A lot on their minds

Parental mental illness is a severe test of the resilience of any child. Joy Ogden examines the support children in this position require

How often do people say “it’ll never happen to me”? Many people feel that way about mental illness, yet one in four people have mental health problems at some time in their lives. And at the time of their illness, at least a quarter will be parents.

Children who live with mentally ill parents face the stigma still attached to mental illness. Some are afraid of being ridiculed because of their parents’ behaviour and fi nd it hard to make or trust friends, and some are the victims of playground bullies. Many feel anxious and fearful.

Not all the children of mentally ill parents become their carers, but research suggests that at any one time between 6,000 and 17,000 young people do. The problems they face vary with the condition and are often compounded by poverty, or alcohol or drug dependence. Severe depression can lead to such things as agoraphobia or self harm; bipolar disorder to dramatic mood changes; and schizophrenia to suicidal thoughts and auditory hallucinations. Many people have more than one diagnosis.

In a few cases, particularly when parents have severe mental illness alongside drug or alcohol dependence, children are at greater risk. But this is rare, and it is important to distinguish
between the different types of illness and the likely effects on the child. A child living with a lone parent with paranoid schizophrenia, for example, will have a very different experience to one with two parents, one of whom is severely depressed.

All will inevitably confront diffi culties. Many children miss school, either because of caring responsibilities or because of anxieties about their parents when they are away from them.

“Many children are frightened to mention their worries about their mum or dad to a professional in case they are taken away,” says Loughborough University academic Jo Aldridge, who has
studied children caring for parents with severe and enduring mental illness. “Professionals should reconcile young people’s fear of outside intervention with their need for formal support.”

Lack of support
Too many mental health professionals fail to spot young carers’ need for support at all. According to Alex Fox, head of young carers’ development at the Princess Royal Trust for Carers, the split between adults’ and children’s services makes this particularly difficult. “Adults are often told by mental health teams that parenting is nothing to do with them and the only help
they can get is if the child is at risk of harm, when they can call on child protection services,” he says.

Fox points out that helping parents is the statutory responsibility of adult services, but that many mental health practitioners feel they are not appropriately trained and ignore the issue until there is a crisis.

The newly launched Children and Parents Empowered project – a joint venture between Greenwich Council and Oxleas NHS Trust – has been established in a bid to tackle this common
problem and integrate services in south east London. Its aim is to support families affected by severe or enduring parental mental illness using a holistic approach. Its work will include supporting parents in getting children to school on time or liaising with a child’s school and reducing parental stress by accessing activities outside the home.

Listen to the children
Aldridge says that caring for a parent who is ill can, in fact, help children feel needed and allay some of their fears. But while professionals need to recognise the value of young carers’
contributions, they must distinguish between good experiences and those that are inappropriate.

“We will make the right decisions for children and parents only when we listen to what they have to say about their particular circumstances,” she says.

But simply listening isn’t enough; professionals need to actually hear what the children are saying too. In interviews with 40 young carers, Aldridge discovered that only fi ve had been included in formal discussions with professionals. Of these, two said their contributions were ignored.


‘When she got ill she shouted a lot’
Kevin has his work cut out caring for his three young sons, Harry, Robby, and Danny. His wife developed severe post-natal depression following Harry’s birth five years ago. She self-harms, has repeatedly attempted suicide, and has recently been sectioned for her own protection for up to six months.

The last suicide attempt was in February after a dispute with neighbours. Kevin explains that he was asleep when Danny came upstairs and asked what was wrong with his mum. “I knew straight away,” says Kevin. “She took over 100 tablets and drank two bottles of wine.”

Kevin says his sons are “all pretty well struggling”. “The little one is old enough now to realise that his mum is not about so if there is anything major wrong he is quite a little handful,” Kevin explains.

“Danny was a very helpful, enjoyable child before this, but now is being referred for a drug problem. He understands what is in my head, how I feel. He is a mixed up boy. Robby has been tearful at school a lot. They all feel very vulnerable. You plod along. Sometimes you just feel like a robot.”

Danny, 14, is on a restricted education programme because he is dyslexic. Robby, 11, is statemented with special needs behaviour. And Harry, 5, is being watched because he has been “very awkward”.

Robby has the support of a befriender from Fun in Action, a Brighton-based charity. She is an artist, and “a brilliant match”, says Kevin. Each week she takes him out and helps him to be an 11-year-old again.

Robby remembers his Mum before she got ill:

“Actually she was quite nice,” he says. “Then when she got ill she shouted a lot, which made me quite upset.” He tries to take the pressure off his dad by being good, but finds school difficult. “I sometimes get upset. I don’t really talk and sometimes my friends at school bully me… they think I am a wuss because I cry.”