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Overview of mental health and wellbeing of parents
Many parents with mental illness have the capacity, strengths and supports to help their children thrive by parenting in safe, consistent and nurturing ways. Some parents may even develop positive parenting strategies because of their lived experiences. However, without the right support, parental mental illness has the potential to impact on children’s mental health, development and wellbeing (Emerging Minds (b)).
Identifying where a parent is currently on the mental health continuum will guide constructive engagement across the child protection continuum. (Refer to Defining mental health.) This can then steer conversations to identify and discuss risk and protective factors present, the impacts for the child and plan for appropriate supports.
Practice prompt
Consider a parent's mental health concerns beyond their diagnosis. Reflect on how these concerns may affect their child and influence the parent's capacity to ensure their child's safety and wellbeing.
Consider the impact that medications a parent is taking may have on their capacity. (Refer to medications and risk management.)
A parent experiencing mental illness or mental health difficulties does not automatically pose a risk of significant harm to their child. For example, Parent A, as illustrated on the continuum image, has a diagnosed mental illness and maintains a high mental wellbeing with support from professionals and family.
If a parent’s poor mental health is affecting how they function in their daily life and is not being managed, it will likely have an impact on their child. For example, as illustrated on the continuum image above, Parent B has no diagnosis but is observed to be languishing, showing low mental wellbeing and struggling with daily functioning.
The following 4-minute video explains the parent-child relationship loop.
Risk assessment and mental health and wellbeing
Mental illness or low mental health and wellbeing can place a lot of stress on a family. This stress can affect the child’s ability to develop positive mental health, impact the parent-child relationship, disrupt daily routines, relationships and connections (Emerging Minds (b)).
Practice prompt
Explore each aspect of the child’s experience and environment to determine the impact a parent’s mental health and wellbeing is having on their child and if this constitutes harm to the child.
It is important to approach the conversation with curiosity, respect, and sensitivity.
The prompts below can be used to guide your assessment.
Understanding the parent’s awareness and experience
- Does the parent understand the concerns about how their mental health may impact their child?
- Can they reflect on how their mental health affects their parenting role?
Patterns and symptoms
- Is there a pattern in the parent’s mental health presentation or experiences?
- What is their history of mental health issues, and how long have they experienced them?
- How severe are the symptoms, and how do they affect daily functioning and parenting?
- Are there noticeable changes during periods of wellness and illness?
Impact on parenting and the child
- How does the parent manage their parenting responsibilities during periods of poor mental health?
- When unwell, is the care provided to the child adequate for their age and developmental stage?
- Does the child feel scared, neglected, or responsible for the parent’s wellbeing?
- Is the child’s development, learning, or social engagement affected?
- Consider the 5 domains of a child’s life and identify if harm has occurred, is occurring or at risk of occurring. (Refer to Impact on children.)
- What does a typical day look like when the parent is feeling well versus when they are unwell?
Medication and Functioning
- How does the parent’s use of medication impact their day-to-day functioning and ability to respond to their child’s needs?
Safety and Support Networks
- Who is in the family’s safety and support network, and what are their roles and responsibilities?
- Does the parent have support during difficult times?
- Is the parent’s mental illness being used against them, such as in situations involving coercive control? (Refer to the practice kit on Domestic and Family Violence: intersectionality and vulnerability.)
Cumulative Harm
- Is the parent’s condition chronic, and is the impact on the child causing cumulative harm? (Refer to Impact on children.)
Culture and cultural identity considerations
Culture and cultural identity are central to social and emotional wellbeing for Aboriginal and Torres Strait Islander peoples. The 7 domains identified by Gee et al. provide a culturally grounded framework to explore both risk and protective factors contributing to a parent or child’s mental health and wellbeing. (Refer to Evolve Therapeutic Service’s resource Aboriginal and Torres Strait Islander Peoples’ Social and Emotional Wellbeing: Domains, Contributing / Risk factors and Protective Factors.)
Practice prompt
When assessing risk to an Aboriginal or Torres Strait Islander child, it is essential to consult with a cultural practice advisor to work towards culturally informed decision-making. (Refer to Cultural considerations for risk assessment and future actions.)
Likewise, when assessing risk for a culturally and linguistically diverse child, consult with a cultural liaison officer and use an accredited interpreter.
Risk factors
Specific to mental illnesses, the risk of significant harm to a child increases when any of the following factors are present:
- The child is part of the parent’s delusions or accepts the parent’s delusions as reality.
- The child is involved in the parent’s obsessive or compulsive behaviours.
- The child is a target of the parent’s aggression or rejection.
- The child takes on caregiving responsibilities inappropriate for their age (parentification).
- The child witnesses disturbing behaviours linked to the mental illness, such as non-suicidal self-injury, suicide attempts, uninhibited behaviour, violence, or homicide.
- The child is physically or emotionally neglected by the parent experiencing low mental health.
