Family Functioning and Health-Related Quality of Life in Parents of Children with Mental Illness

Abstract

Background: When a child suffers from mental illness, their family, and particularly, their parents are adversely affected. Existing research suggests that parents of children with mental illness have significantly lower health-related quality of life (HRQoL) than parents of healthy children. Poor HRQoL of parents is associated with worse symptomology in their children, and decreased ability to care for their children. Previous research demonstrates that dysfunctional family functioning may be associated with lower HRQoL of parent caregivers. Objectives: This project examined whether parent caregivers of children with mental illness have poorer health-related quality of life than Canadian population norms; modelled associations between family functioning and physical and mental HRQoL; and, investigated whether these associations were moderated by parent or child factors. Methods: Cross-sectional data were collected from children receiving mental health care at a pediatric hospital and their parents. Physical and mental HRQoL of parents were measured using the Short Form 36 Health Survey (SF-36), and sample means were compared to weighted Canadian population norms using t-tests and effect sizes were calculated. Multiple regression was employed to evaluate associations between family functioning and parental physical and mental HRQoL, adjusting for child and parent demographic and clinical covariates. Proposed moderators, including child age, sex, and externalizing disorder, and parental psychological distress, were added as product-term interactions to the models. Results: Parent caregivers had significantly poorer physical and mental HRQoL than adult Canadian norms in most domains of the SF-36, and in the physical and mental component summary scores (d = 0.31 to 1.47). Family functioning was not significantly associated with parental physical HRQoL, β = 0.13 (0.17), p = .46. Greater family dysfunction was related to poorer parental mental HRQoL, β = 0.29 (0.14), p = .04. No moderators significantly augmented the associations between family functioning and parental HRQoL. Conclusion: These findings support the uptake of approaches that strive for collaboration among healthcare providers, children, and their families (i.e., family-centered care) in child psychiatry settings, to assist the health needs of all family members. Future research should assess potential mediators and moderators of these associations in longitudinal samples and examine the impact that family interventions may have on improving parent outcomes, and subsequently, child mental health.