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5.5 Working with Parents with Mental Health Problems

RELATED GUIDANCE

Mental Health Crisis Care Concordat – Improving Outcomes for People Experiencing Mental Health Crisis

AMENDMENT

This chapter was updated in September 2014 by adding a link to the DoH, Health Crisis Care Concordat – Improving Outcomes for People Experiencing Mental Health Crisis.

Mental illness in a parent or carer does not necessarily have a negative effect on a child but it is essential always to assess its implications for any children involved in the family. For example:

  • Parental illness may noticeably restrict children's social and recreational activities.
  • With both mental and physical illness in a parent, children may have caring responsibilities placed upon them inappropriate to their age, leading them to be worried and anxious;
  • If they are depressed, parents may neglect their own and their children's physical and emotional needs;
  • In some circumstances, some forms of mental illness may blunt parents' emotions and feelings, or cause them to behave towards their children in bizarre or violent ways;
  • Unusually, but at the extreme, a child may be at risk of severe injury, neglect, or even death. A study of 100 reviews of child deaths where abuse and neglect had been a factor in the death, showed clear evidence of parental mental illness in one-third of cases;
  • In addition, postnatal depression can also be linked to both behavioural and physiological problems in the infants of such mothers.

The negative effects on children of parental mental illness are less likely when parental problems are mild, last only a short time, are not associated with family disharmony, and do not result in the family breaking up. Children may also be protected when the other parent or a family member can help respond to the child's needs. Children most at risk of suffering significant harm are those who feature within parental delusions, and children who become targets for parental aggression or rejection, or who are neglected as a result of parental mental illness.

It is particularly important in these cases that adult and children's services staff work closely together, recognising complementary roles. Those staff working with the adults should always consider the implications for children of adult problems. At the same time, staff whose primary focus is the safety and welfare of the child should give consideration to the needs of all family members.

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