Skip to main content
SpringerLink
Log in

Reaching families where a parent has a mental disorder: Using big data to plan early interventions

Familien, in denen Eltern psychisch erkrankt sind, erreichen: Nutzung von ‚big data‘ für die Planung von Präventionsansätzen

  • original article
  • Published:
neuropsychiatrie Aims and scope Submit manuscript

Summary

Background

Children who grow up with a parent who has a mental health problem (25%) are at increased risk of developing (health) problems themselves. One approach to reach those children for early intervention supports is through their parents seeking treatment within the adult mental healthcare system. We aimed to gain information on the users of adult mental health services in Tyrol, Austria in order to understand more about the identification of these families to provide support.

Methods

We descriptively analysed administrative claims data from the Tyrolean health insurance. Uptake of mental health services (hospital inpatient and day-care services, rehabilitation, outpatient psychiatrist and psychotherapy services), prescription medication and sick leave in persons aged 19–64 in 2017 were analysed.

Results

The vast majority (82%) of an overall number of 49,494 patients were prescribed medication for their mental health issues. Half of them only received medication as their form of treatment. A quarter had contacted an outpatient psychiatrist and 13% received psychotherapy. Five percent were treated in psychiatric inpatient or day-care. The median length of hospital stay was 15 days. More women than men used mental health benefits.

Conclusions

Most parents may be reached via the general practitioner (via drug prescriptions) and low numbers were found accessing services in a psychiatric hospital. The latter may, however, have higher needs for support given their greater acuity of illness. How to get into contact with their children requires thoughtful and sensitive preparation, given the stigmatisation of accessing support for mental health issues. Administrative data are a useful source for planning such early intervention strategies.

Zusammenfassung

Hintergrund

Kinder, die mit einem psychisch erkrankten Elternteil aufwachsen (25 %), haben ein erhöhtes Risiko, später selber (psychische) Probleme zu bekommen. Eine Möglichkeit, diese Kinder für präventive Ansätze zu erreichen, ist über die Behandlung deren Eltern. Wir analysieren die Inanspruchnahme von psychiatrischen Leistungen der Erwachsenenpsychiatrie in Tirol, um Information darüber zu erhalten, wie/wo betroffene Familien erreicht werden können.

Methodik

Es werden administrative Daten der Tiroler Gebietskrankenkasse analysiert. Die Inanspruchnahme von stationären und tagesklinischen psychiatrischen Leistungen, Rehabilitation, niedergelassenen PsychiaterInnen, Psychotherapie, der Psychopharmakakonsum und die Krankenstände aufgrund psychiatrischer Diagnosen von 19- bis 64-jährigen Personen im Jahr 2017 werden deskriptiv beschrieben.

Ergebnisse

Ein Großteil (82 %) der insgesamt 49.494 PatientInnen bekam Psychopharmaka verschrieben. Die Hälfte erhielt außer Medikamente keine sonstigen Leistungen. Ein Viertel suchte niedergelassene PsychiaterInnen auf, 13 % erhielten Psychotherapie und 5 % wurde stationär oder tagesklinisch behandelt – die Hälfte davon wurde nach 15 Tagen entlassen. Mehr Frauen als Männer nahmen Leistungen in Anspruch.

Schlussfolgerungen

Die meisten Eltern könnten über die Primärversorgung erreicht werden (über Verschreibung von Psychopharmaka) und nur ein geringer Anteil auf einer psychiatrischen Station. Letztere haben jedoch aufgrund schwererer Erkrankungen wahrscheinlich größeren Unterstützungsbedarf. Die nachfolgende Kontaktaufnahme mit den Kindern erfordert aufgrund von Stigmatisierung eine sorgfältige und sensible Vorbereitung. Sozialversicherungsdaten sind eine wertvolle Informationsquelle für die Planung derartiger Präventionsstrategien.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. For further information on the project see www.village.lbg.ac.at.

References

  1. Test MA, Burke SS, Wallisch LS. Gender differences of young adults with schizophrenic disorders in community care. Schizophr Bull. 1990;16(2):331–44.

    Article  CAS  Google Scholar 

  2. Fraser C, James EL, Anderson K, Lloyd D, Judd F. Intervention programs for children of parents with a mental illness: A critical review. Int J Ment Health Promot. 2006;8:9–20.

    Article  Google Scholar 

  3. Ostman M, Hansson L. Children in families with a severely mentally ill member. Prevalence and needs for support. Social Psychiatry and Psychiatric Epidemiology. 2002;37(5):243–8. https://doi.org/10.1007/s00127-002-0540-0

  4. Maybery D, Reupert A, Goodyear M, Ritchie R, Brann P. Investigating the strenghts and difficulties of children from families with a parental mental illness. Australian E‑Journal for the Advancement of Mental. Health. 2009;8(2):1–10.

    Google Scholar 

  5. Pretis M, Dimova A. Vulnerable children of mentally ill parents: towards evidence-based support for improving resilience. Support Learn. 2008;23:152–9.

