From representations to practice: how professionals describe supporting parents with psychiatric or somatic illness...

To explore how professionals implement support for parenthood when a parent lives with psychiatric or somatic illness or disability, and to identify conditions that enable or hinder consistent, coordinated, and non-stigmatizing care.

A secondary qualitative analysis was carried out of a corpus of 51 semi-structured interviews with health and social-care professionals working in perinatal, psychiatric, and community settings. Sociodemographic data were summarized descriptively. An inductive thematic analysis was conducted by an independent researcher using NVivo software, with a focus on three domains: (i) characteristics of care provision; (ii) limits to care; and (iii) intra/interpersonal difficulties reported by professionals.

Seven subthemes characterized care: multidisciplinary teamwork, imperative nature of intervention, listening and adaptation, anticipation (ideally antenatal), graded child-placement options (including partial/temporary arrangements), parental self-efficacy, and empowerment. Four constraints limited implementation: insufficient parent-infant-qualified structures and long waits, shifts to child-protection logics under perceived risk, limited compliance or disagreement with recommendations, and missed/irregular appointments. Professionals reported strong emotional reactions and feelings of powerlessness, being challenged by families, and - where teams were cohesive and trained - absence of difficulties.

Professionals strive for protective, coordinated, and adaptive care, yet structural scarcity and engagement challenges narrow individualization of perinatal care. Priorities include strengthening network capacity (parent-infant -adapted care pathways and early antenatal referral), operationalizing shared decision-making, and embedding reflective supervision.