Family Stories about Mental Health Difficulties: an Intergenerational Perspective

Abstract

Background and aims: While individual family members’ experiences of living with mental health difficulties have been widely researched few attempts have been made to understand how families talk about and make sense of their experiences together. Systemic theory highlights the importance of beliefs in shaping how families respond to difficult experiences and acknowledges that these beliefs may be passed down through generations of the family. However, little is known or understood about how this process happens. The aim of this research project is to explore families’ stories about mental health difficulties and to consider how family members’ views, ideas, and beliefs about mental health may shape and be shaped by intergenerational narratives. By understanding the process of creating shared narratives and the content that emerges we can gain further insight into families’ experiences of mental health difficulties, with the aim of informing clinical practice and improving the support offered to families by mental health services. Methodology: A qualitative approach was used in this project. A purposive sample of three families where one adult member was accessing mental health services was recruited. Each family was interviewed on two separate occasions and interviews were audio-recorded and transcribed. Narrative Analysis was used to analyse the transcripts with a focus on the content of the interviews and the processes involved in jointly narrating their experiences. Analysis and findings: To preserve the unique experiences of each family their stories are presented in turn before considering the findings that connect all three. Each family section begins with the context of the interview and a consideration of ‘who’s in the family’, before moving on to the main themes, which varied for each family, and ending with ‘interviewer reflections’. Particular attention was paid to the influence of family interactions on identity construction, sense-making and storytelling. Consideration was also given to the researcher’s influence on the co-construction of the interviews and the influence of the wider socio-cultural context. The combined analysis of all three families is divided into two sections: ‘The legacy of a label’ and ‘What happens when we talk’. The first of these sections considers how the intergenerational narrative ‘it is not okay to talk about mental health difficulties’ has impacted on families experiences and how stigmatising discourses are maintained within the families through relational interactions. The second section explores the complex processes involved when families talk and considers some of the factors that influence their interactions: construction of their preferred identity; their positioning by each other but also by their involvement with this research and by social and cultural discourses; issues of power; the state of their family relationships; and intergenerational beliefs about mental health difficulties. The findings are discussed with reference to the clinical implications, strengths and limitations of the methodology and directions for future research, along with personal reflections.