    Article  Google Scholar 

  6. Power J, Goodyear M, Maybery D, Reupert A, O’Hanlon B, Cuff R, et al. Family resilience in families where a parent has a mental illness. J Soc Work. 2016;16(1):66–82.

    Article  Google Scholar 

  7. Kowalenko NM, Mares SP, Newman LK, Sved Williams AE, Powrie RM, van Doesum KTM. Family matters: Infants, toddlers and preschoolers of parents affected by mental illness. MJA Open. 2012;1 (Suppl 1, 16 April 2012).

  8. Reupert A, Maybery D. Families affected by parental mental illness: A multiperspective account of issues and interventions. Am J Orthopsychiatry. 2007;77(3):362–9.

    Article  Google Scholar 

  9. Reupert A, Maybery D, Kowalenko NM. Children whose parents have a mental illness: Prevalence, need and treatment. Medical Journal of Australia. 2013;199(3 Suppl):7–9.

  10. Hosman CMH, van Doesum KTM, van Santvoort F. Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: The scientific basis to a comprehensive approach. Aust E‑journal Adv Ment Health. 2009;8(3):250–63.

    Article  Google Scholar 

  11. Wansink HJ, Drost RMW, Paulus ATG, Ruwaard D, Hosman CMH, Janssens JMAM, et al. Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives. BMC Health Serv Res. 2016; https://doi.org/10.1186/s12913-016-1498-z.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Falkov A, Goodyear M, Hosman CMH, Biebel K, Skogøy BE, Kowalenko N, et al. A systems approach to enhance global efforts to implement family-focused mental health interventions. Child Youth Serv. 2016;37((2):175–93.

    Article  Google Scholar 

  13. Goodyear M, Hill TL, Allchin B, McCormick F, Hine R, Cuff R, et al. Standards of practice for the adult mental health workforce: Meeting the needs of families where a parent has a mental illness. Int J Ment Health Nurs. 2015;24(2):169–80.

    Article  Google Scholar 

  14. Goodyear M, McDonald M, von Doussa H, Cuff R, Dunlop B. Meeting the Intergenerational Needs of Families Where a Parent Has a Mental Illness. Journal of Parent and Family Mental Health. 2018;3(2). https://doi.org/10.7191/parentandfamily.1011.

  15. Goodyear MJ, Obradovic A, Allchin B, Cuff R, McCormick F, Cosgriff C. Building capacity for cross-sectorial approaches to the care of families where a parent has a mental illness. Adv Ment Health. 2015;13(2):153–64.

    Article  Google Scholar 

  16. Christiansen H, Bauer A, Fatima B, Goodyear M, Lund I, Zechmeister-Koss I, et al. Improving Identification and Child-Focused Collaborative Care for Children of Parents With a Mental Illness in Tyrol, Austria. Front Psychiatry. 2019;10:233. https://doi.org/10.3389/fpsyt.2019.00233.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lyngstad T, Skardhamar T. Nordic register data and their untapped potential for criminological knowledge Crime Justice. 2011;40(1):613–45. https://doi.org/10.1086/658881 52.

  18. Lund IO, Bukten A. Harm to Others from Substance Use and Abuse: The Underused Potential in Nationwide. Regist Subst Abus Res Treat. 2015;9(S2):33–8.

    Google Scholar 

  19. Lund IO, Skurtveit S, Handal M, Bukten A, Ystrom E, Burdzon A, et al. Association of Constellations of Parental Risk With Children’s Subsequent Anxiety and Depression Findings From a HUNT Survey and Health Registry Study. Jama Pediatr. 2019;173(3:251–9.

    Article  Google Scholar 

  20. Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Sources of Parent-Offspring Resemblance for Major Depression in a National Swedish Extended Adoption Study. Jama Psychiatry. 2018;75(2):194–200.

    Article  Google Scholar 

  21. Zechmeister-Koss I, Tüchler H. Prevalence of mental disorders and uptake of mental health services in Tyrol. LBI-HTA Projektbericht Nr. 113b. Vienna: Ludwig Boltzmann Institute for Health Technoloy Assessment; 2018.

    Google Scholar 

  22. Hauptverband der Österreichischen Sozialversicherungsträger. Handbuch der österreichischen Sozialversicherung 2018. Wien: Hauptverband der österreichischen Sozialversicherungsträger 2018.

  23. WHO Collaborating Centre for Drug Statistics Methodology. ATC: Structure and Principles. 2019. https://www.whocc.no/atc/structure_and_principles/. Accessed 7 Aug 2019.

  24. ICD10data.com. Mental, Behavioral and Neurodevelopmental disorders F01–F99. ICD10data.com. 2019. https://www.icd10data.com/ICD10CM/Codes/F01-F99. Accessed 7 Aug 2019.

  25. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria. 2018. https://www.R-project.org/. Accessed 6 May 2018.

