The lived experiences of adult children of parents with serious mental illness (ACOPMI): A systematic review of qualitative studies

BACKGROUND: Adult children of parents with a serious mental illness (ACOPMI) may represent a distinct yet under-recognised clinical subgroup. Although familial transmission has largely been conceptualised in genetic terms, the environmental and psychosocial dimensions of this experience are less clearly defined. This systematic review synthesised qualitative research on ACOPMI lived experiences across childhood and adulthood to inform transdiagnostic identification and intervention. AIM: This systematic review of qualitative studies explored the lived experience of ACOPMI participants in childhood and adulthood to provide clinically relevant psychosocial information for mental health professionals working with this group. METHODS: Four databases, MEDLINE, CINAHL, PsychInfo, and PsycArticles, were searched in accordance with the Joanna Briggs Institute's (JBI) meta-aggregation approach to qualitative studies, which uses PRISMA Guidelines. The JBI qualitative data extraction tool and checklist were used to extract data and assess methodological quality. FINDINGS: Twenty-one studies were included in the final review following full-text screening. Results produced three Synthesised Findings; (i) Childhood Experiences (categories: Traumatic Childhood, Silencing, Parentification, Coping Strategies, and Psychological Impact); (ii) Support in Childhood (categories: Support from Professional Services, Support from Family, Support from Wider Community) and (iii) Impact of Childhood Experiences into Adulthood (categories: Parenthood, Relationships, Resilience). INTERPRETATION: ACOPMI presented as a pragmatic clinical subgroup with distinct psychological difficulties, including early life traumas, specific adaptive and maladaptive coping, and personality changes related to their experiences. Based on the number of categories drawn from early life experiences, identifying ACOPMI as a pragmatic subgroup gives the opportunity for effective transdiagnostic early identification and intervention.