When a parent becomes mentally unwell, it can be difficult for them to explain to their child what is happening and for the child to make sense of their parent’s behaviour.

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Parents and children or young people often feel isolated and unsupported when the parent is unwell, which can increase distress and anxiety across the family. It is important that mental health and social services support both the parent and their child.

Parents with mental health problems

Large numbers of children grow up with a parent who has a mental health problem. Many of these parents will have a mild or short-lived problem. Many children live with a parent who has a long-term alcohol problem or drug dependency, sometimes combined with a mental health problem.

Some parents have a severe and enduring mental illness. These long-term illnesses include schizophrenia, personality disorders and bi-polar disorder.

Estimates suggest that between 50% and 66% of parents with a severe and enduring mental illness live with one or more children under 18. 

How does ill health affect parenting?

Many parents feel under pressure to balance their parenting role with their other roles as partners or workers. Parents with mental health problems may find this particularly difficult. Parents with mental health problems may also struggle to manage their parenting role.

In addition, if a parent has to be admitted to hospital, this may disrupt the stability of their children’s lives and change the balance of their relationship with their children. Putting their children’s needs first can mean parents avoid hospital stays or stop taking medication that makes them tired or unable to think clearly.

How can parents’ ill health affect their children?

Research has shown that some children of parents with a severe and enduring mental illness experience greater levels of emotional, psychological and behavioural problems than children and young people in the rest of the population. This may be because the genes that some of them inherit make them more vulnerable to mental ill health, but it could also be because of their situation and the environment in which they are growing up. For instance, parents with a severe illness are more likely to live in poverty, which in turn can affect their children’s mental health. The children may also feel insecure and anxious that their parent will become unwell. They will also have to be living with the stigma attached to mental ill health and may be bullied at school.

As well as worrying about their parents, children may be reluctant to ask for help for fear that they will be taken away from their parent/s. Children may become carers for their parents and lose out socially and educationally. 

What can protect children’s mental health?

Although many children experience negative effects from their parents’ mental ill health, many others do not. Certain factors can protect children’s mental health when their parents are unwell for a long time. These include:

• being supported by agencies who take a ‘whole family’ approach to supporting the child, their parent and other family members
• getting support from their relatives, teachers, other adults and their friends
• having another caregiver who does not have mental health problems
• being parented in a consistent way
• cultural factors, such as the support of faith communities, which may vary between different communities.

 

These factors all go to building and maintaining a child’s resilience to difficulties. Social support can help children and young people to cope with their parents’ ill health. Young carers’ groups can be an important source of support, offering them a chance to meet up with other young carers, talk to people who understand what they are coping with, and enjoy trips and activities that they can’t usually join because of their caring responsibilities.

What can help children and young people?

• Children need to be given clear, factual information about their parents’ mental ill health – children say they feel less anxious if they are told the truth. The internet increasingly provides a source of information for children and young people to find out about topics that they don’t want to discuss with their friends or other people.
• Barnardo’s has produced a range of materials for practitioners working with parents with mental health problems and their children. The materials can be downloaded from here.
• Writing up an information sheet with their parents can prepare children for times when their parent may be absent. It could describe the children’s daily/weekly routine and their likes and dislikes. If other caregivers follow this guidance it can provide children with continuity and a sense of security. It can also enable parents to maintain a sense of control and that they are contributing to their children’s well-being when they are in hospital.
• Parents can write down what they find helpful and unhelpful when they are unwell. Children often carry this information in their heads which means they may assume the role of their parent’s carer without looking for support outside the family. Sharing the parent’s support needs with a trusted adult reduces the likelihood of the child taking on inappropriate caring responsibilities and can reduce the guilt that parents may feel about being a burden on their children.
• If a child is going to visit their parent in an inpatient unit, it is important that whoever takes them can explain beforehand what to expect – what the building looks like, how their parent may look and behave, and the effects of medication, how the other service users behave. Mental health units should be able to provide a family room when children can see their parent safely, outside the ward environment.