Care for children of parents with depression

Summary

Background:

Depression is burdensome; both in terms of socioeconomic costs and in terms of quality of life for the individuals concerned. Parental depression can affect the child’s wellbeing and can also, in different respects, cause an increased risk for the child. The probability that the child will develop permanent mental, social and cognitive impairments, which will reduce the functional ability in adulthood, is increased. Furthermore, the child is permanent at the risk of developing somatic or mental disorders – especially depression. Negative consequences of a parent’s depression can be prevented by social support, but it remains unknown which type of support these children is given in a Danish context.

Aim:

The overall aim of the study is to examine which type of support is given to 2-14 year old Danish children of parents with depression and to elucidate to which extent the current support fits the needs of the children.

Methods:

On the basis of an explorative mixed methods design, three substudies have been conducted: 1) an interview study among parents, sick-listed due to depression and their partners, 2) a national survey among general practitioners, 3) a focus group study in a number of municipalities among professionals from preschool education.

Results:

In this study, the majority of parents were concerned about the significance of the depression for their children, and they described limitations in their parenting abilities in the form of withdrawal and negativity. The parents described that approximately half of the 39 children involved were clearly affected by the depression of their parent, and only few parents had been offered professional counselling to improve the situation of their children. Of 1760 invited general practitioners, 890 (51%) answered as follows: 94% found it relevant to give attention to the situation of the child when a parent is suffering from depression, 68% mentioned the situation of the child during consultation with a parent, 39% found their own knowledge concerning the significance of the Summary 13 parental depression for the child insufficient, and 41% were interested in increasing their knowledge. General practitioners with perceived sufficient knowledge were six times more likely to talk about the situation of the child than general practitioners with perceived poor knowledge. Female general practitioners focus on the children to a higher extent than their male colleagues. Within pre-school education, the variation is significant when it comes to giving attention to children of parents with depression and mental disorders in general. Individual factors exert great influence on the culture and practice in the individual institutions. Focus group interviews in 9 of the 20 largest Danish municipalities showed that, in general, more knowledge concerning the significance of the parental depression for the child is wanted, and competency development is wanted within the field. Taboo on mental disorders was an important issue in many groups.

Conclusion:

In this study, only about half of the children involved received the necessary support to cope with the stress induced by the parental depression, and the parents were only seldom offered professional counselling regarding the situation of their children. As a whole, the general practitioners find it relevant to focus on the children’s situation when a parent is suffering from depression. The knowledge level is, however, characterised by great variation, and general practitioners with perceived sufficient knowledge talk about the situation of the child markedly more often than general practitioners with perceived poor knowledge. Likewise, among professionals from day care and school, the variation in the knowledge level is great, and also in this context the relation between sufficient knowledge and active attention and care for children of parents with depression is evident. The concept of taboos is not articulated by the general practitioners whereas taboos and reluctance to deal with depression and mental disorders generally play a significant role among professionals in day care and school. Taboos also play a role among parents.