Parents often worry that talking openly with their children about mental illness will make things worse. However, when parents and families are supported to have these conversations and offered accurate information, the opposite is true.
Executive Director of Satellite Foundation Rose Cuff offers some ideas on how parents, carers and family members can discuss mental illness or mental health challenges with the children and young people in their lives.
Parenting, mental health and shame
The first thing to say is that all parents struggle in their parenting role at some point. Life throws up big challenges and can test parents, their relationships inside and outside the family and their life goals. It is also fair to say that the areas in life where parents, carers and family members are thriving – their strengths and their creativity – are most easily and quickly overlooked by themselves and those around them, including the health professionals to whom they might turn to for support.
Experiencing mental health challenges is very often accompanied by feelings of shame, judgement, blame and fear. This can be amplified if you are also a parent – assumptions can be made that you will automatically not be a ‘good enough’ parent. The uniqueness of each person’s experience with mental health challenges can be lost, misunderstood and miscommunicated. So, talking about it becomes the ‘elephant in the room’ – for friends, colleagues, family members and especially, for children.
Why discuss mental health with children?
All parents at some time in their parenting life will come across issues that are challenging to talk about with children. Many of the issues that used to be taboo and difficult to discuss with children such as sex, death and substance use are more openly discussed by parents and educators and, because of that, are less confusing. However, mental health and in particular mental ill-health are still poorly understood by most people.
This and the accompanying stigma of mental illness can prevent people talking about it, its effect on families and on the person with the illness. It can mean people don’t ask for help when it might be most needed. Additionally, how mental health is described and (mis)understood, including the terms used, will vary enormously across cultural contexts. Language is used interchangeably throughout this – mental ill health, emotional and social wellbeing, mental health challenges, mental illness, mental distress. You can use the language that best fits for you and your family.
Children worry less about something if they understand it. Providing children with opportunities to talk with their parent(s) or other trusted adults about times parents struggle or are unwell, may help reduce their worries. If children don’t understand and don’t have things explained to them, they may fill their gaps in knowledge with information that is wrong. They may believe that they are to blame for the struggles they are seeing around them. Children may believe that they will go on to develop the same mental health challenges as their parent. They may also believe, in the absence of an explanation, that their parent who goes into hospital because they are sick is going to die, because their sick grandparent died in hospital. Children often express great relief at knowing that their parent is safe and receiving help, in whatever form, and to know that it is not their fault.
Parents too who are living with mental ill-health worry about the effect this may have on their families and on their children. They often talk about the shame they feel and, like children who do not have enough correct information, blame themselves for their struggles with their mental health. Too often parents easily forget all the great things they are doing as a parent. They may think that if they talk openly about their illness that their children will be frightened, confused, embarrassed, or would not understand. This can lead understandably to silence and isolation.
“I used to think that it was my fault but now I’m older and I know that
it’s not my fault.”
It can be hard to find the right words when talking with children about their parent’s mental health. Adults often find it difficult to talk to other adults about mental health struggles, and many parents have expressed anxiety about talking with their children about their mental health. This is understandable. A good start is the parent and other adults in the family finding out as much as they can about mental health and mental ill-health and thinking about how they might share this safely with children. It is important to carefully consider language – what is already used in the family/by the child to describe mental health challenges and what feels most comfortable, for both adults and children. Be encouraged by knowing that children are better off with simple, accurate, age-appropriate information. This is almost always best coming from their parent/s or other significant adults from their family, friend or supporter network.
Most children are resilient. As a parent or carer, you would know that children often sense problems (they are such noticing beings!). Child and family research tells us that children benefit from understanding what is happening in their family, including the difficulties, in ways they can comprehend.
Some key messages that help children
Much has been learned about the things that are helpful when talking with children about their parent’s mental health. This has been learned from children and young people themselves, their parents and family members, adults who have reflected on their experiences and people working in this field. Some helpful things for children to know and remember are:
- You are not the cause of your parent’s mental health challenges.
- It is not your job to fix things or be responsible for your parent’s emotional and social wellbeing.
- You are loved, strong, and cared about.
- Your parent will have ups and downs like any person – a day when you notice they are not doing so well does not always mean they are becoming unwell. It is always best to ask someone if you are worried or confused.
- You are not the only one who has a family a bit like yours. In your school, most likely every 4th or 5th student in the classroom will have a parent with mental health challenges.
- All your feelings are OK! It’s important to find ways to express them –through talking, sport, music, art, drama, writing, play.
- You will not automatically have the same mental health challenges as your parent. In fact, it is more likely that you will not.
- Taking care of and being loving towards yourself is important. Having fun is important!
- You can talk to your parent/family member/teacher/friend about what is happening at home.
Setting up and preparing for conversations
- If children ask questions about their parent’s mental health, this usually means they want answers and is a good window of opportunity.
- Choose a space and a time which is comfortable for children and the adults involved, preferably where you will not be disturbed.
- Involve family members wherever possible and be clear about the purpose and scope of the discussion.
- Be realistic about what can be achieved.
Check out with children what they think and what they already know. They may have a considerable amount of information and it is important for adults to know this and perhaps understand how they came to learn this. Parents often think their children aren’t worried or don’t know anything because they do not ask any questions. It is important not to assume that being quiet means they understand. Talking to children about what they understand is happening and what they have noticed about how their parent is behaving is an important first step. It can also dispel any myth they may have that it should not be talked about.
