Parental mental illness and the role of stigma: key practice points

Stigma

‘Stigma’ can be understood as a form of social devaluation and rejection of an individual or group because they have an attribute that is seen as socially undesirable (Goffman, 1963). What is considered ‘undesirable’ varies across different societies, but mental illness is one of the most commonly stigmatised attributes.

People with mental illnesses are at risk of being stigmatised as dangerous, unpredictable, incompetent, lacking in responsibility, mentally and emotionally weak (Corrigan & Kosyluk, 2014), and as less capable of being a good parent.

Despite more public conversations about mental health, stigma is still a major problem, and can increase distress, discourage social interaction and help-seeking, and hinder recovery.

Types of stigma

It can be helpful to break down stigma in relation to parental mental health into public stigma, self-stigma, and courtesy stigma.

• Public stigma: the attitudes and beliefs held by other people that lead them to avoid, socially reject and discriminate against the stigmatised person. The consequences of this for a parent can include, for example: workplace discrimination or loss of jobs, friendships or wider family relationships.
• Self-stigma: the internalisation of negative attitudes and beliefs, so that the person comes to believe that the negative stereotypes of mental illness apply to them. This can lower a parent’s self-esteem and sense of self-efficacy (belief in their own ability to positively affect their circumstances). It can also lead to them internalising an idea of themselves as a poor parent and blaming themselves for negative outcomes in the family.
• Courtesy stigma: stigma experienced by people close to those with stigmatised characteristics – ‘stigma-by-association’. Family members can experience prejudice and discrimination through association with their mentally unwell relatives (Larson & Corrigan, 2008). Children of parents with a mental illness can often experience this, notably through bullying or being ostracised by peers.

Consequences of stigma

Without intending to, family members can direct stigmatising ideas and labels towards one another as they try to understand and negotiate the illness, family experiences, relationships and responsibilities (Yates & Gatsou, 2021).

For example, a child might change their behaviour towards their parent – ignoring their authority or being rude. The parent may then feel the child is being disrespectful and hurtful but the behaviour is likely due to societal attitudes, lack of understanding and confusion, rather than malice.

Professionals should also be aware that one of the most common strategies for managing the impacts of stigma is concealment. Parents may try to conceal the existence of their illness, both from other members of their family and from the outside world.

Children can be drawn into strategies to conceal the illness from others, which can add to their distress and confusion. Whole families can then become isolated from contact with peers, friends and potential sources of support. Parents and children may fear that if services learn of the illness, the family will be broken up.

Unwell parents are often highly sensitive to perceived criticisms of their parenting and may have had negative experiences of feeling they were judged or criticised by services in the past.

The full guide to parental mental illness includes more information about key principles for supporting families, as well as how to address the complex needs and adversities experienced by parents with mental illness. If you have a Community Care Inform Children licence, log on to see the full guide and read more detailed information.

You might also be interested in:

• Working with domestic abuse, substance use and mental ill health
• Attachment-based trauma and parenting
• Domestic abuse and mental health problems: quick guide