Living with a parent that has a mental illness: How can the children be protected?
In the UK, 29% of children live with at least one parent reporting symptoms of emotional distress(1). Mental illness can take many forms, such as depression, chronic anxiety, and bipolar disorder. The severity of the illness and the family environment varies from one individual to the next, so this article should be taken as a presentation of research, rather than a one size fits all.
Findings from 2020 suggest that 67% of parents believe their mental illness has an impact on their children directly, but also on their ability to parent(2). Therefore, it is important to understand how children experience growing up in this family context. This article will focus on the potential impact of parental mental illness on children, what the children’s needs might be, and most importantly, how these children can be protected.
Children’s experiences of parental mental illness
Growing up with a parent that has a mental illness can present challenges to the relationship between parent and child. Children must learn to navigate an unpredictable everyday life, requiring a range of ever changing coping strategies to deal with their circumstances(3). For example, children may feel shame when their parent behaves differently, hiding their family life for fear of being bullied(4).
Parent’s think children should be protected from too much responsibility(5), which may lead to children hiding their worry(6) and distancing themselves to protect themselves(4). This is conflicting with a child’s general desire to have an important role in their parents’ wellbeing(5). This moral dilemma of who adopts the caring role between parent and child, means children may adopt additional responsibilities as a way to keep going(6, 7).
The impact of parental mental illness on children
Parental mental illness is often seen in combination with domestic violence and substance misuse(8). Growing up in this environment with disruption to everyday life means the child may develop emotional and behavioural problems(9), while also receiving a lack of attention and support from the parent(10). With that considered, it becomes easy to understand why mental illness is more common in children living with a parent that has a mental illness, than those that do not(11).
However, this is not the full picture, as children may also find strengths and resources that positively support their development. For example, children describe themselves as more independent, mature, and empathic than their friends who do not have a parent with a mental illness(4, 12). They also report acquiring several abilities, such as creativity and the ability to accomplish difficult tasks(12).
The needs of children living with a parent that has a mental illness
Each child is likely to have individual needs that change across different stages of development, and as the parent’s mental illness progresses(13). These might include the need for a normal family life(14), security(10), social and professional support(10, 12). How attainable these needs are is influenced by the child’s understanding of their parent’s mental illness. Yet, less than half of children are aware that their parent has a mental illness(2), with most young children not being told about it(3). As a result, children often have little understanding(9), with many identifying a need for more knowledge and information(9, 12, 14). However, this may be hindered by a parent’s desires to be a good parent(14) and protect their child’s wellbeing(15). Instead, parents may only talk with their children about mental health in response to the child’s search for understanding(3, 15). Though, without basic knowledge and understanding, there is a barrier of whether the child knows to seek information, and more so, what information to seek.
How can children be protected?
In response to children’s needs, research has explored some ways that children might be protected, while living with a parent that has a mental illness.
1. Family centred approach to professional mental health services
When a parent becomes a user of a mental health service, it is likely that the child is also going to have some needs to be addressed. Standards for the adult mental health workforce have been developed to recommend that services are inclusive of all family members and ensure that families are aware of how to access support16. Still, these recommendations may only result in change if driven by the professionals(17).
Although mental health practitioners are typically in favour of supporting children, they may not consider it their role to do so(18, 19). Equally, for children’s social workers, parental mental illness can be a barrier to caring for their children(20). To ensure the needs of both parents and children can be addressed, more collaboration between services is needed(20). Adults want their parenting role to be recognised and supported, so services may make use of joint working with parents and families in a family-centred care approach(21).
2. Improving children’s understanding of mental health
As children often have little understanding of their parent’s mental health(9), it is important to understand what information they need and the benefits of having an improved understanding. There are five themes of important mental health knowledge for children: (a) an overview of mental illness, (b) reducing stigma surrounding mental health, (c) developing coping strategies, (d) increasing capacity to seek help, and (e) identifying the risk factors of mental illness(22). Educating children about their parent’s mental illness can be cathartic(23), as this knowledge can help them to better interpret their parent’s behaviours and experience less uncertainty(24).
3. Encouraging supportive discussions about mental health
To help children feel supported and understand their parent’s mental health, research has examined a “Let’s Talk About Children” resource. This aims to influence parents’ attitudes and behaviour by giving them an awareness of the knowledge and skills required to initiate family discussions about their mental illness(25). Similarly, a strength-based and recovery-focused parenting program helps parents to develop communication strategies and set routines to support their children(26). To compliment this, there are chatrooms available to support adolescents living with a parent that has a mental illness(27). These chatrooms allow them to disclose their experiences with other people in similar situations. Findings show that those who disclosed more, received more social support(26).
Conclusion
Ultimately, empowering children to understand and manage living with a parent that has a mental illness may reduce their risk of developing their own mental health issues(28). Instead, this could allow children to develop positive traits, such as empathy, responsibility, and independence(4, 12). Equally, it may be just as important to empower parents to communicate with their children, so that they can work through recovery together as a family.
References
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