C URRENT O PINION Mental health services for parents affected by mental illness Silvia Krumm a , Thomas Becker a , and Silke Wiegand-Grefe b Purpose of review Despite an increasing awareness of support needs of families affected by parental mental illness, there is a lack of adequate mental healthcare provision for parents. As contemporary mental health services are both user-focused and evidence based, the present review focuses on knowledge regarding the subjective perspective on parenting issues among affected parents and the evidence base for parenting programs. Recent findings There has been a shift in the research focus from adverse effects of parental mental illness on children toward inclusion and the subjective perspective in affected mothers and, more recently, fathers with mental health problems. Parents report on role conflicts, parenting difficulties, and stigma. Despite a broad spectrum of parental needs, many parents are reluctant to use services. There is an increasing evidence base for intervention programs. Summary Adequate care for parents affected by mental illness requires sensitivity for parents’ subjective perspective, interagency collaboration, standard intake practice, high level of professional knowledge and skills, provision of family-friendly environments, evidence-based parenting programs comprising both individual and group approaches and peer support. There is a lack of research on other parenting needs such as desire for children, coping with custody loss, and childlessness related to mental illness. Keywords parental needs, parenting programs, parents with mental illness, service use, subjective perspective INTRODUCTION A significant number of mental health service users are parents, primarily mothers [1]. Families affected by parental mental illness face a number of challenges including negative impact on the course and outcome of parental mental illness [2,3], effects on mother–child interaction and attachment lead- ing to maladaptive parenting [4–8], increased risk for children of developing a range of mental dis- orders [9–11], stigmatization, and socioeconomic deprivation [12–14]. While many parents with mental illness are able to fulfill their parenting roles, adequate care and support for families in need are required. In order to provide adequate mental health services for these families it is crucial to include the subjective perspective of parents and non- affected partners, children as well as important others. This article concentrates on the perspectives of affected parents. While earlier literature on parenthood and mental illness has focused on adverse effects of maternal illness on offspring, more recent literature, predominantly contributions from nursing and rehabilitation studies, has placed more emphasis on mothers’ and fathers’ subjective perspectives including positive aspects of parent- hood, parenting resources, and the potential of support programs for parents. The review focuses on current publications regarding the subjective experience of affected mothers/fathers, parental needs, and barriers to service use. A second focus is on evidence-based parenting programs. Findings a Department of Psychiatry and Psychotherapy II, Ulm University, Bezirk- skrankenhaus Guenzburg, Guenzburg and b Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Correspondence to Silvia Krumm, Department of Psychiatry and Psy- chotherapy II, Ulm University, Bezirkskrankenhaus Guenzburg, Ludwig- Heilmeyer-Straße 2, 89312 Guenzburg, Germany. Tel: +08221 96 2876; fax: +08221 96 28172; e-mail: silvia.krumm@bkh-guenzburg.de Curr Opin Psychiatry 2013, 26:362–368 DOI:10.1097/YCO.0b013e328361e580 www.co-psychiatry.com Volume 26  Number 4  July 2013 REVIEW