SERIOUSLY MENTALLY ILL WOMEN--COPING WITH PARENTHOOD

由于服务的改善和政策的改变， 严重的精神病患者在社区中度过的时间 并且有能力并且渴望履行正常的社会角色。 患有SMI的女性性活跃，生育能力正常， 生育率。然而，精神卫生服务的SMI有所有 却忽视了养育问题虽然对儿童的影响 有一个精神病的母亲是有据可查的，研究 母亲本身缺乏：样本不具有代表性， 临床特征测量不充分， 文化和背景对成果的影响没有得到解决， 没有考虑到的观点，也没有改变母亲的养育方式， 或功能进行了分析。目前资助的RO 1研究 解决了所有，但纵向差距，在这方面的文献。一 招募了大量多文化的重度精神疾病女性样本（N=380） 从CMHC的和病人的精神病单位在底特律 大都会区。与各机构的广泛合作， 确保样本具有代表性。此外，我们还建立了 电话跟踪程序，并成功定位92% 参与者应进行一次或多次3个月的再联系。但要 更充分地了解服务实践，纵向研究是 需要这样的变量，只能随着时间的推移进行研究， 包括（即，持续的经济困难，长期的压力， 由于儿童的发展阶段的变化）和因果关系 方向确立。提出了一个概念模型， 父母作为调解人之间的关系， 压力/资源和妇幼成果。另夕h 模型提出，mh服务，特别是如果他们是父母- 导向，可以缓和模型中列出的关系。的 本申请提出利用来自 我们最初的拨款进行了为期3年的纵向研究， 在18个月和36个月后再次询问P。因为大多数女人的孩子 这一时间框架将包括重大的 过渡时期。它还应包括服务的变化 小票这将增加改变的可能性。 在母亲的养育和整个社区的经验， 适应利用这些纵向数据，我们建议：a）检查 压力因素的变化对孕产妇和儿童的直接影响 结果，控制个人特征的影响 （人口统计学、精神病史）和既往功能; B） 检查这种关系在多大程度上受到以下因素的调节 心理健康服务的提供; c）检查在何种程度上， 养育态度和经历介导压力源的影响 （d）分析在多大程度上 心理健康服务（总体和针对父母的）可以 缓和压力和养育之间的关系， 养育子女和孕产妇/儿童成果。

As a result of improved services and policy changes, persons with serious mental illness spend more of their lives in the community and are capable and desirous of fulfilling normalized social roles. Women with SMI are sexually active and have normal fertility and childbirth rates. However, mental health services for SMI have all but ignored parenting issues. While the effects on children of having a mentally ill mother are well-documented, research on the mothers themselves 's lacking: samples are non representative, clinical characteristics inadequately measured, the effects of culture and context on outcomes not addressed, the mothers perspective not considered, nor have changes in mothers' parenting or functioning been analyzed. The currently funded RO1 study addresses all but the longitudinal gaps in this literature. A large, multicultural sample of SMI women (N=380) has been recruited from CMHC's and in patient psychiatric units in the Detroit metropolitan area. Extensive collaboration with agencies has ensured a representative sample. Furthermore, we have established phone follow-up tracking procedures and succeeded in locating 92% of participants due for one or more 3-month recontacts. However, to more fully inform services practices, longitudinal research is needed so that variables which can only be studied over time are included (i.e., persistent economic hardship, chronic stress, changes due to children's developmental stage) and causal directions established. A conceptual model is proposed for parenting as a mediator of the relationships between stress/resources and maternal and child outcomes. Additionally, the model proposes that mh services, especially if they are parenting- Oriented, may moderate the relationships set out in the model. The current application proposes to utilize the participant sample from our original grant to carry out a 3-year longitudinal study, and reinterview P's 18 and 36 months later. Since most women's children are school-age, this time frame will encompass significant transitional periods. It should also include changes in service receipt. This should increase the likelihood of changes being experienced in the mothers' parenting and overall community adaptation. Using this longitudinal data, we propose to: a) Examine the direct impact of changes in stressors on maternal and child outcomes, controlling for the effects of personal characteristics (demographics, psychiatric history) and prior functioning; b) Examine the extent to which this relationship is moderated by mental health service provision; c) Examine the extent to which parenting attitudes and experiences mediate the impact of stressors on maternal and child outcomes; d) Analyze the extent to which mental health services (overall and parenting-specific) can moderate the relationships between stress and parenting and between parenting and maternal/child outcomes.