The Impact of a Parent's Mental Illness on a Child's Life

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

To explore what it is like for children in the family setting to live with parental mental illness. There are reported risks of negative social and behavioural outcomes among children living with parental mental illness such as poor school performance, isolation and poor mental health. There is yet more to know about how children's interactions with significant members of the family shape their experiences. A phenomenological design following Husserl's concepts of lifeworld and inter-subjectivity was adapted for the study. Twenty-one children (ages 10-17) who lived with a parent with mental illness were interviewed. The data were analysed to attain the essential features of the phenomenon. The study followed the COREQ checklist for qualitative studies. The essence of the phenomenon 'living with parental mental illness' in the family setting comprises strain, sadness and some happy moments. Living with parental mental illness can produce unpredictable life situations for children as relationships and interactions in the family setting can be chaotic and confusing. The ups and downs define their lifeworld as a roller coaster. Strenuous family environment, sibling interaction, navigating separate living arrangements and there are good days were specific themes that clarified the children's lives as a roller coaster. A concept called the 'parent paradox' is coined to reflect how children are torn between what their living situation looks like comparing the parent with mental illness and the other without mental illness. The paradox is founded on children's loyalty towards their parents. To break the unhealthy cycle created by the parent paradox, mental health nurses should ensure that children are well informed about the parent's mental condition including information about treatment procedures and recovery. Child's psychological distress may be reduced when they are informed.

Experiences and outcomes of prevention and early intervention programs for young people of parents with a mental illness

Background and Purpose Mental health services rarely reach children whose parents have mental illness despite their poor outcomes. There is a need to consider how mental health practitioners can prioritize the needs of these children and their families. This study examined kinship involvement in the lives of children whose parents have mental illness. Methods A phenomenological design was used, interviewing 20 children (aged 10–17 years) in families with parental mental illness (PMI) in Ghana. The interview data was analysed to attain the essential features of what kinship support looks like for children and their families. Results The essential feature of kinship support for children and families with PMI is characterized by uncertainty. However, there is an overall impression that kinship is generally supportive to these families, providing respite services, assistance with daily living, emotional support and advice to children and families. Yet, there is a sense that kinship may not always be helpful to these families. Conclusions Kinship support is integral in countries where formal mental health services are inadequate and should be explored/harnessed by mental health practitioners. The study provides directions into ways practitioners can utilize kinship as a resource when working with these families.

Childhood experiences and needs of offspring living with paternal and maternal severe mental illness: A retrospective study in China

Childhood physical abuse can result in serious behavioral, mental health, and physical health conditions. There is a need for improved strategies to identify households in which childhood physical abuse occurs. This article explores three potential correlates of childhood physical abuse: childhood exposure to parental domestic violence, parental addictions, and parental mental illness. Secondary analyses were conducted using the regionally representative 2010 Brief Risk Factor Surveillance Survey (BRFSS) of adults (n = 9,241 men, n = 13,627 women) and the analyses were replicated in the 2012 BRFSS (n = 11,656 men, n = 18,145 women). Bivariate and logistic regression analyses were conducted. Approximately one-quarter of the sample was Hispanic and/or Non-White. In 2010, 78.3% of men who had been exposed to all three of these early adversities reported that they had experienced childhood physical abuse compared with 7.5% of males who did not experience these adversities. Women reported similar levels of childhood physical abuse (66.9% for those reporting all three factors, 5.9% for those with zero risk factors). The 2012 BRFSS analyses resulted in comparable findings. Domestic violence, even in the absence of parental addictions and mental illness, was associated with a high prevalence of childhood physical abuse (between 34% and 38%). Currently, the World Health Organization cautions against routine screening for child abuse due to the high rate of false positives. We propose a two-step strategy to improve targeting: first, identifying households in which two or more adversities exist, and subsequently screening children in these households. Our findings will help improve the targeting of screening and outreach efforts to children most at risk, thereby minimizing the risk of false positives. Our data provide support for universal screening for childhood physical abuse in cases of domestic violence, particularly for those families where parental addictions and/or parental mental illness also exist.

