The Parenting Practices of Parents with Psychosis: A Systematic Integrative Review

Parental psychosis has been reliably associated with adverse outcomes for both parents and children. Despite this, support for these families remains limited. Understanding the everyday parenting practices of parents with psychosis, and whether they differ from parents without psychosis is crucial for developing suitable, evidence-based interventions. We therefore aimed to synthesise quantitative and qualitative research to answer two research questions: (1) 'What are the parenting practices of parents who experience psychosis?' and (2) 'Are the parenting practices of parents who experience psychosis the same as the parenting practices of parents without serious mental illness (SMI)?' Five databases were searched for terms associated with parenting, psychosis and parenting practices, following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The Mixed Methods Appraisal Tool was used for quality appraisal prior to an integrative narrative synthesis being conducted. Twelve studies (n = 9 quantitative; n = 3 qualitative) containing 1115 parents with psychosis were included. The synthesis revealed that parents with psychosis frequently use positive authoritative parenting strategies, but sometimes this can be difficult to sustain, with parents resorting to permissive and inconsistent parenting practices. They appear to do so more frequently than parents without SMI but because only four studies utilised a control group, more comparative research is needed. The review recommends further support, and use of parenting interventions for parents with psychosis, alongside systemic practice change initiatives within adult mental health services.