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Parental Psychiatric Disorder. Distressed Parents and their Families.
  1. ANTONY COX, Professor of child and adolescent psychiatry

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    Parental Psychiatric Disorder. Distressed Parents and their Families. Edited by M Gopfert, J Webster, and M Seeman. (Pp 358; £23.95 paperback.) Cambridge University Press, 1996. ISBN 0-521-45892-7 .

    One of the most important things about this book is its existence. For over 30 years there has been systematic evidence about the links between mental health in parents and children and yet this is still inadequately reflected in service structure or function. Here there is a genuine attempt to draw all the different threads together in a constructive fashion. There is an inevitable tension between endeavours to meet the needs of mentally ill parents and those of other family members, most particularly children. The editors have brought together a distinguished group of authors with either clinical or research expertise from several countries. Despite expectation that they would all be sympathetic to the dilemmas and suffering facing children living with a mentally ill parent, the difference in perspective between those working in ‘adult’ as opposed to ‘child’ settings is at times very apparent.

    Although most relevant areas of knowledge and practice are touched on, this is not a textbook nor a fully comprehensive academic account of this field. The manner in which topics are dealt with varies considerably, but the overall orientation is predominantly clinical and this is reflected in the large number of case vignettes that occur throughout. There is a variable but considerable reference to research literature in a fashion that is not usually critical and this is perhaps reasonable given the book’s overall orientation. However there are times when particular writers appear to be following their own hobby horses in a somewhat selective fashion. There can be benefits in giving authors freedom but there can be disadvantages. For example the information about parenting and specific psychiatric disorders is given very differently in different chapters in that section of the book. It is disappointing that the section on ‘Service Issues’ does not more explicitly grasp the nettle of how adult and child mental health services might change their structure and function, but a particularly welcome feature are the personal accounts by ‘lay’ people about a childhood living with a mentally ill parent or their experience of services’ response to a family with a mentally ill parent. The final chapter on ‘Health Care Policy’ comments that ‘In the case of mental illness in the family, where many of the effects of both illness and care are reflexive, tertiary intervention for a mentally ill parent may also be primary intervention for other family members. This emphasises the desirability of other features of the resource environment...’.

    Let us hope that this book helps to bring about the realisation of those features.