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  • Perspective
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The well-being of children at familial risk of severe mental illness: an overlooked yet crucial prevention and early intervention opportunity

Nature Mental Health volume 1, pages 534–541 (2023)Cite this article

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Abstract

Children of people with severe mental illness are a largely neglected, yet identifiable, population at biopsychosocial risk for reduced well-being and poor mental health. Outside of safety concerns, the well-being needs of these high-risk children are not proactively considered, nor are care pathways organized to systematically address early intervention needs. Mental health policy and treatment guidelines should address the critical interplay between parental severe mental illness and child development and prioritize the development of a coordinated, evidence-based approach to prevention. This Perspective provides a brief overview of what is known about psychopathological antecedents and modifiable risk factors, as well as highlighting developmentally informed prevention targets and potential barriers such as stigma. This integrated evidence could guide the way forward for policy development and prevention with the shared objective of supporting the well-being of children at familial risk, and could highlight research priorities that aim to stop the inter-generational transmission of severe mental illness.

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Acknowledgements

This Perspective was conceived as an idea during the preparation of a COST application (proposal reference OC-2020-1-24623), which involved several scientists, clinicians and experts from 37 countries. We are very grateful to the large number of COST consortium members for the inputs and the numerous ideas and suggestions that they put forward during the preparation of the original application. We hope that this Perspective will contribute to internationally improve the recognition of needs and the support for children of parents with SMI. M.W. as principal investigator was supported in part by National Institute of Mental Health grant RO1 MH 036197. This Perspective is dedicated to the memory of George C. Patton, who was the Director of Adolescent Health Research at the Royal Children’s Hospital’s Centre for Adolescent Health in Melbourne. He held academic appointments at the Murdoch Children’s Research Institute and the University of Melbourne, Victoria, Australia. George was a tireless scientist and clinician who was involved in the study of adolescent health and led some landmark studies in this area. He made a significant contribution to the drafting of this Perspective and played a key role in the development of the COST application, which was the premise for writing this article. We all miss his inspiration and guidance in the study of adolescents and the factors that promote good health during this critical phase of the lifespan.

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Authors and Affiliations

  1. Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada

    A. Duffy

  2. Department of Psychiatry, University of Oxford, Oxford, UK

    A. Duffy & S. M. Goodday

  3. 4YouandMe, Seattle, WA, USA

    S. M. Goodday

  4. Department of Psychology, Philipps University, Marburg, Germany

    H. Christiansen

  5. Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia

    G. Patton

  6. Department of Paediatrics, University of Melbourne, Melbourne, Australia

    G. Patton

  7. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    A. A. E. Thorup

  8. Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    M. Preisig & C. Vandeleur

  9. Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA

    M. Weissman

  10. Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA

    M. Weissman

  11. Mailman School of Public Health, Columbia University, New York, NY, USA

    M. Weissman

  12. IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

    G. de Girolamo

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Correspondence to A. Duffy.

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Duffy, A., Goodday, S.M., Christiansen, H. et al. The well-being of children at familial risk of severe mental illness: an overlooked yet crucial prevention and early intervention opportunity. Nat. Mental Health 1, 534–541 (2023). https://doi.org/10.1038/s44220-023-00090-4

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