Reassure. Children may feel awkward when they talk about these kinds of things. They particularly may be reluctant to express sadness or anger to the parent who is unwell for fear of causing worry or concern. Children are also intensely loyal. It is important they are told that adults understand they may be feeling awkward or worried and that they may not feel like talking much.
Listen carefully! Don’t try to ‘interpret’ what they are asking or have experienced but ask questions to check you have understood properly what they have said or told you.
Ask ‘open’ questions. More discussion may occur when you ask questions or make statements that require more than a ‘yes’ or ‘no’ answer. Encourage children to put things in their own words.
Be yourself. Use a clear, simple manner and avoid using tones that imply pity or could sound patronising.
Be honest. You may not have all the answers to the questions your child has and may need time to get more information and consider your response. At those times you can reassure your child by saying, “Wow, that is a really interesting question! You certainly notice a lot. Can I think more about that and get back to/talk with you a bit later about that?”
Have ready a range of paper, coloured pencils, modelling clay or playdough, art or craft material, whatever feels OK for you and the young person you are with.
Using examples to illustrate the conversation
Talking with children about their parent’s mental health using an analogy (or a way of thinking about it) can be helpful, such as asthma or allergies. Asthma is generally well recognised by children; most have a friend who has asthma attacks or who have things they can’t eat. It can occur ‘out of the blue’ and can be frightening for the onlooker if the attack is severe. It requires immediate treatment, medication and sometimes hospitalisation. The cause of asthma and allergies, like mental illness, is unknown but it is good to know what the triggers are, how to try to prevent attacks and what to do to help the person.
Another example is using the analogy of the brain like a car engine. This example will not suit everyone and the age of the child needs to be considered, but it can be easily adapted for younger or older children. The following is a just a guide.
Car Engine Analogy
We all have a brain and each one is unique and special. The human brain has lots of different parts that do different things. They all need to work together for us to eat, sleep, talk, walk, feel, and so on. It is a very complicated part of the body, so complicated in fact that scientists are still trying to understand what makes it work and what to do when the brain gets into difficulty. When this happens, it can affect the person and how they behave. How they talk, think, feel, and what they do. This can be very scary for the person and also for the people who love them.
One reason why it can be hard to understand the brain is that we can’t see inside it to figure it out. It would be easier if we could! If you look inside the bonnet of a car you can see the engine. Each car engine is unique and special and important.
It is also quite complicated. It has bits that go round and about, up and down, water and oil to keep the parts moving, plugs and so on. If just one bit stops working correctly, the car starts to ‘behave’ differently. It may shudder, it may not start at all, it may blow smoke, it may make new noises. It can happen out of the blue and maybe a real hassle for the family. And it may need to be fixed by a special person, a mechanic.
In a similar way, a person’s brain may not work properly sometimes and needs extra help to work, not by a mechanic, but by a doctor (a psychiatrist) or a counsellor who can talk things through, maybe with medication, (tablets, medicine or injections), maybe some time away for rest. You may notice this is happening because my/your mum or dad’s behaviour may change. I/your mum or dad may seem extra angry or extra sad; I/they may be staying in bed a lot and not be able to do the things they usually do. I/they may say or do things that seem strange to you. But they/I am still your mum/dad.
Just as the car may need to go to the garage to be helped, I/your mum or dad may need to go to hospital to get extra help to get better and come home again. The people there have special training, so they know the best way to help me/your mum or dad.
Cars need to be looked after so that they won’t need a mechanic too often. People need to look after themselves too and this may mean taking medication, getting enough rest and breaks or talking about how they feel to others. Sometimes finding the right kind of medication can take a while and this can be frustrating. All these things will help cars to keep moving and people with mental health challenges to stay well.
“I can be more confident around other people about my mum now
I know what’s wrong.”
After using examples like those described above, parents/carers/health workers/teachers can elaborate further or offer more time for questions. Keep checking in with the child or young person to make sure that they understand what you are saying, and that you have heard them correctly. it can also be important to reassure children/young adults depending on their age that they might not understand this all at once and can ask more questions later.
Planning for relapses or unexpected events
Sometimes even with everyone trying to help to make things better, crises can occur, and these times can be very worrying and scary for everyone, particularly for children. It is a really good idea to have an agreed upon plan, rather like a Bushfire Plan, for times like these. People who live in the country or near forests have bushfire plans that the whole family knows about, and which is kept somewhere visible.
In the same way, a Family Action Plan for example can avoid last-minute decisions having to be made when everyone might be very stressed and panicky about what is happening. It should include 24-hour numbers that a child or young person can call. This could be Kids Helpline for example or a family member/friend. A Family Action Plan should be made with as many people involved as possible developing it, with the child/young person, at a time when people feel calm and well. A Family Action Plan provides instructions for the child’s care when their parents are unwell or unavailable.
These types of explanations can easily be adapted for all ages and can be shortened or extended. Other ways to approach talking with children about their parent’s mental health include using drawings or puppets.
Check out the Emerging Minds website for more resources, age specific information and downloadable handouts.
Children understand things differently at different ages. Keep in mind the words and examples you chose and use your own unique understanding of your child to guide you. Find other trusted adults to help you. They may also be able to help you explain your experiences with mental illness to your child. Your child’s teacher or an identified person at school may be able to sensitively provide you and your child with support. Above all, remember you are the expert in your child’s life and know them best. Take time for yourself, think about self-care and self-compassion as an integral part of your life, and celebrate your role as a parent in all its complexities.