There are methods to try when working with a family who are experiencing mental health issues. There are also some methods that are considered outdated and no longer best practice. Look at the outline below to see what to do and what to avoid.
What to try
At the core of these practice considerations is direct work with families. Help parents overcome the practical obstacles to better mental health, such as finances, their schedule and transport, as well as planning about what to do if they become very unwell.
Keeping parents healthy and safe keeps children healthy and safe too. Use time with the family to build trust through a genuine working relationship.
When working with families:
- be optimistic about the family’s future
- model healthy behaviours — such as demonstrating to parents how to talk to children about mental health and wellbeing
- encourage parents to take care of themselves.
Help parents to talk to their child about their mental illness
It is common for parents to think it’s better to avoid talking to children about their mental illness, to protect them from stress and confusion. Yet research shows that when parents talk openly about their struggles, in language their child can understand, it actually helps the child to cope better. It can help them to make sense of the changes that they observe in their parents when they’re unwell and to know that they’re not at fault or somehow responsible for looking after them.
Parents may need help from Child Safety or another health or helping professional, to think about the best way to discuss their mental health difficulties with their child.
Encourage parents to be physically healthy
Physical health and mental health are closely linked. Encourage parents to look after themselves — get enough sleep, exercise, eat well and set aside time for the things they like to do. Learn more about physical activity and mental health, tips for healthy eating and sleep.
Get help for new parents
Ask the Child Health Service to visit or make extra visits to the home to support the parent and baby. Also find out if there are early parenting support groups and playgroups in the family’s local area.
Help parents seek mental health treatment
Talk to the family and mental health practitioners about options for referrals to therapy and counselling services.
Support parents to build a wider network of support by linking in with a mutual support group like GROW — a community-based organisation across Queensland and Australia that help people recover from mental health issues.
Find out if the family has a mental health treatment plan. If not, take steps to get one put in place — talk to the parent about getting a review with their General Practitioner, or supporting a referral to the local mental health service. Talk to the parent and mental health professional about how the child should be included in the plan. When appropriate to do so, make sure the child is aware of the plan.
Encourage parents to plan ahead for if they become unwell. Use these COPMI templates to help you develop plans with the parent:
- Family Care Plan (whole family)
- Care Plan for Kids and Young People (parent to help complete with their child)
- Baby Care Plan (parent to complete about their wishes for their baby).
Focus on practical assistance
Consider what practical help Child Safety or other services can give the family to help manage the stressors of day-to-day life. They may need help with:
- safe and affordable housing
- developing a household routine
- financial planning and assistance
- accessing parenting resources, like parent hotlines and websites
- good quality child care
- support for carers
- information about free and low-cost community activities and school holiday programs.
Look for opportunities to build the family’s social networks in the local community and think about who can help parents make changes. Start with the local school, playgroups, and sporting or support groups.
Consider practical ways to support and measure whether the family is achieving the goals to make the child safe. Consider tracking these goals by using scaling tools. To check-in on how a family is doing, ask:
- Is the child going to school regularly?
- Is the parent attending appointments? If so is this working to create change?
- Is the parent taking medication? If so is this helping?
- How is the parent talking about how they are feeling?
Focus on the child
Take action to support the development and wellbeing of the child such as:
- get them into a good child care
- organise home visits
- set up family support services
- develop a Family Care Plan to plan support for families and children when a parent becomes unwell or requires hospitalisation.
Think about how to help a child in practical ways. This includes identifying who they can turn to for help.
A child may need:
- behaviour support
- peer support
- help with homework.
Increase the child’s connections and visibility in the broader community through:
- sporting teams
- community groups
- school activities
- culture or faith-based groups
- family and friends.
Link the child with support services that meet their needs such as:
- telephone and face to face counselling
- link up services
- Kids Helpline
- Young Carers Network.
Help the parent to focus on their child’s wellbeing
Parents may need support to think about their child’s wellbeing. Encouraging parents to consider and support their child’s social and emotional development can help to prevent their child experiencing their own mental health difficulties.
Help parents to:
- enhance their understanding of their child’s social and emotional development
- talk about their child’s behaviour and whether this is typical for their age and stage of development
- think about whether their child needs further support
- inform parents about what supports are available and how to access those supports.
See this Emerging Minds resource for further information.
What to avoid
Some actions get in the way of positive change. A generic, intrusive and pathologising approach to care can be detrimental both to a person's mental health and to a child's care and safety.
Case planning around a diagnosis
It is important not to case plan around a diagnosis or rely on a mental health assessment as your case plan intervention. These will not fully address the care and protection strategies needed to keep a child safe.
When interventions recorded in a case plan are too generic, such as ‘get a mental health assessment’ or ‘engage in relapse prevention’, families are set up for potential failure. Be more behaviourally specific and link interventions to measurable goals and positive outcomes for children.
Be practical about what a family is being asked to do. Sometimes setting up too many supports and interventions can cause stress for parents as they struggle to schedule everything into their day. Make sure parents can attend appointments and follow up on any additional therapeutic work they have to do alongside their everyday commitments and lifestyle.
Pathologising normal reactions
Stress, frustration and anger are emotions a person may experience in response to their own mental health issues and life’s commitments and pressures. These are also normal reactions to having Child Safety involved in their family’s lives. Do not always assume these expressions are a part of a person’s mental illness.
Not listening to the family about what they want
Set goals with the family not for them. Take a collaborative approach and listen to what they need and want.
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