- The child is not adequately protected when visiting or staying with the parent experiencing low mental health, even if they do not live with them.
- The child is at risk of severe injury, profound neglect, or death due to the parent’s behaviours.
- An unborn child is at risk when the pregnant person has a current or past diagnosis of a mental illness or behaviours which pose risk of harm to self or others.
(London Safeguarding Children Partnership)
Intersecting risk factors
The risk of harm to a child magnifies when multiple risk factors coexist. Some risk factors, such as substance use and domestic and family violence, are more likely to occur alongside mental illness, compounding the impact on parenting capacity and child’s safety.
Substance use and low mental health and wellbeing
The relationship between mental illness and substance use is complex as people with a mental illness are at an increased risk of substance use and those who use and misuse substances are at a higher risk of developing mental illness (Australian Institute of Health and Welfare (b)). In some cases, a parent may 'self-medicate' with substances or misuse prescribed medication. Alternatively, a parent’s use of a substance may contribute to their initial symptoms of mental illness, such as substance-induced psychosis.
Severe substance use can:
- significantly reduce effectiveness of intervention for healing or management of low mental health and wellbeing
- mask mental health symptoms by altering or influencing the mental health presentation
- increase unpredictability in parenting behaviour.
Domestic and family violence and low mental health and wellbeing
When the parent experiencing violence has low mental health and wellbeing
When a parent experiencing domestic and family violence also has low mental health and wellbeing, the impact on their child can be significant. The trauma, fear, and isolation associated with violence can worsen the parent’s mental health, often causing or intensifying conditions such as anxiety, depression, and post-traumatic stress disorder. This emotional distress can leave the parent felling physically and emotionally paralysed making it hard to escape and focus on their child’s needs.
The person using violence may further undermine the parent’s confidence in their ability to care for their child, further reducing their capacity to provide consistent and nurturing care. Isolation from family, friends, and community supports often leaves the parent without the resources or strength to meet their child’s needs – increasing vulnerability.
The chaos and unpredictability of violence disrupt routines such as meals, school attendance, and bedtimes–affecting the child’s attachment and sense of stability and predictability. Children exposed to violence may become acutely aware of their parent’s distress, which can lead to feelings of fear, guilt, or confusion. As the parent struggles to cope, the child’s needs may be overlooked. In some cases, children may take on caregiving responsibilities, which can interfere with their own development and place long-term burdens on their wellbeing.
An intersectional lens and trauma-informed approach is needed to understand the impact of violence on parental capacity and mental health and child development.
When the parent using violence has low mental health and wellbeing
When a person using violence also has low mental health and wellbeing, the home environment can become increasingly unsafe and unpredictable.
Undiagnosed and untreated mental health conditions, such as personality disorders, affective disorders, trauma, or substance use, may intensify the severity of violent behaviour, and contribute to controlling, erratic or impulsive actions that make the home environment unsafe and unpredictable for a child.
When the person using violence focuses on controlling or harming the other parent, they become emotionally unavailable or neglectful, and unable to meet the child’s basic needs for safety, stability, and nurturing. As a result, the child may feel fear, grief and loss, confusion, guilt, shame, ignored, unloved, or unsupported, which can significantly impact their emotional development and sense of security.
A trauma-informed approach is essential to understand how the parent’s mental health and use of violence interact and affect their parenting capacity. It is important to recognise that mental illness can sometimes be used to excuse violent behaviour, for example, ‘he couldn’t help it because he is depressed’—a narrative that may be perpetuated by both the individual and by others.
In all cases, the child’s safety, wellbeing, and developmental needs must remain the highest priority.