Parental physical illnesses can be stressful for children. We estimated the prevalence of children who experience parental physical illnesses, and whether parental physical illnesses during childhood were associated with behavioral problems in adolescence. Data on children from the Northern Finland Birth Cohort 1986 was collected through questionnaires at ages 8 and 16 (n = 7037). Data on parental illness diagnosed during this study period was obtained from health registers. We investigated the association between parental physical illness (based on the International Classification of Diseases) and children’s behavioral problems at age 16 (measured by the Youth Self-Report questionnaire). During the study period, 3887 (55.2%) children had a parent with at least one physical illness. Associations were found between parental physical illness and children’s behavioral problems, with most associations found between maternal illness and males’ externalizing problems, and females’ internalizing problems. After adjusting for child behavioral problems at age 8, parental psychiatric illness and socioeconomic status, and multiple testing correction, only associations between parental physical illness and male behavioral problems were significant. Interestingly, parental illness was associated with lower problems. A notable proportion of children experience parental physical illnesses. Although mixed, our findings suggest that the impact of parental physical illness on children’s behavioral problems is complex, and that the experience of parental illness may lead to resilience in males. This study emphasizes that children’s needs should be taken into account when treating a parent with physical illness.

Children of parents with mental illness are not routinely included in psychoeducational and supportive family interventions provided by adult mental health systems. The family, therefore, is an important and, sometimes, the only source of information and support for them. To understand the experiences of well parents in talking to their children about parental mental illness. This article presents the findings of a qualitative study of the experiences of well parents in talking to their children about parental mental illness. Ten well parents whose spouses were diagnosed with a severe mental illness participated in the study. Socio-demographic information, family details and history of the spouse's mental illness along with their experiences of talking to children about parental mental illness, the perceived risks and benefits, challenges they faced and the role of others in the process were recorded. Qualitative data were analysed using interpretative phenomenological analysis. The themes of 'distancing children from parental mental illness', 'avoiding conversations about the illness', 'giving and receiving emotional support', 'providing explanations of the illness' and 'regulating other sources of information' show the complex ways in which well parents influence their children's understanding of parental mental illness. The findings are examined in the background of what is known about this topic from the perspective of children or of the parent with illness. Possible ways to support well parents in families affected by parental mental illness are discussed. This study is a step forward in the understanding of how families talk to children about parental mental illness and provides the perspective of the well parent.

ObjectiveTo determine the association between parental mental illness and the risk of injuries among offspring.DesignRetrospective cohort study.SettingSwedish population based registers.Participants1 542 000 children born in 1996-2011 linked to 893 334...

In this study, we aim to examine the feasibility of two guidebooks in Japanese healthcare services, which aimed to support parenting and child well-being in families with parental mental health illness. We sought and explored professionals' perspectives on the translated versions of the Finnish guidebooks, one for parents with mental illness and the other for children. 55 professionals providing support to parents and/or their dependent children were included in this study. Participants were asked to read the guidebooks and completed a self-report questionnaire as regards the necessity/helpfulness and utilization of the guidebooks. Berelson's content analysis method was utilized to analyze the participants' free description responses. As per our findings, around 70%-85% of the participants see the guidebooks necessary and helpful for family members and professionals. These guidebooks were assessed to provide parents and children emotional support, helping them to understand each other, and guide parents in finding ways to address their children's issues. Similarly, the guidebooks were seen to help professionals understand these families, in terms of how to support them and explain parental illnesses to children. Approximately 90%-95% of the participants shared that they would use these guidebooks, but half of them said that they would use them only to a certain extent. Many had worries about how and with whom to utilize them. Guidebooks are recommended for use in clinical training. In conclusion, this study suggests that guidebooks are feasible in Japan as resources in clinical practice and for training professionals to support families. They are likely to promote awareness of families and children with parental mental illness among professionals and within families.