    Google Scholar 

  26. Heubacher A. 1,6 Millionen Mal Psychopharmaka in Tirol verordnet. Tirol Tagesztg. August 23rd, 2018, https://www.tt.com/panorama/gesellschaft/14720081/1-6-millionen-mal-psychopharmaka-in-tirol-verordnet. Last access: September 4th 2019

  27. Lenz A. Materialen zu Frühen Hilfen. Handreichung: Eltern mit psychischen Erkrankungen in den Frühen Hilfen. Köln: Nationales Zentrum Frühe Hilfen; 2017.

    Google Scholar 

  28. Roscoe JN, Lery B, Chambers JE. Understanding child protection decisions involving parents with mental illness and substance abuse. Child Abuse Negl. 2018;81:235–48.

    Article  Google Scholar 

  29. Patrick PM, Reupert AE, McLean LA. “We Are More than Our Parents’ Mental Illness”: Narratives from Adult Children. IJERPH. 2019;16(5):839. https://doi.org/10.3390/ijerph16050839.

    Article  Google Scholar 

  30. Eaton NR, Keyes K. M, Krueger RF, Balsis S, Skodol AE, Markon KE et al. An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. J Abnorm Psychol. 2012;121(1):282–8.

    Article  Google Scholar 

  31. Ramchandani P, Psychogiou L. Paternal psychiatric disorders and children’s psychosocial development. Lancet. 2009;374(9690):646–53.

    Article  Google Scholar 

  32. Ramchandani PG, O’Connor TG, Evans J, Heron J, Murray L, Stein A. The effects of pre- and postnatal depression in fathers: a natural experiment comparing the effects of exposure to depression on offspring. J Child Psychol Psychiatry. 2008;49(10):1069–78.

    Article  Google Scholar 

  33. Hauptverband der Österreichischen Sozialversicherungsträger, Salzburger Gebietskrankenkasse. Analyse der Versorgung psychisch Erkrankter. Hauptverband der Österreichischen Sozialversicherungsträger, Wien. 2011. http://www.hauptverband.at/cdscontent/load?contentid=10008.564640&version=1391184577. Accessed 9 Jan 2018.

  34. Christiansen H, Anding J, Donath L. Interventionen für Kinder psychisch kranker Eltern. In: Kölch M, Ziegenhain U, Fegert JM (Ed.) Kinder Psych Kranker Eltern Herausford Für Eine Interdiszip Koop Betreu Versorgung. Weinheim Basel: Beltz Juventa; 2004.

  35. Stelzig-Schöler R, Hasselbring L, Yazdi K, Thun-Hohenstein L, Stuppäck C, Aichhorn W. Incidence and risk factors for mental abnormalities in children of psychiatric inpatients. Neuropsychiatrie. 2011;25:192–8.

    PubMed  Google Scholar 

  36. Raitasalo K, Holmila M, Autti-Rämö I, Martikainen JE, Sorvala V‑M, Mäkelä P. Benzodiazepine use among mothers of small children: a register-based cohort study. Addiction. 2014;110:636–43.

    Article  Google Scholar 

  37. Kendler KS, Ohlsson H, Sundquist J, Sundquist C. Familial transmission of externalizing syndromes in extended Swedish families. American Journal of Medical Genetics. 2018;177B:308–18. https://doi.org/10.1002/ajmg.b.32611.

Download references

Acknowledgements

We would like to thank the Tyrolean health insurance for providing administrative data on mental health service uptake and Katharina Hintringer for coordinating data transfer, quality control, and reading first drafts of the analysis.

Funding

This research was conducted as part of the Ludwig Boltzmann Gesellschaft Research Group ‘Village’ in cooperation with the Medical University of Innsbruck, funded by the Austrian Ministry of Education, Science and Research. We thank all co-investigators for their contributions.

Author information

Authors and Affiliations

  1. Ludwig Boltzmann Institute for Health Technology Assessment, Garnisongasse 7/20, 1090, Vienna, Austria

    Ingrid Zechmeister-Koss & Heinz Tüchler

  2. School of Rural Health, Monash University Melbourne, Wellington, 3800, Clayton, Victoria, Australia

    Melinda Goodyear

  3. The Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway

    Ingunn Olea Lund

  4. Tirol Kliniken GmbH, Mental Health Research Group Programme, The Village, Ludwig Boltzmann Gesellschaft, MedUni Innsbruck, Schöpfstraße 23a, 6020, Innsbruck, Austria

    Jean Lillian Paul

  5. Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Jean Lillian Paul

Authors
  1. Ingrid Zechmeister-Koss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heinz Tüchler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Melinda Goodyear
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ingunn Olea Lund
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean Lillian Paul
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ingrid Zechmeister-Koss.

Ethics declarations

Conflict of interest

I. Zechmeister-Koss, H. Tüchler, M. Goodyear, I.O. Lund, and J.L. Paul declare that they have no competing interests.

Ethical standards

An approval by an ethics committee was not applicable.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zechmeister-Koss, I., Tüchler, H., Goodyear, M. et al. Reaching families where a parent has a mental disorder: Using big data to plan early interventions. Neuropsychiatr 34, 39–47 (2020). https://doi.org/10.1007/s40211-019-00323-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40211-019-00323-y

Keywords

Schlüsselwörter

Search

Navigation