Chaos, Conflict and Distance: A Narrative Analysis of the Experiences of Parents of Children in Inpatient Child and Adolescent Mental Health Services

The prevalence of mental health difficulties among children and adolescents appears to be increasing. In the UK, young people receive treatment for mental health difficulties in child and adolescent mental health services (CAMHS), and those requiring the most intensive treatment receive this in inpatient CAMHS. Research into family caregiving in the context of mental health has favoured spousal relationships and other adult-to-adult relationships. Literature on parents caring for children has concentrated on physical illnesses or disabilities. Research has also favoured objective aspects of caregiver burden, with less attention given to subjective, psychological experiences. A qualitative, systematic review of the experiences of parents caring for children of any age with mental illnesses indicated that no research had explored the experiences of parents who have a child in inpatient CAMHS. As such, the aim of this research was to explore the subjective experiences of parents of children who are receiving treatment in inpatient CAMHS. In-depth interviews were conducted with fifteen parents of children in inpatient CAMHS wards in England. A critical realist ontology was maintained, and the research was conducted within a contextualist epistemology. A narrative analysis was conducted, using Frank’s (1995/2013) narrative types (chaos, restitution, quest) as listening devices. Narratives of restitution and quest were not found to represent the parents’ stories, so two new narrative types were proposed. The three narrative types therefore comprised: narratives of chaos, narratives of conflict, and narratives of distance. These reflected parents’ responses to distressing situations and emotions, and their attempts to make sense of those experiences. The results are critically considered in relation to narrative theory and existing literature on caregiving, and the implications of the research are discussed. The narrative types may be used by clinicians working with parents to better understand their experiences and to tailor therapeutic interventions to support them.