CRISP Seminar:

Towards Inclusive Political Participation in Mental Health

Helsinki, August 21st 2018

Silvia Krumm

Ulm University, Department of Psychiatry and Psychotherapy II,

Germany

How can MHSU influence parenting/family policies?

Stigma Low

SES

Few social networks

Single

parent

families

Marital conflicts, separation

Centrality of motherhood

Fears

Dilemmata Shame

Guilt

Stigmatization

Parenting values

Eugenics

Difficulties to access suitable services for affected parents

Parental stress

Community-Based Rehabilitation:

„Political participation“ WHO 2010

• Interrelationships between people – between men and

women, parents and children, people with and without

disabilities – and the operation of power at every

level of human interaction.

• Broad range of activities through which people

develop and express their opinions on the world and

how it is governed, and try to take part in and shape

the decisions that affect their lives.

• …from developing thinking about disability or other

social issues at the individual or family level, joining

disabled people's organizations or other groups and

organizations, and campaigning at the local, regional

or national level, to the process of formal politics,

such as voting, joining a political party, or standing for

elections.

MH and parenting – sociocultural/historical context

bis 1945 1960 1970 1980 1990 2000 2010 2020

„Total institutions“ hospitalization

Psychiatric reforms Community services

Family planning?

Increasing fertility rates?

Prevention of parenthood Children of mothers with MH

problems

Mothers, fathers?

Focus on Individual ressources and social

context

Dorothea Buck * 5.4.1917

Writer, Sculptor 1936: Schizophrenia Coerced sterilization at age 19, without knowlede

• From 1960s stage plays about the murder of hundreds of thousand mentally ill people and disabled persons during the Nazi era

• Numerous books, articles, talks, interviews

• 1989 Psychosis Seminar („Trialogue“)

• 1992: Bundesverband Psychiatrie-Erfahrener • 2007: „Coercive Treatment in Psychiatry: A

Comprehensive Review“ at the Congress of the World Psychiatric Association (Dresden, Germany)

Dorothea Buck * 5.4.1917

• Part of disabled persons‘ movement / 1977

• Exclusively for persons with disabilities

scandalization of sterilization practises against genetic counseling practises

„Krüppelbewegung“ („Cripple movement“)

Psychiatry: Why was the girl sterilized? Many unanswered questions in the case of Elvia J. Die Zeit. Von Claus Leggewie 26. März 1982

„Secret actions“

„Krüppelbewegung“ („Cripple movement“)

MH and parenting - sociocultural/historical context

bis 1945 1960 1970 1980 1990 2000 2010 2018

„Total institutions“ hospitalization

Psychiatric reforms Community services

Children of mothers with MH problems

Family planning?

Increasing fertility rates?

Prevention of parenthood

Mothers, fathers?

Focus on Individual ressources and social

context

Netz-und-Boden.de

Initiative for children of

mentally ill parents

lobbying

providing materials networking training

mentoring projects

Katja Beeck Starting in 1999 „Mit Steinen, die dir in den Weg gelegt werden, kannst du auch etwas Schönes bauen"

Netz-und-Boden.de

bis 1945 1960 1970 1980 1990 2000 2010 2020

„Total institutions“ hospitalization

Focus on Individual ressources and social

context

Psychiatric reforms Community services

Children of mothers with MH problems

Family planning?

Mothers (fathers?) Increasing fertility rates?

Prevention of parenthood

MH and parenting - sociocultural/historical context

‘Perfect parent'

It can be easy to blame any difficulties you have as a parent on your mental health

problems, or try to over-compensate by becoming a ‘perfect parent’.

However, it’s important to remember that all parents have difficult times and there

is no such thing as being perfect.

Try not to put too much pressure on yourself or give yourself too much of a hard

time. Remember that you have general skills as a parent – regardless of any mental

health issues – that will remain useful.

https://youtu.be/WHpHP4HFRT4

Member of EUFAMI -

family self-help

„Bundesteilhabegesetz“ 2017 (Federal law on social/political participation)

UN Convention on the rights of persons with disabilities

Welfare Reform Act

Support for parents with disabilities („Elternassistenz“)

Working group; participation of

different consumer organizations:

"Nothing about us without us!”

Juli 2014 - April 2015 • 9 meetings on

reform aims and issues

! Focus on physical disabilities / specific needs re mental health problems?

Maybery & Reupert 2009

Peer support

for parents

Lloyd-Evans et al. (2014); Davidson et al. (2012), Pitt et al. (2013); Chinman et al. (2014); Miyamoto & Sono (2012); Castelein et al. (2008), Walker & Bryant 2013, Repper & Carter 2011

Service user Peer provider Services

• Similar outcomes

• Hope, recovery,

empowerment

• Re-Admissions

• Social network

and social support

• Symptoms

• Functioning

• Self-esteem

• Social networks

• MHP attitudes

• Recovery

focuses changes

• Normalizing

• De-

Stigmatization

Peer support

Develop Peer Support Principles for the Perinatal Mental Health sector

• Co-design is defined as a method where decision making is shared equally throughout

the process, everyone taking part (people working in the sector and people with lived experience) have an equal level of power within the process. Using co-design to create the principles means people with the relevant skills and experience can come together to create a tangible outcome that everyone feels is relevant to their work.

• By taking part in this event you will:

Help us articulate values that represent people’s experiences of peer support Influence the perception of peer support for maternal mental health Co-design bespoke principles of maternal mental health peer support

• Who should attend?

People working in perinatal services • People offering Peer Support • People with lived experience of mental health problems pre / postnatally

Sharing own stories and experiences: Raising (media) awareness for sterilization, situation and needs of children and parents

Building (self-help) networks: influencing policies and laws for victims of NS regime, parents with disabilities

Providing and developing peer support for mothers: Changing services towards family focused practises

Thank you.

Dr. phil. Silvia Krumm MAsoz Clinic for Psychiatry and Psychotherapy II at Universität Ulm Bezirkskrankenhaus Günzburg Ludwig-Heilmeyer-Str. 2 89312 Günzburg, Germany silvia.krumm@uni-ulm.de http://www.uniklinik-ulm.de/psychiatrieII/forschung