Challenges of Parenting among Mentally Mothers - Research Proposal Example

Challenges of Parenting among Mentally Ill Mothers Name: Course: Tutor: Date: Table of Contents Table of Contents 2 Background 3 Literature Review 4 Aims and significance of the proposed research 9 Expected outcomes/ implications for practice 9 Research Plan: Methodology 10 Sampling 10 Data collection techniques 11 Data analysis 11 Rationale for choice of method 11 Limitations 12 Timetable 12 Ethical Considerations 12 Administration of the research, resource requirements and Budget 13 Appendix: 13 Research objectives This research seeks to unearth the challenges that mentally challenged mothers experience in their day-to-day struggles to provide their children with parental care. Specifically, the research seeks to find out how the mothers cope with the fear that they may be deemed unfit parents due to their mental illnesses. Background Unlike years back when mentally sick women were looked down upon as less capable of child bearing and parenting, their deinstitutionalization and community integration since the 1970s means that they are now able to engage in normal social activities, including child bearing and parenting (Park, Solomon and Mandell, 2006). However, while child bearing potential among mentally ill and the mentally healthy women are equal, research carried out by Park, Solomon and Mandell (2006) suggest that the former group of women experience increased parenting challenges when compared to the latter, especially because often times they lack services that address their specific needs. This opinion is also shared by Noble and Douglas (2004). Additionally, Park et al. (2006) note that mentally ill women are more likely to use drugs and alcohol while pregnant; are less likely to seek and receive pre-natal care; and are also more likely to have obstetric complications. Literature Review The major challenges of parenting among mentally ill mothers relate to the day-to-day handling of their children’s needs (Park et al., 2006). Irrespective of the nature of mental illnesses that different mothers have, Oyserman et al. (2000) and Mowbray et al. (2004) established that all mentally ill mothers across demographic divides usually record higher parenting stress than their healthy counterparts. More so, they are less satisfied with the relationships they develop with their children, and also record increased difficulties disciplining their children. Park et al. (2006) also observe that regardless of how inadequate or insufficient mentally ill mothers may feel, they are always more hesitant than their healthy counterparts in seeking professional assistance. This stems from the fear that seeking such assistance would make them the subject of scrutiny. They fear that such findings would ultimately lead them to losing custody of their children. Gullotta and Bloom (2003) also noted that mothers who suffered from unipolar depression and schizophrenia had less task-oriented behaviours towards their children and were more critical and less encouraging to their children. In a study conducted by Miliken and Northcott (2003) however, it was established that mentally ill mothers who feared losing their children’s custody were more careful about how they handled their children. This suggests that such mothers were more conscious about how they treated their children than the non-mentally ill mothers were. This observation is also shared by Oyserman et al. (2000), who found out that mentally ill mothers were more willing to follow on treatment because attaining normal lives became more important for them once they had children. According to Oyserman et al. (2000), the hallmark of good parenting especially in infancy and adolescence include warmth and nurturance from parents. In addition, a parent needs to provide the children with “developmentally appropriate and consistent supervision, structure and autonomy” (p. 296). Notably however, mentally ill mothers always find it more challenging than their mentally healthy counterparts to meet the identified ‘hallmark of parenting’. This is in spite of the fact that they too have aspirations of forming good and intimate good relationships with their children. In addition to aspects of mental illnesses presenting economic and social-related challenges to mentally-ill mothers, Stallard et al. (2004) noted through a research that most mothers worried about their illness affecting the children. Of the 24 parents surveyed by Stallard et al. (2004), 21 reported that they were concerned about their children worrying ‘too much’ about their (mother’s) health. Eight out of the 24 parents surveyed were also concerned that their mental illnesses would disrupt their ability to meet their children’s social, psychological and emotional needs. In the study, it was also established that most mothers engage in parental denial, whereby they do not acknowledge that their illness may be affecting their children. Mentally ill mothers experience increased parenting challenges where they have limited resources and time pressures. Considering that mentally ill mothers are unable to find long-term jobs, while some even loose their jobs following the onset of mental illness, a high percentage has to contend with limited economic resources, which affect the kind of lifestyle they are able to give their