Children as Next of Kin and the General Practitioner, 2015

Children of parents suffering from mental health illnesses, substance abuse or severe somatic illnesses are vulnerable and at risk of psychosocial and somatic illnesses. In addition they often tell about stigma, shame and fear, feelings of responsibility, loneliness, and depression during childhood. They are in need of coordinated and comprehensive care, with a solid base in primary care. Little is known about how the general practitioners can contribute in identifying and establishing well-functioning su pport for these children and their families. The objective of this project was to generate knowledge on how general practitioners can aid children as next of kin. The topic was addressed seen from the perspective of three groups: the burde ned children, their parents, and the general practitioners. Data was collected from focus group interviews with children as next of kin 10-15 years of age and experienced general practitioners, in-depth interviews with parents from the target groups and a e-mail based survey to all registered Norwegian general practitioners based on the hypotheses from the results of the analyses of the qualitative data. The project group was interdisciplinary and international, although the core group was based in Norway.

The main goal of this project was to develop guidelines and tools that general practitioners (GPs) can use when meeting with parents with mental health issues, substance abuse problems, and serious somatic illness, and their children. Collaboration with specialist healthcare services was a central theme here. The guidelines and tools were developed based on documented experiences and thoughts collected from various stakeholders: GPs, children, and parents.

The project consisted of five sub-projects:
1. A study based on data from focus group interviews with a strategic selection of experienced GPs about their experiences in meeting with children as dependents and their parents, and their thoughts on the role the GP can play.
2. A study based on data from focus group interviews with children participating in support groups for dependents about how their daily lives are affected by their parents' difficulties and what kind of support they need, including from their GP.
3. A study based on data from in-depth interviews with parents in the target group about what support and follow-up they as parents want from the GP and what services they want for their children.
4. A survey based on the results from sub-studies 1-3 sent to GPs to get an overview of the distribution of attitudes and viewpoints on what general practice can be implemented for dependents and their families, and how the expectations of parents and children can be met.
5. Documented development of guidelines and tools that the GP can use when meeting with children and parents.