Child-rearing Support Provided by Public Health Nurses to People with Mental Illness: Qualitative Descriptive Study

BACKGROUND: The growing rates of deinstitutionalization in Japan have resulted in an increase in the number of children being raised by parents with mental illness. Given this situation, public health nurses working for local governments play an important role. OBJECTIVE: The purpose of this qualitative descriptive study was to describe the child-rearing support provided by public health nurses to parents with mental illness. METHODS: Seven nurses identified 28 cases of parents with mental illness. Descriptions of the goals and details of the appropriate nursing support were extracted from transcripts, coded, and categorized. RESULTS: Parents with mental illness diagnosed with addiction and personality disorders were more difficult to support than those diagnosed with mood disorders or schizophrenia. Public health nurses supported parents with mental illness with the aim of achieving goals such as “building continuous consultative relationships,” “ensuring living conditions had a minimum level of safety and comfort,” “parents playing their roles,” “parents and children living together in the community,” and “fostering children’s growth.” While they provided support by “assessing their relationships with parents,” “building consultative relationships with parents,” “assessing parents’ illnesses/disorders and supporting,” “assessing child-rearing abilities and supporting,” and “cooperating with related agencies,” they tended to focus on the growth of the children rather than the recovery of parents. CONCLUSION: Consultative relationships were the beginning of support, as well as the most important and difficult skill. Public health nurses need to provide support for the recovery of parents with mental illness and learn about personality disorders and addiction.