children. Anxiety, depression and low-motivation suffered by most mentally ill-mothers means that a significant number of them have challenges organising their schedules, and often feel stressed or overburdened by the parenting chores (Stallard et al., 2004). The study also identified that mentally ill mothers admitted that they had challenges prioritizing what between their own needs and those of the children needed attending to first. While supporting the mentally ill mothers may provide the much needed assistance that would help them prioritize, the Social Care Institute for Excellence - SCIE (2009) notes that often times, the society does not recognise that mentally ill mothers need to meet their parenting responsibilities. As such, the recognition and support that would otherwise be given to such mothers from the government or societies where they live in is not accorded to them. In an analysis of literature conducted by SCIE (2009), it was established that mentally ill parents would want the society to understand them more and stop the discrimination and stigma attached to mental illness. In addition, the parents would want to be provided with practical services that would allow them to meet their children’s needs. They also wanted to their respective governments to help set up support groups, where they would share their parenting experience and learn ways to improve on the same. Finally, most parents expressed a desire to live free of fear that their mental illness would lead to the inevitable removal of children from their custody. In an opinion and debate article, Howard (2000) writes that denial of custody to mentally ill mothers is always done with good intentions. Apart from parenting responsibilities putting extra pressure on mental patients and hence negating some of psychiatric treatments, Howard also notes that mentally ill mothers are more likely to avoid seeking psychiatric services since the service providers may draw the attention of social services, who may in turn remove the children from their mother’s custody. The effect that the mental illness has on children is also highlighted by Howard (2000). In his analysis, the author argues that in addition to genetic predisposition, the neglect, aggressive behaviour or parental discord usually associated with mental illnesses may affect the children’s mental health negatively. Citing an earlier study by Naslund et al. (1984), Howard (2000) notes that children whose mothers have schizophrenia registered an increase in anxious-attachment patterns when compared with children raised by mentally healthy mothers. The increase in the patterns was especially high in children from single-parent households. While acknowledging that children whose mothers suffer mental illnesses may be at increased risk of compromised mental health, Farmer (2009) notes that most mentally ill mothers become responsible, caring and nurturing parents on receiving parenting help. Some of the specialized services that mentally ill mothers can benefit from include psychiatric counselling and parenting lessons. Citing the example of the United States, Farmer (2009) observes that most mentally ill mothers have their fears well founded in recent trends in the country where an estimated three-quarters of seriously mentally ill mothers lose custody of their children. According to the analysis by farmer, most mentally ill mothers would be good-enough parents for their children with the necessary support from their families and communities. The Raising Children Network (2009) identifies some of the challenges that mentally ill mothers may experience as difficulties in providing children with predictable and stable environments, problems establishing schedules and sticking to routine, in ability to accomplish simple chores such as cooking or shopping, and holding a regular job. In some worst case scenario, a mentally ill mother may have self injurious tendencies, which may mean that the children are also exposed to risk. According to the Raising Children Network (2009) however, most long-term mental illnesses are manageable and mothers can cope with parenting just as mentally-health mothers would. Thornicroft and Susser (2001) on the other hand argue that most mentally ill mothers can improve their parenting skills with education and support from governments, family members and the society at large. Some of the long-term, but manageable mental illnesses include chronic depression, bipolar disorder, schizophrenia, obsessive compulsive disorder and chronic anxiety. Family and communities where mentally ill mothers live can play an important role in assisting the mother as pointed by Raising Children Network (2009), whereby, they can take care of the children when their mother is unable to, they can talk to the children regarding their mother’s illness in order to alleviate the fears and confusion they may have, and they may also help the mother join a support group or network of other mothers who suffer mental illnesses. Hurley (2009) has addressed fears faced by mentally ill mothers from both views. While she argues that events that saw some mentally-ill patients kill their children in the past is good enough reason to take all the necessary precautions to ensure children are safe, she also notes that “a mental health diagnosis is not an effective way to assess whether someone is capable