due to guilt and shame felt by the unwell parent, a belief that concealing the illness will protect children and lack of capacity in families for communication in general. This lack of communication affects how families make sense of one another’s experiences and behaviours and impacts individual coping and family relationships. Fostering positive communication around the illness in social work settings has the potential to improve relationships, reduce perceived burdens of illness and aid recovery.