Informants Share Insights on Peer Supports for Parents with
Serious Mental Illnesses
A
study funded by the National Institute on Disability, Independent Living, and
Rehabilitation Research (NIDILRR).
People with serious mental illnesses (SMI)
have conditions like schizophrenia, depression, or bipolar disorder. Many
adults with SMI are parents. Parenting can be a valuable, rewarding part of
family life for people with SMI. However, parents with SMI may face a variety
of challenges. Studies have shown that parents with SMI may face stigma and discrimination,
and they are much more likely than parents without SMI to have child
welfare systems get involved with their families or to lose custody of their
children. In addition, parents with SMI may have challenges
balancing the everyday demands of parenthood while also managing their SMI.
In previous studies, support from peer
specialists has been shown to aid people with SMI in their recovery process. A
peer specialist is an individual who has personal experience living with SMI
and who has been trained to provide support to others with SMI, but who is not
a therapist. Peer specialists may be employed at mental health agencies to
serve as positive role models for clients with SMI. In a recent NIDILRR-funded
study, researchers asked a diverse group of individuals familiar with peer
supports to describe how peer support might specifically benefit parents with
SMI. They wanted to find out more about the challenges and needs of parents
with SMI, how peer specialists might be especially well-suited to meet those
needs, and what unique challenges peer specialists might encounter when
supporting parents with SMI.
Researchers at Parents Empowering Parents: National Research Center for
Parents with Disabilities and their Families interviewed 22
informants who were individuals with diverse knowledge regarding the lived
experiences of parents with SMI. The informants included therapists and staff
at community mental health agencies; agency directors and policymakers;
experienced peer specialists; and persons served by community mental health
agencies. All of the informants were parents, and most had experience living
with SMI and receiving professional and peer support services themselves. The
informants were interviewed individually for 1 to 2 hours, and they also
participated in a full-day group workshop to identify common experiences among
the informants. The informants were asked to describe the unique challenges and
needs of parents with SMI; how peer specialists can meet those needs; and how
support from peer specialists was unique.
The researchers identified several recurring
themes in their interviews with informants. These themes centered on several
challenges and unmet needs and the ways that peer specialists may be able to use
their lived experience with SMI to help:
·
Parents with SMI may
feel isolated and may encounter gaps in support and resources available in the
community. Peer specialists can leverage their community connections to help
parents access resources and advocate for themselves and their families.
·
Parents with SMI may
not reach out to obtain mental health supports, due to perceived biases in the
child welfare system and fear of being referred to Child Protective Services.
While not a substitute for traditional mental health services, peer specialists
can offer other types of mental health support. For example, they can provide
support based on their own experience through a more equal-status relationship
with clients. They may also be able to encourage the building of
self-determination and autonomy for these parents, so that parents can begin to
see that change is possible and that they are capable of making it happen.
·
Parents with SMI may
be coping with stigma, self-blame, or complex family relationships, and may
need advice on decisions around family planning or if and how to disclose their
SMI to their children or other family members. Peer specialists may be able to
help to reduce stigma through relationships that are nonjudgmental and that
foster autonomy and choice for clients. Unlike therapists, they can utilize
self-disclosure to share their own lived experiences with SMI and serve as role
models for success.
·
Parents with SMI may
find that ordinary parenting challenges can become magnified by their mental illness.
Peer specialists can draw upon their own experiences living with SMI in order
to assist parents. They may have time tested strategies to address the
every-day problems, like preparing nutritious meals, helping their children
with homework, or driving them to appointments, and bigger issues like planning
for the future.
In addition, the informants noted that some
parents with SMI may prefer to work with a peer provider who also has parenting
experience. However, others may find that connecting with a peer provider who
understands life with an SMI and who can be reflective about the role of family
in recovery is just as valuable, regardless of the peer provider’s parenting
experience.
The informants also described some challenges
that peer specialists may face when supporting parents with SMI. Due to the
emotional nature of family relationships, peer specialists may be triggered
themselves by witnessing the challenging family experiences of their clients.
Peer specialists may also feel especially compelled to help their clients when
the welfare of young children is involved, which could challenge the
professional boundaries of the peer specialist. For example, a peer specialist
may have difficulty turning down a request to drive a parent and child to an appointment
on their personal time. Related to this, it may be challenging for peer
specialists to support their clients’ freedom of choice if they feel that the
client is making choices which could harm their young children.
The authors noted that peer specialists can
fill some of the existing service gaps for parents with SMI. However,
supporting parents with SMI may be emotionally challenging for peer
specialists. The authors recommended additional training and organizational
supports for peer specialists serving parents with SMI, such as training on
issues related to having a history of traumatic experiences. They also noted
that not all peer specialists may wish to work with parents with SMI. Based on
the findings of this study, the authors noted that the quality of the match
between peer specialist and client may be especially important when the client
is a parent. Although peer specialists may not necessarily need to be parents
themselves, shared experiences and values around family life may be an important
part of the matching process. Future research may also be useful to identify
the components of a successful peer support program for parents with SMI.
To Learn More
The National Research Center for Parents with Disabilities
and Their Families offers many resources for parents with
disabilities and the professionals who work with them, including how-to videos,
information about parental rights, and the ParentingWell practice profile. This
Center also supports the Disabled Parenting Project, online space
for sharing experiences, advice, and conversations among parents with
disabilities as well as those considering parenthood.
What is Peer Support and What is NOT Peer Support? From the Rehabilitation Research and Training
Center on Pathways to Positive Futures. While this factsheet is geared toward
youth with SMI, it offers an excellent explanation of the basics of peer
support relationships, including setting boundaries for what is not part of the
supportive relationship.
To Learn More About this Study
Nicholson, J., and Valentine, A. (2019) Key informants specify core elements of peer supports for
parents with serious mental illness. Frontiers in Psychiatry,
10(106). This article is available free in full text from the publisher and
from the NARIC collection under Accession Number J72160
Date published: 2019-11-21
Download this article in PDF format: 
Informants Share Insights on Peer Supports for Parents
with Serious Mental Illnesses.pdf
Informants Share Insights on Peer Supports for Parents
with Serious Mental Illnesses.pdf
Research In Focus is a publication of the
National Rehabilitation Information Center (NARIC), a library and information
center focusing on disability and rehabilitation research, with a special focus
on the research funded by NIDILRR. NARIC provides information, referral, and
document delivery on a wide range of disability and rehabilitation topics. To
learn more about this study and the work of the greater NIDILRR grantee
community, visit NARIC at http://www.naric.com or call 800/346-2742 to
speak to an information specialist.
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