of being a good parent” (p. 16). Ackerson and Venkataraman (2003) through a survey conducted on experts who had handled mentally ill mothers, concluded that rather than condemn all mentally ill mothers as incompetent parents, social workers and other government agencies that care for the welfare of the children need to carry out individualized assessments in order to verify each mother’s strengths, weakness, and training and support needs. The researchers specifically noted that each mentally ill mother needs to be assessed on how well she can ensure the safety and discipline of her children. More to this, Ackerson and Venkataraman (2003) noted that mothers with young children also need to be assessed on how well they can handle the daily caring tasks necessary to ensure that the children are well cleaned, fed and rested. Aims and significance of the proposed research This research is meant to contribute to the existing gap in knowledge regarding how mentally ill mothers cope with the knowledge that they may be deemed unfit parents to their own children. Previous researches have covered the challenges faced by such parents, but none is yet to address the coping mechanisms adopted by the ill mothers. Notably, this research recognises that the desire to be “good-enough” mothers may pile some more pressure on the mentally ill mothers thus making their conditions even worse. Expected outcomes/ implications for practice This research will be geared to test these hypotheses: i. Mentally ill mothers are just as nurturing and caring as mentally healthy mothers are. However, the realisation that their mental illnesses may be deemed to mean that they are unfit parents usually push them to try harder at being better parents ii. Trying ‘too hard’ to be an ideal parent only pushes a mentally ill mother into worse mental health. iii. Most mentally ill mothers are able to overcome their feelings of inadequacy, and are able to embrace their parenting role upon receiving support and some training from special service providers. Research Plan: Methodology The main research tool will be a structured telephone interview to 30 mentally ill mothers. Due to logistical challenges involved, a telephone interview was deemed the most appropriate research technique for this study since it does not involve a lot of travelling. More so, some mentally ill mothers may find it hard to open up to strangers especially on a person-to person basis (Reid, Lloyd and Groot, 2005). As such, the telephone questionnaire was deemed less intrusive on the respondent’s personal space, and was also deemed as more appropriate because honest and non-restrained responses from the respondents were required. Sampling The sample for this study will be attained from two mental health facilities in the ***1. With the consent of the health facilities’ administration, the researcher will get at least 50 telephone numbers of mentally ill mothers. The researcher will then seek the mothers’ consent to be engaged in the study. Although the responses will be recorded for clarity especially during data analysis, the mothers will be made aware of the same, and will also be assured of confidentiality. Data collection techniques Since this will be a telephone-based survey, the respondents’ answers will be recorded on a digital tape recorder and later transferred to a computer database where each recording will be analysed for content. The researcher will also take short notes during each interview noting details such as the respondents’ mental illness, number of children, and their main parenting concerns. Data analysis Data gathered will first be reviewed in order to retain only relevant answers to the open-ended questions. Responses that make no sense will also be eliminated at this stage. The data will then be entered into a computer dataset ready for statistical analysis. SPSS will then be used to conduct a complete statistical analysis of the data gathered Rationale for choice of method The data collection technique was chosen due to its convenience to the intended respondents. As noted by Reid, Lloyd and Groot (2005), questions directed to mentally ill patients on a person-to-person basis, especially by strangers may be discomforting to them. As such, the telephone interview was chosen as the ideal method of getting direct responses from the mothers without imposing the researcher’s presence on them. The data analysis method was chosen because most questions will be open-ended and hence the responses may require review for clarity and ease in coding and analysis. Limitations The researcher anticipates that not all targeted respondents will participate in the survey. Out of the 50 targeted respondents, the researcher estimates that 15-20 mentally ill mothers may turn down the request to participate in the survey. As such, it is expected that the respondents will average 30 people. Reservations on the health centres’ part about giving the researcher their patients’ contact numbers may also be a limitation in this study. Timetable Week 1 Identify the two mental health facilities and get the necessary telephone contacts for the identified respondents Week 2 Contact the identified respondents and seek their consent for participation in the survey. Week 3 Conduct the telephone survey on respondents who agreed to participate in the study Week 4 edit responses