Registered psychiatric nurses’ practice with parents who have mental illness, their children and families, within general adult mental health services in Ireland

The overall aim of this study was to investigate Registered Psychiatric Nurses’ (RPN perceptions of their family focused practice (FFP) with parents who have mental illness, their children and families, in general adult mental health services in Ireland. The study sought to measure the extent of RPNs’ FFP in acute admission units and community settings and to establish how RPNs’ FFP compared with Australian RPNs’ FFP. It also sought to identify the significant predictors of RPNs’ FFP and to explore the scope and nature of high scoring RPNs’ FFP and factors that affected their capacity to engage in FFP. A mixed methods approach, using a sequential explanatory design, was employed to address the study aims. In Study One a clustered, random sampling approach was used to access 610 RPNs in 12 mental health services in Ireland (practicing within acute admission units and community mental health services). Data was elicited using the Family Focused Mental Health Practice Questionnaire (FFMHPQ) with a 57 percent response rate (n= 346). RPNs’ FFP was ranked on the basis of their responses on the questionnaire. RPNs were deemed to be high scoring if they obtained between five and seven on at least three of the six FFP behavioural subscales within the FFMHPQ. In Study Two, fourteen high scoring RPNs, from Study One participated in semi-structured interviews. Whilst the majority of RPNs in Study One were not family focused, and had lower mean scores than RPNs in Australia, a substantial minority were family focused. Most of the higher scorers were practicing within the community setting. The most important predictors of FFP were skill and knowledge, followed by RPN group (acute versus community setting) and confidence around parenting and children generally. Study Two suggested that high RPNS’ FFP WITH PARENTS AND THEIR FAMILIES iv scoring RPNs’ FFP was complex and multifaceted, comprising various family focused activities, principles and processes. Their capacity to engage in FFP was determined by certain enablers and barriers with other results focused on future potential developments in FFP. The findings have enhanced understanding of RPNs’ FFP with parents who have mental illness, their children and families, in the Irish context and internationally. The findings also represent a starting point for future research in this area within Ireland and elsewhere. On the basis of the results, various implications for RPNs’ education, practice and policy can be made. It is recommended that national policies be introduced to mandate the identification of service users’ parenting status by mental health professionals, including RPNs, on admission to mental health services, and to embed information and support regarding parenting into ongoing care. Furthermore, key enablers, including child and family focused education and time to engage in FFP, should be provided to RPNs, to facilitate the transfer of policy into practice. Future research is required to develop an in-depth understanding of RPNs’ FFP in different settings.