Parental Mental Health Problems And How It Affect School Children

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Hart (2007) defines methodology as "a system of methods and rules to facilitate the collection and analysis of data" 2007: 28). To guarantee the accurate results of the review, high quality original research had to be used. This methodology section will provide a description of the way in which materials have been selected for the review. The criteria used for the search inclusion and exclusion of articles will be given. Fink (2005) states that when a literature search has no guidelines there is a possibility that there will be many articles that are retrieved which are irrelevant. This study uses a literature review approach, which refers to 'the comprehensive study and interpretation of literature that relates to a particular topic' (Aveyard 2007:5). Benoliel (1985) adds that a qualitative literature review is a mode of systematic enquiry concerned with understanding human beings and the nature of their transactions with themselves and with their understandings. This research study aims to review grey and published literature and provide unknown results; unrealistic or misinterpreted results (Aveyard 2007). Grey literature include publications "produced at all levels by government, academia, business and industry, both in print and electronic formats, but which is not controlled by commercial publishing interests, and where publishing is not the primary business activity of the organization." (1999 International Conference on Grey Literature in Washington, D.C.). Although not considered to be a scholarly form of publication, grey literature is produced by experts in the field, and "serves scholars and lay readers alike with research summaries, facts, statistics, and other data that offer a more comprehensive view of the topic of interest." (Outten 2008).

The literature review attempts to answer the following:

To what extent does a parental mental health problem affect school children between the ages of 5-11 years?

What mental health problems face school children aged 5-11 years who have parents with mental health problems?

What challenges and implications are faced by professionals in working with this particular group of children?

The benefits of literature review approach are that the data is already available and published; easy to access; cheap and it exempts the author from seeking approval from the research ethics committee (Aveyard 2007). Ethics deals with the way people think and their morality. The way a person behaves depends upon how they will be viewed by others; this can be a little confusing as people hold their own values and beliefs. Ethical codes and guidelines are seen as a way to help people to be responsible for the decisions they make (Cormack 2000). The professional codes and guidelines that researchers follow require them to act with intellectual honesty and integrity and the work they do must be appropriate for example it would not be appropriate "to conduct a study which does nothing to contribute to further knowledge" (Cormack 2000: 53). In their classic text Discovery of Grounded Theory, Glaser and Strauss (1967) describe what they believe to be the primary goal of qualitative research: the generation of theory, rather than theory testing or mere description. According to this view, theory is not a "perfected product" but an "ever developing entity" or process (1967: 32). Glaser and Strauss claim that one of the requisite properties of grounded theory is that it be "sufficiently general to be applicable to a multitude of diverse situations within the substantive area" (1967: 237). It is also seen that researchers bring their own personal thoughts when carrying out research. Having their own personal interests in the topic is not the problem, but it is the prejudices and bias that may occur if a person's history is not highlighted. Intellectual honesty should be followed when reporting any findings that does not support the initial topic question (Cormack 2000). Ethics approval is not required when undertaking a literature review; this is substantiated by Aveyard (2007) who notes that the:

... reviewer collects data in the form of published material that relates to the research topic and then undertakes to critique and analyse the literature. The reviewer does not have direct access to those who participated in the original research and hence is exempt from seeking the approval of an ethic committee" (2007: 21).

Aveyard (2007) adds that in as much as the literature review describes the subject that has already been reported; it also demonstrates an individual's ability to identify significant information and sketch existing knowledge. In addition, literature review approach helps fill in the gap in the research that the work will address, and generates rationale or justification for the study. In other words the main purpose of a literature review is to demonstrate the scholarly capacity, identify information, and outline the presented knowledge.

Machi (2009) asserts that literature review approach serves in identifying new ways to understand, and shed light on any gap in the previous research and position on the way forward for further research. Resolving conflicts among apparent contradictory previous studies too is a crucial purpose of the review. It also identifies areas of prior studies to prevent duplication of the endeavour.