for clarity and code the responses ready for analysis Week 5 Analyse data, document the survey findings, and write the final report about the study. Ethical Considerations The mental health facilities will need to be assured that the contacts obtained from their records will only be used for the purpose of this study and nothing more. The mentally ill mothers on the other hand will need to be assured that the information they give the researcher will be treated with utmost confidentiality. Administration of the research, resource requirements and Budget The researcher will need a digital voice recorder to record the telephone interviews; he will also need a telephone line, a computer with document processing software as well as the data analysis package SPSS. He will also need the services of two data entry personnel on week 4, who will help in transferring the voice data into typed records ready for the analysis stage. The entire budget for this research is estimated to be......2Australian Dollars. Appendix: Interview Schedule Age of the respondent: Number of children: Date of diagnosis: 1. Tell me how you cope with the fear that you may loose custody of your child/children one day as a result of your mental illness 2. Do you attend parental counselling, group therapy, family therapy or psycho education? a. Give reasons for your answer above. 3. How did you feel when you first became ill? How did your children handle it? 4. Have you had increased challenges in taking care of your children since your diagnosis? a. If so, how do you ensure that your children get maximum care even when you are unable to provide the same to them? 5. Do you feel that your desire to act like the ‘ideal mother’ puts extra pressure on you sometimes? 6. Do you experience fear or anxiety that your parenting skills are not at par with the parenting skills of mentally-healthy mothers? 7. On a scale of 1 to 10, with 10 being a perfect score, how would you rate your ability to discipline your children? a. Give reasons for your response above. 8. What is your opinion regarding seeking professional parenting help? a. Would you seek parenting professional help or would you be afraid that it will open you up for scrutiny? b. Give reasons for your answer in (a) above. 9. Do you think the society judge mentally ill mothers’ parenting abilities too harshly? a. Give reasons for your answer above. 10. If there is one thing that you wished the society new about your parenting abilities, what would that be? References Ackerson, B.J. & Venkataraman, M. (2003). ‘Issues in Parenting by Clients with severe and persistent mental illness: a survey of experts.” Journal of Family Social Work,. 7(1):35-52. Farmer, A. (2009). “A supportive home in Brooklyn: with help, many parents with mental illness can safely care for their children. In: Hard Choices: caring for the children of mentally ill parents.” Child Welfare Watch, 17(winter), 1-28. Gullotta, T.P & Bloom, M. (2003). Encyclopaedia of Primary Prevention and Health Promotion. New York: Springer. Howard, L. (2000). “Psychotic disorders and parenting – the relevance of patients’ children for general adult psychiatric services.” The Psychiatrist, 24: 324-326. Hurley, K. (2009). “Deciding if a mother is fit: Mental health evaluations are far from scientific.” In: Hard Choices: caring for the children of mentally ill parents. Child Welfare Watch, 17(winter), 1-28. Milliken, P., & Northcott, H. (2003). “Redefining parental identity: Care giving and schizophrenia.” Qualitative Health Research, 13(1):100-113. Mowbray, C., Oyserman, D., Bybee, D., et al. (2004). Parenting of mothers with a serious mental illness: Differential effects of diagnosis, clinical history, and other mental health variables. Social Work Research, 26(0):225–240. Noble, L.M., & Douglas, B.C., (2004). “What users and relatives want from mental health services.” Current Opinion in Psychiatry, 17 (1): 289-296. Oyserman, D., Mowbray. C., Meares, P., et al. (2000). “Parenting among mothers with a serious mental illness.” American Journal of Orthopsychiatry. 70(0): 296–315. Park, J., Solomon, P. & Mandell, D.S. (2006). “Involvement in the child welfare system among mothers with serious mental illness.” Psychiatric Services, 57(0): 493-497. Raising Children Network. (2009). “Parenting with a mental illness.” Raising children network: The Australian parenting website. Retrieved October 13, 2010 from: http://raisingchildren.net.au/articles/parenting_with_a_mental_illness.html. Reid, J., Lloyd, C. & Groot, D. (2005). “The psycho education needs of parents who have an adult son or daughter with mental illness.” Australian e-Journal for the Advancement of Mental Health. 4(2): 1-13. Social Care Institute for Excellence. (2009). Think child, think parent, think family: a guide to parental mental health and child welfare.1-94. Retrieved October 13, 2010 from: http://www.scie.org.uk/publications/guides/guide30/files/guide30.pdf Stallard, P., Norman, P., Huline-Dickens, S., Salter, E., & Cribb, J. (2004). ”The effects of parental mental illness upon children: A descriptive study of the views of parents and children.” Clinical Child Psychology and Psychiatry, 9(39):39-52. Thornicroft, G., & Susser, E. (2001). “Evidence-based psychotherapeutic interventions in the community care of schizophrenia.” British Journal of Psychiatry, 78(1): 2-4. Read More