Social Support for Families in the Context
of Children's Mental Health
 A number of interventions in the field of children's mental health now include explicit attention to enhancing families' social support resources. This seems particularly appropriate in light of efforts to promote family-driven services. Nevertheless, many families' reports of their experiences of caring for children with mental health difficulties indicate that they often "go it alone." Reasons for this include lack of access to the appropriate services, poorly coordinated services, delays in diagnosis, and stigma.
The Benefits of Social Support
If children's mental health interventions are to include proactive efforts to enhance families' social support, it is important to consider what we know about what types of support are effective for which families, under what circumstances. An examination of the general social support literature reveals a rich tradition of research on social support and health. In this field, there is substantial evidence that, on average, having close social ties and higher levels of social support is associated with better health.
To what extent can the lessons of this research be applied to the enhancement of family social support in the context of children's mental health interventions? This question is discussed by Walker & Sage (2006). They review the types of support described in the literature and summarize the main findings of the research. Support can encompass both formal support, such as that provided by professionals working with children and families, and informal or natural support, available from family and friends. Some groups, such as advocacy organizations or family support groups, may provide both formal and informal support. For some specific examples from different perspectives see the most recent issue of Focal Point.
However, even if support providers are well-intentioned, recipients may not always benefit. Support is relational and occurs in a social and cultural context. It may be difficult to ask for help. In some instances, support may be experienced as intrusive or disempowering. The opportunity to develop support relationships that are reciprocal may be an important aspect of social support, though norms are likely to vary in different community and cultural contexts.
Understanding the complexity of social support
Support can serve a number of functions. Although researchers use different typologies to describe dimensions of support, most include emotional support, tangible or instrumental support, and informational support. The multidimensional nature of support makes it difficult to generalize the research findings or to extract clear guidelines to inform the design of effective interventions in the field of children's mental health. Different types of support may be relevant to families at different times and in different contexts. While classifying support according to the type and function is useful, it is also important to consider the direct and indirect effects of support interventions. Support provided in one domain may affect a parent's experience in another domain. For example, flexibility at work may reduce family stress by enabling parents to attend their child's appointments, without having to worry about being fired from the job. Unless support is seen and understood from the family's perspectives and priorities, support interventions are unlikely to be effective.
Approaches to Enhancing Social Support for Families
As Walker & Sage discuss, much of the existing research on social support is problem focused, with less attention to the role of social support in promoting positive development. Learning more about parents' general experiences of parenting and their strategies for success may provide useful information for the design of support interventions. Family life is affected by social trends, such as increased mobility, less job security and change in family structure. One recent study asked nearly 1400 African American and Latino/Latina parents to share their experiences of parenting. Although more than half of the participants reported that parenting is very challenging, approximately eight out of ten parents reported that they felt successful. When asked about what would be most helpful to them in their parenting, the most frequent response was having more time to spend with their children. When asked about the challenges faced as parents, job loss was the most frequently reported challenge. Efforts to enhance family support for all families need to take a holistic view of their lives.
If families caring for children with mental health difficulties are to be less isolated, it is essential to understand their shared and unique needs for support. This is likely to require action at national, community, group, and individual levels.
Please share your experiences and opinions on this topic by writing your comments in the box below.
As always, we appreciate your thoughts and look forward to hearing your views.
Here are a few questions to consider:
- As a family member, what advice do you have for mental health professionals about enhancing support for parents, based on your experiences?
- If you have experience of providing formal or informal support, what have you learned that might be useful to others?
- How does the social and cultural context affect the experience of support? How can these factors be integrated into the design of interventions?
Your thoughts…
Comments:
 One important issue is to look at professionals training and service delivery. Do professionals who are trained to be experts in their field have the additional skills to really find out how families view support and what would be most helpful to them? To what extent does current professional training and the way in which services are structured and funded help or prevent the dialogue necessary to make this happen? Posted Thursday, March 9, 2006 at 08:30 AM
When you look at research about people's retrospective assessments of the contributions to their recovery of various types of services and supports, the importance placed on "informal" or "natural" supports far, far outweighs that of professionally-supplied services. Our service systems have begun trying to find ways to use professionally-supplied services as a means of helping clients access natural and informal supports-- but research so far does not show that these efforts are particularly successful. It seems to me we need some new paradigm for this work-- this is an important challenge that should engage us all in some creative thinking. Posted Tuesday, February 28, 2006 at 09:08 AM
I am in total agreeance of your comments in relation to the need to find as many supports as possible to enhance the family life of mental health children.
In my experience, often times parents tend to become isolated as a result of people (professional, friends, aquaintances and support agencies) either telling them what they should be doing for the child or ignoring their requests for what they believe they need.
While the parent is not the "professional" it is them who is with the child 24/7. My experience tells me that parents want the support but would rather go it alone rather than being told, instructed, directed what is best by someone who spends minimal time with the child, yet understands the "illness".
In actual fact the parent is the professional who studies not only the child's illness but also the personality, understands the environment and constantly watches for responses. We can learn so much from "supporting" the parents who can better help us to understand the child and equip the professionals to assess correctly, diagnose correctly, treat correctly and hopefully to reflect on all that we have learned so as to become better at what we do in the future.
The secret to true support is to listen to what is "needed", not to give what we think somebody needs. Posted Friday, February 24, 2006 by Brian D Hayhurst (buzlouis@aap at 08:39 PM
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