In comparison with quantitative research, qualitative literature review has the benefit of being subjective; which may be a selective choice of an article to support the author's point of view. The review addresses clearly focused questions and counts each study and/or article as an equal unit in a straw poll to attain consensus, without considering that studies have different sizes, and varying robust methodology. It considers the value of methodology of the constituent rather than dramatically regarding the conclusion of all as a valid voice.

Combining data from different articles is justified according to Cooper (2010) especially where a mathematical meta-analysis aspect like difference of the study is addressed. In addition there is a definite benefit in using the meta-analytic method in a literature review as it makes the evaluation more applicable. Literature review approach combines studies from diverse environments, making generalization to other populations more justifiable. Its effectiveness is illustrated consistently across a range of studies. For example, Allan (1996) points out that results can be obtained not as a subjective discussion of the trend, association and relationship, but as defined numerical values, with assured intervals and estimates of the interventions effect. In other words literature review limits biasness in identifying and declining studies. The conclusions are more reliable and precise due to the techniques employed. A large amount of information is incorporated quickly by the researcher.

Furthermore, Allan (1996) argues that literature review reduces delay between research discoveries and implementation of successful diagnostic and beneficial strategies. The review recognizes inconsistency in the result across studies and can generate new hypothesis about a particular subgroup. At the same time, the quantity systematic review enhances the precision of the overall result. The literature review approach therefore has a bigger and more methodologically sound research study which can be weighed to have more power and it provides consistency and generalizing of findings.

What needs to be pointed out at this stage is that a systematic 'error' may arise if only one person screens studies for inclusion because judgements made could be prone to personal bias (Aveyard 2007). In addition, data may be outdated, particularly in issues relating to mental health. This study was, however, limited by word count implying that it was impossible to conduct a full systematic review as required by the Cochrane guidelines (Aveyard 2007).

The author identified published literature from 2005 to date through a thorough comprehensive search strategy. The author searched relevant data covering social work, social policy and mental health from databases such as social care online; SAGE Journals online and Science Direct (Elsevier) including utilising the University library.

The author used the following words and phrases "children"; "mental health", "mental illness", "child development", "health", "children's act", "children's well being" "parental mental health", "mental health impact"; "children and mental health", and "child and adolescent mental health issues" to search for relevant literature. In addition, the author sought grey literature from the Rochdale Social services, UNICEF website; and Children's Act 1989 and 2004. The advantage of using published and grey literature is that it minimises biasness that may affect the research findings (Aveyard 2007).

The author used abstract and titles to determine relevance of the data. The data was categorised and minimised using inclusion and exclusion criteria. Published and grey literature searches were scanned to find out whether it was relevant to the study. If published literature appeared to meet the inclusion criteria, full publication was then obtained and incorporated to the review while irrelevant literature was discarded (Aveyard 2007). The author automatically discarded data that was only available on sale. The articles, journals and grey literature chosen by the author met the following inclusion criterion:

Literature discusses effects parental mental health problems to children,

Literature discusses children of mentally ill parents,

Discusses children's health and mental health problems;

Highlights the psychological issues of children,

Discusses impact of parental mental health/ in social work practice [children and families].

The author had to use practical screening to decide upon inclusion and exclusion of articles, as suggested by Fink (2005); this enabled usefully studies to be collected. Without this criterion there may be many articles produced that have little relevance for the project. In addition to the above inclusion/exclusion criteria the literature should meet following guidelines:

Literature should be published in English language only.

Published and grey literature.

Published 2005 onwards.

Journals chosen related to health and human sciences

The author identified 20854 published and grey literature as references for literature review. However, following further analytical reading, scrutiny of references, abstracts and titles, 36 references were categorised as relevant to the literature review.

The author did not voluntarily choose to search for a qualitative source of data; the availability of research papers determined the research methodology. According to Greenhalgh and Taylor (1997) qualitative data is appropriate in human subject research; therefore since this study is about the effects of parental mental health on school children aged 5-11 years, this effect will be better understood on the basis of how they (children) "live and felt" (Greenhalgh and Taylor 1997). Qualitative research is suitable for social work research because social workers should be interested in how people feel and how they are going to enable them to change their circumstances.

