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In focus: Talking with children about parental mental health difficulties

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Parents may be reluctant to talk to their children about their mental health difficulties. They might worry it will unnecessarily upset them or have doubts about whether young children will understand.

The overwhelming majority of parents want the best for their children. For parents experiencing a mental illness or mental health problems, this can include attempting to ‘shield’ their children from the difficulties they are facing. Furthermore, the parenting role isn’t always addressed in adult mental health services.

Research and the lived experiences of parents and children shows, however, that having age-appropriate conversations about parental mental health is beneficial for children and parents alike. We know that the experiences of parents have a direct impact on children’s social and emotional wellbeing, but parents who are dealing with mental health difficulties can still parent well and minimise the impact on children when provided with the right support.1

For parents, starting these conversations can be daunting. Practitioners can play an important role here – helping parents to understand more about what children notice and comprehend about parental mental health, and backing parents up with the right tools and support to enable these conversations to happen.

In the following video (34 seconds), Child and Family Partner Gemma talks about the impact of losing a parent to mental illness.

Having conversations with children about mental health early in life can help remove the stigma and encourage them to ask for help and learn how to cope with adversity later in life.

What do young children notice about mental illness?

Babies and toddlers might not understand everything we say, but from a very early age, children are sensitive and respond to the emotions of their parents and people around them. They register tones of voice and facial expressions, and are highly perceptive of even the smallest changes.

Despite a parent’s attempts to ‘hide’ their mental health difficulties and/or illness or protect their children from the impacts, children will often pick up on changes in their parent’s behaviour and body language.

School-aged children will attempt to piece together clues from what they see, hear and feel to help them understand the cause of these changes. Children look to parents and adults around them to help make meaning of their experiences, and when an explanation is missing, children might create their own beliefs about the cause. They may come to believe that they’re at fault, or that it’s their responsibility to make the parent feel better. This can often be a more confronting and damaging belief than the reality.

In the following video (25 seconds), Child and Family Partner Skye talks about the uncertainty of having a parent with a mental illness.

It’s important to reassure parents that their experience with mental health challenges do not make them ‘bad’ parents.

Understanding children's experiences of their parent's mental health

It is important that parents consider how their symptoms and changes in behaviour, facial expressions and tone of voice may be experienced by their child. What would the child be seeing and hearing, and what is the impact of these observations on how they are feeling?

Parents may also want to consider the following questions:

  • What might your child infer from your facial expressions?
  • What might they hear in your tone of your voice?
  • How might they make sense of this?
  • Which of your behaviours might worry your child?
  • What have you noticed about their reaction?

It can be challenging for parents to think about how their child views what is happening, particularly if they are still making sense of it for themselves.

It is important to reassure parents that their experience with mental health challenges do not make them ‘bad’ parents. They need to know that even when things are tough it is possible to have a great relationship with their child.

In the following video (21 seconds), Child and Family Partner Gemma discusses the challenges of parenting with mental illness.

Preparing to talk with children

Conversations with children about their parent’s mental health are important. These conversations help children understand the family situation and make sense of what they’re experiencing. When a child doesn’t understand what is happening in the family, they can worry, feel alone and misunderstand the situation. They may feel personally responsible and worry about both their parent’s and their own health and safety.

Most children want to know more about the causes of a parent’s behavioural changes and what treatment is being sought. Having conversations with children about mental health early in life can help remove the stigma and encourage them to ask for help and learn how to cope with adversity later in life.

Helping children understand mental illness and what it means for their family will:

  • help them to know that it’s OK to talk about mental illness
  • allow your child to ask questions and get the correct information
  • help them to approach their parent (or others) when they are worried or feeling overwhelmed; and
  • build an understanding that can strengthen relationships.

Communicating with infants about parental mental health

A child’s need for information changes as they grow. For example, there’s no need to explain your mental illness to a baby – but parents may notice that when they’re struggling with difficult moods and emotions, their baby’s responses also change.

Some simple actions that parent’s can take to help their baby feel comforted and secure include:

  • smiling while looking at them
  • maintaining eye contact until their baby looks away
  • holding their baby close and cuddling them
  • using warm, calm, ‘sing-song’ voice; and
  • smiling and nodding when their baby makes sounds.

A child’s need for information changes as they grow.

Talking with toddlers and young children about parental mental health

Toddlers and young children have an increasing understanding of language, which they are beginning to depend on in making sense of their experiences. Talking about feelings and experiences from an early age can help normalise these conversations.

When talking about mental illness, parents of toddlers and young children can:

  • use simple language and words the child will understand
  • take a moment to manage their own feelings before comforting the child
  • use a calm voice and gentle facial expressions; and
  • link words to feelings. For example, when a parent is feeling irritated, it can be reassuring for a child to hear that, ‘Mummy/Daddy is grumpy/angry right now. But it’s not you that’s making me angry – it’s just how I’m feeling. And I can see that this is making you sad.’

In the following video (30 seconds), Child and Family Partner Jess talks about explaining mental illness to young children.

Talking with primary school-aged children about parental mental health

Starting conversations about mental health and illness will help primary school-aged children understand what it means for them, their parents and their family. It also reassures children that it is OK to talk about mental health and emotional difficulties, while also helping them get the correct information about changes that may be concerning them.

These conversations can help build an understanding that strengthens the parent-child relationship, particularly when they:

  • use simple language that children understand
  • provide opportunities for children to think and ask questions
  • encourage children to speak about the things they are concerned about
  • reassure them that it’s not their fault and that things are in place to help make it better; and
  • are part of regular communication, as one conversation will not be enough.

Building a shared understanding and safe space to talk about these experiences will take time, and children’s need for information may change as they grow. Parents should feel empowered to seek support as needed.

In the following video (31 seconds), Child and Family Partner Neisha discusses being open with children about parental mental illness.

Resources

Resources for parents

Emerging Minds has a range of resources practitioners can share with parents, including fact sheets and reflective exercises designed to help parents start age-appropriate conversations with their baby, toddler, primary school-aged child or teenager during ‘tough times’. You can find these helpful resources and more in the Families section of our website and in the following list of factsheets.

Supporting your child’s understanding of your mental illness Starting the conversation about your mental illness with your child Communicating with your baby when you’re experiencing mental health difficulties Talking to your young child about your mental health difficulties Talking to your primary school-aged child about your mental health difficulties Talking to your teenager about your mental health difficulties

Resources for practitioners

Emerging Minds also offers a range of resources for practitioners, plus practitioner training resources, to help support parents and their children.

References

1. Reupert, A. E., Maybery, D. J., & Kowalenko, N. M. (2013). Children whose parents have a mental illness: Prevalence, need and treatment. MJA Open, 1 (Suppl 1), 7–9. 

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