Tip
Parental risk factors
Remain vigilant when assessing how a parent's mental health and wellbeing may affect their ability or willingness to meet the needs of their child. The presence of the following parental factors may indicate a parent's mental health concerns are detrimentally impacting their parenting capacity:
| Changed or altered view of their child | A parent may develop distorted perceptions of their child, such as seeing them as a burden, a source of stress, or even as a threat. This can lead to emotional neglect or inappropriate responses to the child’s needs. |
|---|---|
| Maladaptive coping strategies | Parents may turn to harmful coping mechanisms, such as substance abuse, non-suicidal self-injury or suicidal behaviours, which can impair their ability to provide a safe and stable environment for their child. |
| Lack of insight into illness and impact on child | A parent may not recognise how their mental health affects their child, or they may not act on this awareness. This can result in unmet physical, emotional, or developmental needs for the child. |
| Non-compliance with treatment or poor engagement with services | Failure to engage with mental health services or adhere to treatment plans can worsen the parent’s condition and can reduce their caregiving capacity. |
| Involuntary treatment orders | A history of treatment under the Mental Health Act 2016 (QLD) may indicate severe and ongoing mental health challenges that could compromise the parent’s ability to provide consistent care to the child. |
| Untreatable or long-term disorders | If a parent’s mental health condition is deemed ‘untreatable’ or cannot be managed within timelines that align with the child’s best interests, this may result in prolonged harm or unmet developmental needs for the child. |
| Compounding factors: domestic and family violence or relationship difficulties |
Relationship issues, including domestic and family violence, can intensify the negative impact of a parent’s mental health challenges, creating an unsafe or unstable environment for the child.For the person using violence, mental health concerns can fuel abusive behaviours and create barriers to change. For the person experiencing violence, domestic and family violence can severely impact their mental health, compounding the trauma and making it harder to escape the cycle of abuse. (Refer to Mental health concerns in the context of domestic and family violence.) |
| Isolation or poor support networks | Without social or community support, parents may struggle to meet their child’s needs, increasing risk of neglect. |
| Criminal offending | Criminal behaviour linked to the parent’s mental health challenges may result in instability, absence, or unsafe conditions for the child. |
| Non-identification of illness by professionals | Undiagnosed and untreated mental health conditions, such as post-natal depression, can go unnoticed leading to significant issues like attachment challenges for infants and children. |
| Previous engagement with child protection services | A history of child protection involvement, including concerns about other children, may indicate ongoing patterns of behaviour or circumstances that place the child at risk. |
These factors highlight the potential for a parent’s low mental health and wellbeing to compromise their ability to provide safe, stable, and nurturing care. Consider the following indicators holistically rather than in isolation:
- the child’s best interests
- the parent’s strengths and support system
- whether intervention is required to ensure the safety and wellbeing of the child.
Protective factors
When a parent with mental health concerns or a diagnosed mental illness is effectively managing their condition, a range of protective factors can help reduce risks to the child and promote positive outcomes for the whole family.
Culture and cultural identity considerations
Culture and cultural identity are critical to the social and emotional wellbeing for Aboriginal and Torres Strait Islander peoples. This resource produced by Gee et al. identifies 7 domains to a person’s social and emotional wellbeing which can be explored to identify both risk and protective factors contributing to a parent or child’s circumstance. (Refer to Evolve Therapeutic Service’s resource Aboriginal and Torres Strait Islander Peoples’ Social and Emotional Wellbeing: Domains, Contributing / Risk factors and Protective Factors.)
Protective factors related to the parent
- Effective management of mental health: The parent is actively managing their mental health through treatment, such as therapy, medication, or support groups, and demonstrates insight into how their condition may affect their child.
- Parental capacity and resilience: The parent maintains the ability to consistently provide care that meets the child’s physical and emotional needs and establish routines despite their mental health challenges.
- Strong parent-child bond: The parent has a positive, nurturing relationship with the child, fostering a sense of security and attachment. This may include a parent articulating and acting on their positive and specific hopes for their child.
- Willingness to seek help: The parent is open to accessing support services, including mental health professionals, parenting programs, or community resources, when needed.
Protective factors related to the child
- Secure attachment: The child has a strong emotional bond with the parent or another caregiver which provides a sense of stability and trust.
- Positive coping skills: The child demonstrates age-appropriate coping mechanisms and emotional regulation, often supported by the parent or other caregivers.
- Access to education and extracurricular activities: The child is engaged in school or community activities which provide structure, social connections, and opportunities for personal growth.
- Supportive relationships: The child has access to a safety and support network of trusted adults, such as extended family, teachers or mentors, who they feel safe to speak to and in turn they provide emotional and practical support.
Protective factors related to the family and environment
- Stable home environment: The family maintains a safe, predictable, and nurturing home environment, free from violence or significant disruptions.
- Supportive co-parenting or extended family: Other caregivers, such as a co-parent or extended family members are actively involved in the child’s life and provide consistent support.
- Access to community resources: The family has access to mental health services, parenting programs, financial assistance, and other community supports that help reduce stress and promote stability.
- Social connections: The family is connected to a supportive social network, reducing isolation and providing emotional and practical assistance.
Protective factors related to professional involvement
- Early intervention and monitoring: Professionals, such as mental health practitioners or teachers are aware of the parent’s mental health challenges and provide ongoing support and monitoring to ensure the child’s needs are met.
- Trauma-informed care: Professionals working with the family adopt a trauma-informed approach, recognising the potential impact of the parent’s mental health on the child and addressing it sensitively.
- Child-centred practice: Professionals working with the family use respectful conversations with parents exploring how the parent’s mental illness or low mental wellbeing (or additional co-existing risk factors) may be impacting their parenting, hopes for their child and their child’s experiences.
