In focus: Talking with children about parental mental health difficulties

As a parent, you may wonder if talking to your children about your mental health difficulties is in their best interest. You might be worried 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 (Reupert, Maybery, & Kowalenko, 2013).

For parents, starting these conversations can be daunting. Practitioners can play an important role here – helping parents to understanding 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 sec), Child and Family Partner Gemma talks about the impact of losing a parent to mental illness.

Vimeo video: https://vimeo.com/517971489

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 are at fault, or that it is 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 sec), Child and Family Partner Skye talks about the uncertainty of having a parent with a mental illness.

Vimeo video: https://vimeo.com/517972225

It is important to remember that your experience with mental health challenges do not make you a bad parent.

Understanding the experiences of your child

It is important to consider how your symptoms and current changes in behaviour, facial expressions and tone of voice may be experienced by your child. Think about what they would be seeing and hearing, and the impact of these observations on how they are feeling.

You may 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?

As a parent it can be challenging to think about how your child views what is happening, particularly when you may still be making sense of it for yourself. You are a parent – but this doesn’t mean you are unaffected by life’s challenges. It may be useful to talk with your health professional or another support person about the impact of mental health difficulties on your parenting.

It is important to remember that your experience with mental health challenges do not make you a bad parent. It is possible to have a great relationship with your child, even when things are tough.

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

Vimeo video: https://vimeo.com/517971239

Preparing to talk with your child

Conversations with your child about your mental health are important. These conversations help your child understand the family situation and make sense of what they are experiencing. When your child does not understand what is happening in the family, they can worry, feel alone and misunderstand the situation. They may feel personally responsible and worry about your 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 your child understand mental illness and what it means for your family will:

  • help your child 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 come to you (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 your baby – but parents may notice that when they are struggling with difficult moods and emotions, their baby’s responses also change.

Some simple actions that can your baby feel comforted and secure include:

  • smiling while looking at them
  • maintaining eye contact until your baby looks away
  • holding baby close and cuddling them
  • using warm, calm, ‘sing-song’ voice; and
  • smiling and nodding when your 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 your 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 sec), Child and Family Partner Jess talks about explaining mental illness to young children.

Vimeo video: https://vimeo.com/517971837

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 these conversations:

  • 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 conversations, as one discussion 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 sec), Child and Family Partner Neisha discusses being open with children about parental mental illness.

Vimeo video: https://vimeo.com/517970896

Resources

For parents

Emerging Minds has a range of resources for parents, including resource 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, along with other helpful resources, in our Parents, carers and families toolkit.

You may like to find a health professional or another adult you trust to help you work through these resources. Looking after yourself is looking after your children: seeking support during times of mental health difficulties is important for you and your family.

Emerging Minds has also developed two apps to help parents support their children’s mental health.

  • Child360 has been designed as a tool for parents to reflect on how they are going in supporting their children’s social and emotional wellbeing, and identify areas where action can be taken to strengthen resilience.
  • While I’m Away helps parents support the mental health and wellbeing of their child should they need to be cared for by someone else (e.g. if a parent needs to go into hospital, travel for work, or is separated from their child for any period of time). It guides parents through a series of questions that capture the most important information about their children, including key people, daily routines, interests, hobbies, medical information and more.

For practitioners

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

References

Reupert, A. E., Maybery, D. J., & Kowalenko, N. M. (2013). Children whose parents have a mental illness: Prevalence, need and treatment. MJA Open1(Suppl 1), 7–9. Available here.

Discover more resources