Data analysis

Data analysis was an on-going process. It was fundamental to conceptualise; analyse; and critique searched data. The data was analysed as it was collected and constantly compared with other transcripts, and therefore the data collection ceased only when the data analysis process ceased to uncover new insights from the data (Glazer and Strauss 1967).

The author worked with the data, organizing it, breaking it into manageable units, synthesizing it, searching for patterns, discovering what is important and what is to be learned, and deciding what to "tell others" (Bogdan and Biklen 1982: 145). The author used inductive analysis of data, meaning that the critical themes emerge out of the data (Patton 1990). In addition the author showed some creativity, for the challenge is to place articles to be reviewed into logical, meaningful categories; to examine them in a holistic fashion; and to find a way to communicate this interpretation to others. While data analysis is a daunting task, the author identified and tentatively named the categories into which the phenomena observed would be grouped. The goal was to create descriptive, multi-dimensional categories which form a preliminary framework for analysis. Words, phrases or events that appear to be similar were grouped into the same category.

Study Limitations

There were limitations of this study was primarily the complete reliance on previously published research and the availability of these studies using the method outlined in the search methodology and the appropriateness of these studies with the criteria of the selection/exclusion procedure discussed above. Of the original 40 journal articles which were appropriate to this literature review, 36 journal articles were excluded for non compliance with the selection criteria and thus their findings were not included in the final analysis. The reasons for the exclusion of these articles are that full texts of the journal articles were not available, some were available on sale, and a few were not written in English language.

In relation to the topic, the journal articles for the literature review consist of 5 European (1 UK) and a single American article. This would not pose a problem since the UK is part of the European Union and much of its health policies follow the EU guidelines. The single American journal article did not cause any problem for the study since the UK is often seen to follow the trends on America in relation to social sciences.

Reliability and Validity of the Study.

It is important to note that high reliability may suggest a systematic bias at work in data, a bias shared by multiple researchers or across observations by the same researcher. This is why many qualitative researchers emphasize validity rather than reliability; documenting what occurs in an accurate manner may reveal inconsistencies.

Guba and Lincoln (1981) stated that while all research must have "truth value", "applicability", "consistency", and "neutrality" in order to be considered worthwhile, the nature of knowledge within the rationalistic (or quantitative ) paradigm is different from the knowledge in naturalistic (qualitative) paradigm. Consequently, each paradigm requires paradigm-specific criteria for addressing "rigor" (the term most often used in the rationalistic paradigm) or "trustworthiness", their parallel term for qualitative "rigor". They noted that, within the rationalistic paradigm, the criteria to reach the goal of rigor are internal validity, external validity, reliability, and objectivity. On the other hand, they proposed that the criteria in the qualitative paradigm to ensure "trustworthiness" are credibility, fittingness, auditability, and confirmability (Guba and Lincoln, 1981). These criteria were quickly refined to credibility, transferability, dependability, and confirmability (Lincoln and Guba, 1985). They recommended specific strategies be used to attain trustworthiness such as negative cases, peer debriefing, prolonged engagement and persistent observation, audit trails and member checks. Also important were characteristics of the investigator, who must be responsive and adaptable to changing circumstances, holistic, having processional immediacy, sensitivity, and ability for clarification and summarization (Guba and Lincoln, 1981).

The author used verification strategies in the process of the research so that reliability and validity were actively attained, rather than proclaimed by external reviewers on the completion of the project (Morse et al 2002). The strategies for ensuring rigor were built into the literature review process per se. These strategies include investigator responsiveness, methodological coherence, theoretical sampling and sampling adequacy, an active analytic stance, and saturation (Morse et al 2002). These strategies forced the author to correct both the direction of the analysis and the development of the study as necessary, thus ensuring reliability and validity of the completed project. For example a clear record was kept of how journal articles were accessed enabling other researchers to have a clear audit trail of the methods used to retrieve articles. In addition the literature review was also chosen with care ensuring that each article met up to the standards of the framework to assess each article quality.

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