Impact on children
Exploring the impact of a parent’s mental illness or low mental wellbeing on their child can be complex. To support this process, Emerging Minds offers a framework (PERCS) that highlights key factors influencing a child’s social and emotional wellbeing, structured into five key domains (Emerging Minds (b)):
5 Domains |
Impact |
| Parent-child relationship | Parents with low mental wellbeing may:
|
| Emotions and behaviours | Parents with low mental wellbeing may:
|
| Routines | Low mental wellbeing can disrupt:
|
| Communication and meaning making | Secrecy or stigma around mental illness, parental guilt or shame, and the lack of a shared language and understanding about a parent’s mental health and wellbeing can create a family dynamic where children may:
|
| Support networks | Stigma or secrecy around mental health may lead to:
|
Use the following resources provided by Emerging minds to support collaborative and respectful conversations with parents:
- PERCS Domains
- PERCS Conversation Guide - Summary
- PERCS Conversation Guide – example questions
- In focus: Parent-child relationships.
Impact of parental low mental health and wellbeing on children by developmental stage
The following table explores how a parent’s low mental health and wellbeing may affect a child during different developmental stages. This summary can be useful when you are deciding what kind of support to provide the family. You can also use this as a tool to talk to parents about what their children may need, depending on their age and development.
Infant
|
Infant’s experience |
| The infant learns basic trust to prepare them for all future relationships. Connection and attachment play a crucial role in the development of the ‘self’:
|
'I need you to keep me safe and warm. I need you to feed me when I’m hungry, change my nappy, come to me when I cry and help me fall asleep. That’s how I learn you can be trusted. If you don’t do these things, it makes it hard for me to bond with you.' 'If you are worried, I get worried too.' 'I need you to notice what I’m doing and respond to me when I cry. If you notice what I’m doing, I’ll learn that you can meet my needs. If you don’t always respond, I will learn that my needs aren’t important and that grown-ups can’t be trusted.' 'I need you to enjoy my company — look into my eyes, sing to me, play with me and show me you love me. This helps my brain to develop.' 'If you have to go into hospital, I need someone who can keep my routine the same.' |
| Potential impacts | |
|
Disrupted bonding and attachment Parents may struggle to respond consistently to their infant’s cues, for example, crying or feeding, which can affect secure attachment formation. Reduced emotional availability A parent experiencing low mental wellbeing may appear withdrawn, anxious, or overwhelmed, limiting emotional connection. Inconsistent caregiving routines Feeding, sleeping, and soothing routines may be irregular, affecting the infant’s sense of safety and predictability. Delayed developmental milestones Lack of stimulation and responsive interaction may impact early cognitive, motor, and social development. |
|
Toddler
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Toddler's experience |
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More awareness of the consequences of behaviour. Beginning of self-confidence. Time for exploration. Begins to use symbols (images, words or actions that stand for something else). Begins socialising and language development. Developing autonomy and independence. Learning emotional regulation. Beginning language and social interaction. |
'I’m growing but I’m not big enough to look after myself. I still need you to feed me, bathe me, play with me and keep me safe, warm and clean. If you can’t help me with these things, I might get hurt or sick.' 'I am learning to adjust to different situations and people. I am exploring my world and learning new things. But I still need you to be near me and keep me safe.' 'I don’t understand the reason why you might be sad, worried or upset. I also don’t understand the way other people respond to you when you are not feeling well.' |
| Potential impacts | |
|
Emotional dysregulation Toddlers rely on caregivers to help manage big emotions. A parent with low mental wellbeing may struggle to co-regulate, leading to tantrums or withdrawal. Behavioural challenges Inconsistent responses to behaviour may confuse the child, leading to increased frustration or acting out. Reduced interaction may affect language development and opportunities for imaginative play. Role reversal Some toddlers may begin to take on caregiving roles (e.g., comforting a distressed parent), which can interfere with healthy emotional development. Social isolation If the parent withdraws from social networks, the child may have fewer opportunities to interact with peers or attend early learning environments. |
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Pre-schoolers
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Pre-schooler’s experience |
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Autonomy and mastery. Socialisation continues. Child needs safety to explore the environment. Expanding imagination and play. Learning social norms and emotional expression. Building independence and self-concept. |
'I am still learning a lot about my world. I need you to help me stay safe while I’m doing this. If you try to stop me exploring, I’ll think I’ve done something wrong — this can make me feel ashamed or worried.' 'I still don’t really understand what might be making you sad or worried, but I’m starting to notice that other people treat you differently, depending on your mood.' 'I learn by watching you. If you act like the world is a scary place then I feel scared too. This can make it hard for me to try new things or talk to new people.' 'If you don’t help me, I might try to do things that are too hard for me like boiling the kettle to make noodles. Or I might stop trying to learn new things and wait for you to help me out again.' 'I need you to be consistent with the rules in our house. It’s confusing when you sometimes let me do what I want when you are happy and are really strict when you are sad or tired. I might stop doing things I know how to do because I am worried about how you will react.' 'I might spend a lot of time watching you to see what sort of mood you are in. If I think you aren’t coping very well, I will try to look after you.' 'I need my daily life to be predictable. I need you to feed me, take me to appointments and pick me up from preschool on time. If you are unwell, I need someone else to help me with these things, otherwise I don’t feel safe.' 'If you become ill, or need to go into hospital, I feel very sad and lonely. I worry that you may not come back. I might start acting like a much younger child or forget how to do some of the new things I have learnt.' 'When things at home are chaotic, I don’t know what’s going on. It makes me worried. Sometimes I get so worried that I don’t want to leave you alone in case something happens to you.' 'When I see you worried about everything, I don’t know if it’s real or not — that makes me scared.' |
