Outcomes of the ON FIRE peer support programme for children and adolescents in families with mental health problems Kim Foster*, Ingrid McPhee†, Judith Fethney‡ and Andrea McCloughen§ *Associate Professor Mental Health Nursing, ‡Biostatistician, §Senior Lecturer Mental Health Nursing, and †Research Assistant, Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia Correspondence: Kim Foster, Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia E-mail: kim.foster@sydney.edu.au Keywords: adolescents, children of parents with mental illness, evaluation studies, peer support, prevention, resilience Accepted for publication: January 2014 ABSTRACT Children in families with mental health problems may encounter multiple risks to their well-being. General aims of peer support pro- grammes for these children include fostering resilience and effective coping strategies, and enhancing self-esteem and social skills. This study aimed to evaluate outcomes from a pilot multi-site implemen- tation of the ON FIRE peer support programme. The purpose of ON FIRE is to cultivate hope, resilience and well-being in children and adolescents aged 8–17 years living in families affected by sibling or parental mental health problems. We employed a pre-post test (base- line and 4 months) evaluation using a suite of outcome measures. The Strengths and Difficulties Questionnaire (SDQ), Children’s Hope Scale, Kids Connections Scale and Positive and Negative Affect Scale for Children (PANAS-C) were completed for 64 child/adolescent par- ticipants. At baseline, participants had significantly greater difficul- ties compared with Australian norms. At 4 months, there were significant differences in children’s hope and in connections outside the family. There were no significant differences in the SDQ or the PANAS-C. INTRODUCTION International longitudinal studies indicate that chil- dren whose parents have mental illness (COPMI) have between 41% and 77% risk of developing mental health and/or psychosocial problems (van Doesum et al. 2005). Compared with other children, COPMI are at greater risk of disrupted attachments (Cunningham et al. 2004), poorer school attendance, academic and peer-interaction problems (Mensah & Kiernan 2010), and behavioural and emotional problems (Maybery et al. 2009a). A complex inter- play of genetic, environmental and socio-economic factors has been linked with the increased level of risk (Erlenmeyer-Kimling et al. 2000), and children can experience a range of outcomes. Using cluster analysis methodology, Mowbray et al. (2004) found that over half of 166 adolescents whose parents had mental illness demonstrated no psychosocial prob- lems, while 42% experienced a range of issues; 27% had behavioural disturbances and 15% demonstrated mental health problems. Consistent with previous lit- erature, Mowbray et al. (2004) found that a combi- nation of risk factors, in particular, social contextual factors, were related to outcomes for these children. While the majority of literature has focused on chil- dren of parents with mental illness, both parental and sibling mental illness can affect the well-being of the family unit and parent–child/sibling–child rela- tionships. Qualitative literature on sibling mental illness indicates that well siblings can experience embarrassment, resentment and guilt (Sin et al. 2012). Siblings have also been found to experience stigma, burden and stress in relation to siblings’ mental health problems (Greenberg et al. 1997; Sin et al. 2012). doi:10.1111/cfs.12143 © 2014 John Wiley & Sons Ltd Child and Family Social Work 2016, 21, pp 295–306 295