Children of parents with major mood and psychotic disorders are at increased risk of psychopathology, including psychotic symptoms. It has been suggested that the risk of psychosis may be more often transmitted from parent to opposite-sex offspring (e.g., from father to daughter) than to same-sex offspring (e.g., from father to son). To test whether sex-specific transmission extends to early manifestations of psychosis, we examined sex-specific contributions to psychotic symptoms among offspring of mothers and fathers with depression, bipolar disorder and schizophrenia. We assessed psychotic symptoms in 309 offspring (160 daughters and 149 sons) aged 8-24 years (mean=13.1, s.d.=4.3), of whom 113 had a mother with schizophrenia, bipolar disorder or major depression and 43 had a father with schizophrenia, bipolar disorder or major depression. In semi-structured interviews, 130 (42%) offspring had definite psychotic symptoms established and confirmed by psychiatrists on one or more assessments. We tested the effects of mental illness in parents on same-sex and opposite-sex offspring psychotic symptoms in mixed-effect logistic regression models. Psychotic symptoms were more prevalent among daughters of affected fathers and sons of affected mothers than among offspring of the same sex as their affected parent. Mental illness in the opposite-sex parent increased the odds of psychotic symptoms (odds ratio (OR)=2.65, 95% confidence interval (CI) 1.43-4.91, P=0.002), but mental illness in the same-sex parent did not have a significant effect on psychotic symptoms in offspring (OR=1.13, 95% CI 0.61-2.07, P=0.697). The opposite-sex-specific parent-of-origin effects may suggest X chromosome-linked genetic transmission or inherited chromosomal modifications in the etiology of psychotic symptoms.

Effects of parental mental illness on children

Effects of parental mental illness on children

Many adults with mental illness have dependent children; these parents must navigate decisions about whether and what to tell their children about the illness. Parents are often influenced by shame and guilt about their disorder, and a desire to protect their children from distress. Communication about parental mental illness can have important benefits for children's psychological outcomes; professionals could be central in facilitating these conversations. This study explored parents' experiences of talking to children about their mental illness and the role of their clinical team in this process. Fifteen parents with a mental illness under NHS care in England participated in qualitative interviews. Audio recordings were transcribed verbatim and analyzed using an inductive coding approach following the principles of thematic analysis. Thematic analysis identified 4 themes: 1. Factors that affect what children are told about parental mental illness, 2. Perceived benefits of talking to children about parental mental illness, 3. Experience of 'who' talks to children about parental mental illness, 4. Role of healthcare professionals in supporting families to talk about parental mental illness. There was wide variation in what information was shared with children, influenced by fears about how to share particular diagnoses and the impact of the information on parents themselves and their family. Participants reported that no professionals had asked them what their children knew about their mental illness or offered advice on how to have these conversations, but all would have welcomed this guidance. Improving communication about parental mental illness requires targeted training programs for professionals and age-appropriate resources for families. This study emphasizes the critical role of fostering effective communication about parental mental illness to enhance children's mental health and strengthen family functioning.

PurposeTo estimate the prevalence and characterize children and adolescents aged 0–21 years with a physically or mentally ill parent based on registers. Further, to explore the use of register and survey data to identify parental serious illness.MethodsThe study is based on: 1) a 20% register sample of children and adolescents aged 0–21 in 2014; and 2) survey data from the Danish Youth Profile 2014 including 63,437 youth education students linked to registers. In registers, parental physical illness comprised hospital diagnoses included in the Charlson Comorbidity Index, and parental mental illness encompassed all mental diagnosis in the registers. Information about socioeconomic and demographic characteristics and use of health care services was retrieved from national registers. In the survey, students were asked if they had experienced serious illness of a parent.ResultsIn the register sample of 0–21-year-olds, 25.3% had a parent with a physical or mental diagnosis, the prevalence increasing with age of the child. Compared to children without parental illness, children with an ill parent more frequently had unemployed parents, lower parental educational level, and a chronic medical condition. Analyses of the discrepancies between register and survey data revealed that 9% of the adolescents were identified as having an ill parent in both data sources and 64.1% had no identified ill parents. Moreover, a higher frequency of parental primary health care service use was seen for adolescents with an ill parent, across identification method, indicating that both methods identify adolescents with an ill parent.ConclusionThe social inequality and elevated frequency of health problems among children and adolescents with an ill parent, underline the vulnerability of this population. Parental illness can be identified from both parental hospital diagnoses as well as self-reported by adolescents, however the two methods detect different populations. Both methods have several limitations and would benefit from further refinement and validation.