| Potential impacts | |
|
Increased anxiety or aggression Children may act out or withdraw in response to parental distress or unpredictability. Confusion about parental behaviour Without age-appropriate explanations, children may feel responsible or ashamed. Reduced play and learning Lack of stimulation and structure may affect school readiness and creativity. Difficulty forming friendships Emotional insecurity may impact peer relationships and trust in adults. Exposure to adult stress Children may overhear or witness distressing conversations or behaviours, leading to premature emotional maturity. |
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Middle childhood
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Child's experience |
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Emotional development. Educational adjustment. Development of a sense of competence and importance. Onset of puberty:
|
'It makes me nervous when you think people are watching us. I start to look out for those people too. When you say we can’t trust anyone, it makes it hard for me to make friends and believe adults.' 'I know when you are sick, you need help to get better. But sometimes I feel left out. I might do something silly or wrong to get attention.' 'If I grow up with screaming, yelling and name calling, I get used to this. I don’t like it but I learn to expect it.' 'Sometimes I have big feelings and I need you to help me understand them. If you can’t help me understand my feelings, it makes it hard for me to make friends and learn new skills.' 'I need to start learning about who I am as a person, what I like and don’t like and who I want to be. This is hard for me to do if I need to spend a lot of my time looking after you. When I look after you, lots of people think I’m very grown up but inside I feel like a little child.' 'If my world feels out of control, I might try very hard to keep everything in order.' 'Belonging is very important to me. Although I will always belong with my family, I want to start feeling like I belong with my friends too. I’m noticing similarities and differences between my family and my friends. It’s important to me that you know who my friends are and help me to learn how to stay connected with people who are good for me. If I don’t have good role models, I might choose to hang out with unsafe people. I may start to drink or use other drugs to block out what is happening at home (aged 10+ years)' 'I don’t want to bring my friends home in case you are unwell and say something that makes them tease or bully me.' 'When I feel that I need to come home after school to make sure you are okay it means that I don’t get to other activities, like sports and clubs.' 'Sometimes my teachers say I’m being disruptive or not concentrating. I don’t mean to do those things but it’s hard to focus when things at home are up and down.' 'I am learning to adapt. I know that there are things I can’t talk about with my friends. I have learnt that the rules are different in different places.' |
| Potential impacts | |
|
Internalising behaviours Children may experience guilt, worry, or sadness about their parent’s wellbeing, often without expressing it. Externalising behaviours Anger, defiance, or attention-seeking may emerge as coping mechanisms. Academic challenges Disrupted routines or lack of support may affect concentration, homework completion, and school attendance. Social withdrawal Children may avoid friendships or feel embarrassed about their home life. Caregiving roles Some children may take on responsibilities beyond their age, such as cooking, cleaning, or caring for siblings. |
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Early adolescent
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Young person's experience |
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Accepting their physique and using the body effectively. Achieve new and more mature relations with age-mates of both sexes. Peer groups are becoming very important. Achieve emotional independence from caregivers and other adults. Desiring and achieving socially responsible behaviour. Expanding imagination and play. Learning social norms and emotional expression. Building independence and self-concept. |
'Sometimes I feel ashamed that you have a mental illness. Then I feel guilty about feeling ashamed, because I know it’s not your fault. I get worried this might happen to me too. When I feel like I can’t talk to people, it feels like I’m carrying a big secret around with me all the time.' 'I feel sad about your mental illness but sometimes I also feel angry about it. I know it’s not always bad, but I wish our lives had been different.' 'Belonging is even more important for me now. Sometimes my friends do things that I don’t really want to do, like drinking or staying out late. I need to know you notice these things. When you put in boundaries, it lets me know you care about me being safe.' 'Sometimes I feel confused about who is the grown up at home. I know it’s you, but when I’m with my friends I feel a lot more mature than them, because of how things are at home. That makes it hard for me to feel close to them.' 'Lots of things are changing for me right now. My body is changing and so are my thoughts and feelings. There are lots of new hormones in my system. I need adults to be positive about who I am and support me when I feel worried about the future, or the way that I look.' ‘It is hard for me to notice what is going on for me, when I feel like I need to take care of my parents and my siblings.' 'I really want to feel close to you, but sometimes your illness makes me feel like you are very far away, especially if you are in hospital. If I don’t feel close to you, I may express it by taking risks like running away or experimenting with substances.' ‘There are lots of strong feelings in our house and I don’t always know what they are going to be. When I don’t know if you will be happy or sad it makes me feel like I’m walking on eggshells. I ‘switch off’ when I get to school, but my little sister is doing really well. It’s like she’s trying to keep everything perfect at school.' |
| Potential impacts | |
