Abstract
This fascinating and somewhat unique paper is the product of a small scale but important study focusing on an island community in which the author interviews grown children of parents who have experienced a serious mental illness. The respondents are truly ‘experts by experience’ and offer a series of insights into the challenges and of having a parent who can be very unwell. The particular setting for the study is the Faroe Islands, and has had to accommodate the special experience of living in a small island community and how mental illness is dealt with by the resident population plus the effects on children of having a mentally ill parent.
Research work related to serious and enduring mental illness has grown significantly during the past three decades. From a position in which medication and containment was routine and the illness was viewed as a troubling life sentence, present-day interventions are radically different. Large scale studies have shown that working differently and purposefully with individuals and families can bring beneficial and lasting change. Family intervention studies (Brooker et al., 1994) have brought refreshing new approaches to care, and psycho-social education continues to develop apace. The reviewed study now offers intriguing insights into a previously under-researched area.
People raised in small and sometimes insular communities understand only too well the particularities of how they work as social systems, ‘minding everybody's business’ can be both intrusive and supportive at the same time, but understanding mental illness in that context is particular and something the authors clearly understand well and address in their work. From interviews, the authors uncover and identify several interesting themes from the informants.
The first theme informs the focus for the study: ‘childhood experiences pursue adulthood for better and worse’. It has subthemes, all of which could probably offer substantial papers in their own right: becoming open and courageous – seeking and giving help – feeling uncertain and different and being resilient and sensitive. All of us will have experienced the effects of living with a family member who has mental health problems. It will perhaps have affected us as children and continues now into our adult lives. It will probably have shaped our experiences of dealing with mental ill-health but the effects on us as children may well have been unresolved. This study will help everyone understand this a little better and the added effects of living in ‘small-scale communities’ as the study reveals. The authors call for the establishment of collaborative and family focused interventions with families, and one can only echo that call. Sadly, in many parts of the United Kingdom such programmes are not always available, and the focus is now on more ‘quick-fix’ and time-limited Improving Access to Psychological Therapies (IAPT) programmes. These have their place but are being widely instituted at the cost of more sustained and costly programmes that are needed by people with serious and enduring mental illness. The psychological costs of not providing necessary and sustained support for families are clear from this study. It is very timely.