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Abstract
This thesis explores the family experience of child/adolescent acute mental illness and the first hospitalisation. The focus of the qualitative study of parental narrative is on the developmental and interactional process within families and between systems across the lifespan of the acute crisis and subsequent hospital admission from the parent(s) perspective. The dialogical approach taken explores parent narratives on the experience of child/adolescent mental illness within the Australian mental health system. The sample involved 9 parents from the NSW region, whose child/adolescent had experienced ONE psychiatric hospitalisation. The interviews were offered to parents at least 3 months after post discharge and no more than 5 years. In-depth interviews were conducted with transcripts given post-interview within 3 weeks for further depth and reflection. The family relational process, family adaptation, and adjustments and accommodation for change is explored as parents share their observations about the journey and how they and the care system come together during the pre-admission, admission, and post-discharge process.
The conceptual/interpretive framework is grounded in a social constructionist approach allows for the issues of power, language, knowledge, communication, and the ecology of systems for the promotion of a holistic, contextualised understanding of the family experience. Drawing upon significant contextual events, definitions and treatments pertaining to mental illness in the current era of community treatment and deinstitutionalisation are examined. The rise of the consumer movement, its influence on legislation, policy, and treatment practices informs a critical approach to current mental health practice, the critique of the biomedical model, and the impact of professional and political power on the identity, inclusion and exclusion of consumers and their families.
The focus on parent(s) voices highlights unintended consequences of mental health intervention and the fragmentation that results from a stepped care approach, and the position of parents in the family s journey. Empowerment and advocacy of parents and a partnership model between professionals and families for the advancement of family centred, inclusive, and trauma informed service planning, policy, research and practice. The implications and conclusions drawn from the parent(s) narratives of the family experiences are constructed around three admissions.