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Emotional burden Young people may feel responsible for their parent’s wellbeing, especially if mental health is not openly discussed. Identity confusion Parental instability may affect self-worth and confidence, particularly during a time of identity formation. Social withdrawal or peer conflict Shame or secrecy about family circumstances may lead to isolation or bullying. Academic disengagement Stress at home may reduce concentration, motivation, or attendance. Early caregiving roles Young people may take on responsibilities such as caring for siblings or managing household tasks, which can interfere with their own development. Increased vulnerability to anxiety or depression Exposure to emotional distress or trauma may lead to internalising behaviours. Difficulty expressing emotions Young people may suppress feelings to avoid burdening others or due to fear of stigma. Young people may engage in high-risk behaviours as a way of seeking control over their own life, to gain attention or express unmet emotional needs. |
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Late adolescent
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Young person's experience |
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Achieving emotional independence from caregivers and other adults. Preparing for financial independence. Preparing for significant intimate relationship and family life. Developing their sexual identity. Establishing independence and autonomy. Exploring values, beliefs, and future goals. Forming intimate relationships. Transitioning to adulthood (education, employment, housing). |
'I am almost an adult now and it’s time for me to become more independent, both physically and emotionally. There are things I would like to try, but it’s hard for me to step out on my own because I have responsibilities at home.' 'I feel like some of my choices are limited in comparison to my friends. I think it’s because I missed quite a bit of school, and I don’t feel very confident in what I can do. It can be hard for me to commit to things, especially when you are unwell, and everything is up and down.' 'I don’t know if I’ll ever be able to do the things my friends are doing, like getting a job and finding a partner. It feels like all my time is taken up at home.' 'I’ve read that some mental illness can be inherited. I get really worried I might get unwell too. Every time I feel a bit down, I am scared that I might be getting depressed.' |
| Potential impacts | |
|
Mental health risks Increased likelihood of depression, anxiety, non-suicidal self-injury, or substance use, especially if the young person feels unsupported or overwhelmed. Parentification Teens may take on adult roles, including financial management or emotional support for parents, which can delay their own transition to independence. Conflict and emotional distancing Young people may struggle with boundaries or feel emotionally disconnected from parents. Reduced future planning Stress at home may limit engagement in education, employment, or goal setting. Risk-taking behaviours Some may seek escape or control through risky behaviours, including unsafe relationships, substance use or criminal behaviour. Barriers to help-seeking Fear of stigma, loyalty to family, or lack of trust in services may prevent young people from accessing support. Disrupted transitions Parental instability may affect readiness for leaving home, entering the workforce, or pursuing further education. |
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Tip
Further reading
Medications and risk management
Understanding how a parent’s medications affect their ability to care and meet the needs of their child can be complex. Always work with the parent’s health professional to get accurate information. Use the Choice and Medication© Leaflets provided by Queensland Health to find and print helpful information about specific medications. These include a variety of easy-to-read fact sheets and translations.
Practice prompt
Engagement strategies with parents
Support parents to understand how their mental health issues can impact their parenting and their child’s experience. This includes helping the parent notice and manage the symptoms of their illness.
Connect the parent with appropriate resources such as the Parenting with a mental health condition | Raising Children Network website.
Explore a parent’s past, present and future experiences with humility and compassion, to further understand their current situation within the context of their life. This helps to:
- build a trauma-informed understanding of what may be placing the child at risk
- best direct effective trauma-informed practice and intervention
- align the interventions to the Queensland Trauma Strategy (Queensland Mental Health Commission (b)).
Attention
The following table provides engagement strategies to support these difficult conversations.
| Start with empathy and curiosity | Use open-ended prompts such as:
|
| Build trust through consistency |
Show up reliably. Be consistent in your contact and follow-through. Explain your role clearly. Help parents understand your purpose is to support their child’s safety, not to judge or punish. |
| Validate strengths and efforts |
Acknowledge parents’ strengths and what they are doing well, even in small ways. Reinforce their role and importance in their child’s life. |
| Use trauma-informed approaches |
Be aware past trauma may affect how the parent engages with Child Safety or helping professionals. Offer choices where possible to increase a sense of control. Avoid re-traumatisation by being transparent and predictable. Avoid sudden changes or surprises in your approach. Be mindful of body language, tone, and pace—especially during stressful conversations. |
| Collaborate on safety planning | Involve the parent in identifying what helps them stay well. Ask:
Co-create plans for times when they may struggle to meet their child’s needs. Include the parent’s own strategies and supports. |
| Use reflective listening |
Repeat back what the parent says to show understanding.
|
| Respect cultural perspectives | Ask:
Engage cultural practice advisors or Aboriginal and Torres Strait Islander practice leader when appropriate. For culturally and linguistically diverse parents use cultural liaison officers and accredited interpreters where necessary. (Refer to Queensland Transcultural Mental Health Centre.) |
| Plan around the parent’s capacity |
Schedule meetings at times when the parent is most likely to be well. Break information into manageable parts and check for understanding. |
| Build relationships over time |
Consistency matters. Try to have the same worker engage with the parent. Use relational approaches For example, PACE (Playfulness, Acceptance, Curiosity, Empathy) to foster connection. |
| Reflect and repair | If engagement breaks down, revisit the relationship:
|
Note
Be mindful of the words you use when talking about mental health and wellbeing as the words have the power to promote hope and encourage change or exacerbate barriers and stigma. (Refer to Use of language.)
