Transgenerational mental health concerns the transmission of cognitive and social-emotional abilities and vulnerabilities from parents to children, including the transmission of psychiatric and related problems from generation to generation. Research has yielded strong evidence showing that children of parents with mental illness (COPMI) or addicted parents are at high risk of developing a wide range of emotional, behavioural, social and also physical health problems during their lifetime, especially when risk factors accumulate and social support is lacking. Many patients in current child, adolescent and adult mental health care have a history of growing up in families dealing with parental mental illness. Preventing this continuous transgenerational transmission of problems and disorders is one of the main current challenges for psychiatry and public mental health. Longitudinal child and family studies and listening to the voices of children and parents have generated growing insight in the involved risk factors, developmental trajectories and transmission mechanisms. There exists growing evidence showing that these transgenerational problems are preventable by reducing risk factors and strengthening positive factors and resilience in children, families and their social environment.
Over the last two decades, researchers, professionals, NGOs and experts by experience in many countries have collaborated locally and also internationally (e.g. the Prato Collaborative on COPMI) to develop preventive interventions, educative materials, early treatment methods, family-focused care and consumer network activities to support these children and families. In this opening keynote an overview will be given of the different strategies that practitioners in mental health care, youth care, primary health care, family organizations, social services and public health can use to tackle this continuous transmission of psychiatric problems and to foster the social-emotional development of these children and families at risk. Controlled studies in different countries have shown that such interventions can make a significant difference, i.e. have influence on important risk and protective factors and can reduce the onset of mental disorders in new generations. To date, effective programs, tools and practices are worldwide exchanged.
Some challenges for our future agenda will be discussed. First, although interventions have shown positive effects, their effectiveness need further improvement. Results from prevention science offer guidelines to systematically improve outcomes and more evaluation research is needed. Secondly, available options for prevention and early intervention are still implemented on a small scale with limited reach. To create a significant preventive impact in populations of children and families dealing with parental mental illness (public health perspective), we need to invest in creating the necessary conditions for successful implementation. Such conditions include advocacy, supportive national and local policies, professional expertise on transgenerational mental health and preventive options, combining interventions and interorganizational and -sectoral collaboration to create ‘collective impact’, and supportive financing arrangements and legislation. In sum, a better future for these children at high risk is possible, if we are choosing to invest in it both from child and adolescent psychiatry and adult psychiatry.