Dutch youth of parents with a mental illness reflect upon their feelings of guilt and shame

Children of parents with a mental illness (COPMI) have a higher risk of acquiring a mental illness themselves. Feelings of guilt and shame could increase COPMI risks of acquiring mental health disorder symptoms. These feelings of guilt and shame could also impact the quality of the parent-child relationship. Data were drawn from the qualitative part of a mixed method study featuring 18 face-to-face interviews with Dutch COPMI aged 12–21. Interviewees were asked about their experiences with guilt and shame related to their parent with mental illness and the extent they felt that these feelings affected their relationships with their parents. Qualitative thematic analysis (QTA) revealed that most COPMI youth described feelings of guilt and some of them reported feelings of shame. They reported making behavioral adjustments especially using caution in parental communication. In their perception, guilt and shame did not have long-term impacts on their relationships with parents.     

Community mental health professionals' theoretical assumptions about families: responses to a practice simulation vignette

Seventy-three community mental health professionals read a practice simulation vignette about a man with increased schizophrenia symptoms who appears at a community mental health agency accompanied by his parents. Professionals reported their levels of agreement that the parent/s may play a role in the man's schizophrenia symptoms and/or mental health treatment, i.e., serving as treatment resources; expecting consultation from professionals; serving as partners and allies; expressing negative emotions; expressing double bind communication; engaging in hostile behavior per the schizophrenogenic mother; having marriage conflicts; and also having a psychiatric disability. Professionals reported their level of agreement that the parents may be experiencing responses to their son's schizophrenia such as coping; grieving; adjusting to a biological illness; dealing with caregiving responsibilities/burdens; and remaining strong, resilient people. Findings revealed that this sample of mental health professionals most strongly agreed that families are coping, grieving, and positive treatment resources.     

Medical education in pediatric rheumatology—unique challenges and opportunities

Clinical Rheumatology - Pediatric rheumatology faces workforce shortages in both developed and developing regions of the world resulting in suboptimal care of children with chronic rheumatic...     

Perspective: beyond counting hours: the importance of supervision, professionalism, transitions of care, and workload in residency training

The medical education community's conversations about residents' duty hours have long focused solely on the number of those hours. In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) enacted its most recent iteration of standards regarding duty hours. Those standards, as well as a 2008 Institute of Medicine report, look beyond the quantity of duty hours to address their quality as well. Indeed, the majority of the 2011 ACGME standards specify requirements for the qualitative components of residents' working and learning environments, including supervision of residents; professionalism, personal responsibility, and patient safety; transitions of care; and clinical responsibilities (including workload). The authors believe that focusing on these qualitative (rather than quantitative) components of the resident's working and learning environment provides the greatest promise for balancing patient care with resident education, thus optimizing the safety and effectiveness of both. For each of the four qualitative components that the authors discuss (enhancing supervision, nurturing professionalism and personal responsibility, ensuring safe transitions of care, and optimizing workloads and cognitive loads), they offer agendas for faculty development, educational program planning, and research. Thus, the authors call on the medical education community to expand its discussion beyond counting duty hours to focus on these critical issues that ensure quality resident education and patient care and to implement necessary strategies to address them.