Further reading
If there are concerns about a parent’s ability or capacity to participate in the assessment, or take part in case planning:
- consult with the senior team leader and senior practitioner to identify who knows the parent and is best placed and suitably qualified to report on their capacity to participate and make decisions (for example, a mental health service or the Office of the Public Guardian)
- consult with a relevant specialist clinician or practice leader for their guidance on the specific circumstance
- seek endorsement from the CSSC manager on the recommended course of action.
When planning engagement with a parent, consider how gender shapes their identity, responsibilities, and help seeking behaviours. For example, young fathers may feel pressure to appear strong or emotionally detached, which can mask distress or reduce their willingness to access support.
Early engagement that acknowledges these gender dynamics can prevent behaviours from escalating to the point of needing clinical intervention. Be curious about how the parent’s gender influences their experience of parenting, mental health, and connection to services. This insight can guide more respectful, effective, and culturally responsive practice.
The table below provides prompt questions to start these conversations.
| To explore identity and gender roles |
‘Tell me what being a dad/mum means to you?’ ‘What expectations do you feel are placed on you as a parent?’ ‘How do you think your role in the family has changed since becoming a parent?’ |
| To support early intervention |
‘Sometimes people feel they have to cope alone. What’s helped you in the past when things felt overwhelming?’ ‘Have you noticed any changes in how you respond to stress or frustration lately?’ ‘What do you think your child sees or feels when things are tough for you?’ |
| To reduce stigma and promote help-seeking |
‘Lots of parents feel pressure to be strong all the time. It’s okay to ask for help - that’s part of keeping your child safe.’ ‘You’re not alone in this. We can work together to find support that fits you and your family.’ |
| To engage culturally |
‘In your culture, what does is look like to be good parent?’ ‘How is mental health talked about in your family and community?’ |
Further reading
Use realistic goals and interventions
Work with families to develop realistic case plan goals that are practical and meaningful to them. These goals should reflect what matters most to the family while also clearly outlining what the child needs to be safe and well.
Take time to explore what has and has not helped in the past to inform new plans are informed by the family’s lived experience. If the family has concerns about particular services, listen carefully and work together to find alternatives that feel more suitable, accessible and culturally safe. The most successful interventions are a collaboration between Child Safety and the family.
Emerging Minds has created several care plan templates which can be used to plan for those times when the parent may be unwell and unable to care for their child and draw on health professionals, family and friends to help:
- How to use the Emerging Minds child care plan templates
- Care plan for children and young people
- My baby’s care plan
- My child’s care plan
- Self-Care Plan.
When collaboratively developing case plan goals and actions steps for intervention consider the following:
| Culture |
What is needed for the goals and interventions to be culturally appropriate? Which services provide culturally safe interventions? How does the family’s culture experience mental health and wellbeing and mental illness? (Refer to Understanding mental health across cultures.) |
|---|---|
| Planning |
Can the child and family access the service? Consider practicalities of location, transport and appointment times to fit around school, work and other family commitments. Plan to support participation and avoid creating additional barriers. |
| Family stress |
Be mindful of the cumulative impact multiple services and intervention can have. Review the services involved are providing clear and meaningful benefit to the child and family, and adjustment to reduce pressure as required. |
| Consultation approaches | What will be the process to continue to consult with the family, their mental health professional and their safety and support networks to ensure consultation occurs throughout the case plan cycle? |
| Agreement |
Establish a clear agreement between the family, their safety and support network and the services involved about the case plan goals, actions and expected outcomes of the case plan. Agreement builds trust and accountability to keep everyone working towards a common purpose. |
Plan for relapse
Relapse is a common part of managing mental illness, especially for parents with ongoing conditions. Planning for times when a parent may become unwell helps reduce the stress and worry for both the parent and child and strengthens the family support network.
Work with the parent and their safety and support network to develop and document a long-term plan that can be activated if the parent becomes unwell. This plan should be practical, strengths-based, and tailored to the family’s needs. Use a parent’s own language when discussing mental health — where appropriate. This can help build safety, trust and reduces stigma. Common expressions may be feeling flat, down, low, sick and unwell.
Practice prompt
Use reflective questions to understand what has happened previously when the parent became unwell:
- Tell me what happened for the children last time you were unwell?
