Background: Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices. Methods: In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0–100 point likert scale. Results: Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user. Conclusion: Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.

This paper provides a framework for essential family‐focused practices (EASE: Engage, Assess, Support, Educate) for clinicians to support parents with mental illness in the context of their family. The framework is underpinned by relational recovery as the parent/consumer's recovery is considered within the context of their relationships, including the relationship between clinician and parent/consumer. The central aim is to strengthen nurses’ and other clinicians’ capacity to address key psychosocial needs of parents and to strengthen relational recovery in families where parents have mental illness. The EASE framework is a theory and evidence‐informed family practice approach to relational recovery within healthcare provision. The EASE practice components are defined and illustrated with practice exemplars that operationalize the framework within adult service settings. Potential applications and outcomes of using EASE are also described. The framework is intended as a practical guide for working with parents and families in inpatient and community mental health settings and may also be relevant for clinicians in a range of contexts including child welfare and primary health care.

Background: There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness.Aim: The aim of this study was to explore factors associated with self‐reported QoL in children affected by parental illness or parental substance abuse.Design: A cross‐sectional multicentre study.Methods: The sample included 246 families with children 8–18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children’s self‐reported QoL.Main outcome measure: KIDSCREEN‐27.Results: The children’s self‐reported QoL was positively associated with the ill parent’s self‐reported physical health, the children’s self‐reported social skills, the degree to which other adults took over the ill parent’s responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children’s QoL was negatively associated with the children’s self‐reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R²) in children’s total QoL.Study limitations: Sampling bias may have occurred during recruitment.Conclusions: The findings suggest factors of importance for the children’s QoL. Clinicians should assess whether an ill parent’s physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children’s self‐reported QoL to identify children who are most negatively affected.

Living with a partner with substance abuse problems may induce strains in an individual’s everyday life, including poor health, disrupted family life, and social isolation; this may lead to dropping out of education or work, a lack of safety and support, and facing various dilemmas and stigma. Aim: The purpose of this study was to explore these partners’ everyday life experiences, including their parental roles. Method: A qualitative design comprising qualitative interviews with ten partners and ex-partners was performed, and a thematic analysis was used. Results: The findings demonstrated that sharing their lives, including parenthood, with a partner with substance use problems affected every aspect of the participants’ lives, and entailed being influenced by their partner’s ups and downs. The overall theme, “being stuck on an unsafe and unpredictable rollercoaster”, is explored through three themes: “dilemmas, stigma, and shame”, “lack of safety, security, and support,” and “searching for hope and meaning.” Conclusion: As a result of the negative impact of their circumstances on their everyday lives, these individuals need support to handle the challenges that they face, but often find it difficult to ask for help. Peer support groups seemed helpful in enabling them to find ways out of their situation.