Parenting

Parental mental illness can significantly impact on family life. All the members of the family are affected if someone in the family has mental illness but research shows that children are especially vulnerable.

Compared with adults, children have more limited coping skills and strategies, are more dependent on other people in their lives, and have fewer psychological defences.

The impact of parental mental illness varies according to a number of factors.

  • one is the severity and duration of the illness - for instance, a temporary and minor illness handled by a GP is likely to be much less disruptive to family life than a severe and chronic psychotic illness requiring lengthy or repeated hospitalisation
  • other variables include the child's age and resilience,
  • the presence or absence of a "well" parent/carer
  • the extent to which the illness affects all aspects of family life.

Impact on children

The extent of the impact is not determined by the diagnosis, rather by the parental behaviour. The research into parental mental illness finds that it can affect a child in three main ways, impact on parenting, direct effects on children and children who care for a mentally ill parent.

Effects on parenting
Increasingly, research points to people with mental illness having impaired social skills and a disproportionately conflictual relationships. Parenting may be adversely affected. In practice this has been shown to lead with relationship problems with children and the latter having increased levels of behaviour difficulties.

Direct effects on children
 The greatest risk to the majority of children is not one of physical safety but of risk to their own attachments, development and mental health. Research shows that young children are particularly vulnerable to psychiatric problems, as are the children of psychotic parents.

Children who care for a mentally ill parent
It is estimated that there are 10,000 to 40,000 young carers in the UK, of which about one-third care for a mentally ill parent. Care is more likely to be provided by girls than boys and may well have a physical and emotional component. It is also likely to be provided to younger siblings as well as ill parents.

Several studies point to the difficulties experienced by a proportion of young carers. The problem is not the caring, many young carers report a wish to undertake this role. It is the missing out on educational, social and leisure activities that is sometimes part of this role. Young carers are something of a "hidden problem" being either unknown to services or being left to cope. A study by the NSPCC showed that many young carers had significant experiences of loss, self-blame and stigma.

Taking positive steps

Despite evidence that children whose parents suffer from mental illness are at greater risk of psychiatric problems, some children, nevertheless, develop normally. There is alot that a parent with mental illness can do to reduce the risk of a child developing psychiatric problems.

Help from within the family
Some protective or positive factors have been found that decrease the risk of a parents mental illness on children. These include:

  • knowledge that their parent is ill and that they are not to blame
  • help and support from family members 
  • a stable home environment
  • psychotherapy for the child and the parent 
  • a sense of being loved by the ill parent 
  • a naturally stable and happy personality in the child
  • positive self esteem
  • inner strength and good coping skills in the child 
  • a strong relationship with a healthy adult
  • friendships, positive peer relationships
  • interest in and success at school
  • healthy interests outside the home for the child
  • help from outside the family to improve the family environment (for example, marital psychotherapy, parenting classes, family therapy)

Help from outside the family
Working together with families can greatly improve family life and reduce the burden on children of parents with mental illness. In order to be effective, services for families in which the parent has a mental illness should be family-centred, comprehensive and long-term.

Family-centred care addresses individuals' needs within the context of their communities, roles and responsibilities, to ensure that the needs of the whole family are addressed. Services should tackle both the parental mental illness and child welfare together through an integrated approach of health, social, housing, and education services. Services that may be of some use are:

  • adult mental health services
  • child and adolescent mental health services
  • social services
  • family therapy services - see Talking treatments 
  • carer support workers
  • young carers groups