International prevalence rates of both Adverse Childhood Experiences (ACEs) and Mental Health Difficulties (MHD) are consistently high. Research has also repeatedly identified strong positive correlations between these two widespread public health issues, both of which demonstrate intergenerational continuity and broad negative health and social outcomes. Due to these intergenerational risks, this thesis attempts to contribute to the knowledge base regarding aspects of both ACEs and MHD, from a familial perspective.

Chapter one synthesises qualitative literature regarding the way in which children of parents who experience MHD make sense of their parent’s MHD. The review analysed findings across 14 studies, which produced three overarching themes. Children’s understanding of their parent’s MHD seemingly operated within a biopsychosocial model. This conceptualisation had numerous effects on their life and impacted on their perception of mental health more generally. Clinical implications for services working with children, parents and families, alongside limitations and recommendations for future research are discussed.

Chapter two presents a research paper that aimed to understand how parents experienced routine enquiry about their own ACEs. Thematic analysis produced three themes across eleven semi-structured interviews, from seven participants. The findings proposed a five-stage chronological model of ACE enquiry, which seemed to incorporate a process of post-disclosure behaviour change. However, results also raise important clinical issues associated with power dynamics. Theoretical contributions and clinical recommendations are presented in relation to trauma enquiry and disclosure literature.

Finally, chapter three offers a summary of the research findings and reflections, presented as chapters that articulate key decision and learning points.