- Where did they go? Did that arrangement work well? Why or why not?
- What are the early signs that you are becoming unwell or that the kids might need to stay somewhere else for a time? What would others in your safety and support network see?
- Help the parent think through what support might be needed if they become unwell again:
- Let’s explore a plan for the children if you’re not feeling well.
- How can your support network help during this time?
- What does your support network need to know about your mental health to support you effectively?
- What do they need to know about the children’s routines and how to stay in touch with you if you’re in hospital?
- How can we explain this plan to the children in a way that feels safe and reassuring?
- What would be most helpful from me during this time? (Refer to Use realistic goals and interventions.)
Engagement strategies with children
Conversations with a child about their parent’s mental health are important as they help explain and make sense of what the child is experiencing, reducing confusion and fear. Most children want to know more about the causes of a parent’s behavioural changes and what treatment is being sought (Emerging Minds (c)).
Support child to understand how their parent’s mental health is affecting the family. Reassure them that while things may feel difficult, they are not alone in their experience. Use age-appropriate resources to guide conversations and provide ongoing support.
Children may feel shame, confusion, or responsibility for their parent’s low mental health and wellbeing. They may think or were told they caused the problem or that it’s their job to ‘fix’ it. It’s important to reassure them that they are not at fault, and that treatment and recovery are the adult’s responsibility, not theirs.
Initiating these conversations gives children the opportunity to ask questions, receive accurate information, and learn that it’s ok to talk about mental health and wellbeing. These discussions also model openness and reduce stigma (Emerging Minds (c)).
Initiating these conversations will provide opportunities for the child to ask questions and obtain correct information and model that it’s ok to talk about mental health and wellbeing (Emerging Minds (c)).
Tip
Further reading
- Supporting your child’s understanding of your mental illness
- Communicating with your baby when you're experiencing mental illness
- Talking to your young child about your mental health difficulties
- Talking to your primary school-aged child about your mental health difficulties
- Talking to your teenager about your mental health difficulties.
Support a parent experiencing a mental health crisis
When a parent is experiencing a mental health crisis, the priority is to assess the immediate safety of the child. Consider whether the parent’s crisis poses risks such as neglect, exposure to harmful behaviours, or physical danger. If there are safety concerns, involve emergency services, such as Queensland Ambulance Service, a mental health crisis team, or arrange temporary care arrangements for the child.
Approach the parents with empathy, respect and clear communication. Ensure they feel heard and involved in decision-making wherever possible. This helps reduce distress and supports engagement.
- Connect the parent to appropriate mental health services, including Queensland Health’s community mental health teams, crisis support services, or hospital-based care.
- Encourage engagement with professionals such as GPs, psychologists or counsellors.
- Provide information about helplines and resources. (Refer to Suicide and mental health support services.)
- Address practical needs by supporting the parent to access essential services, such as housing, food, or financial assistance.
- Explore options for parenting support, including respite care or help from family and community networks.
Strengthen protective factors for the child by:
- encouraging social support
- promoting consistent routines for the child
- highlighting the parent’s strengths to build their confidence.
Tip
Recognise the crisis may be linked to past trauma. Take a trauma-informed approach. Take care to ensure your actions do not cause further distress.
Collaborate with other professionals to provide holistic and integrated support, and work with the parent to develop a safety plan for managing future crises.
Attention
When navigating the mental health system with a parent:
Clarify roles
- Identify who is best placed to initiate a mental health assessment.
- Understand the limits of Child Safety’s role in clinical decision-making and focus on advocating for the child’s safety and coordinating care.
Document and communicate clearly
- Keep accurate records of observed behaviours, risk indicators, and steps taken.
- Share relevant information with health professionals to support timely and informed assessment.
Plan for the child’s immediate and ongoing safety
- Consider temporary care arrangements if the parent is admitted or unable to care for the child.
- Ensure the child’s routine, emotional needs, and connection to their parent are maintained where safe and appropriate.
- Engage the child’s support network early to reduce disruption.
Support the parent’s recovery and engagement
- Encourage the parent to participate in safety planning and decision-making when possible.
- Reinforce their strengths and capacity for change, even during crisis.
- Provide information about recovery pathways and available supports.
Coordinate with services
- Work closely with Queensland Health, community mental health teams, non-government organisations, and cultural support services.
- Ensure the parent’s mental health needs are considered in case planning and that services are culturally safe and accessible.
Monitor and review
- Regularly review the parent’s progress, the child’s wellbeing, and the effectiveness of supports.
- Be alert to signs of relapse and have a plan in place to respond quickly and safely.
- Use supervision to reflect on complex cases and ensure practice remains child-focused and trauma-informed.
Tip
When engaging with a parent who responds with anger or hostility to Child Safety involvement, approach the situation with empathy and understanding. Avoid assuming their reaction is solely a symptom of mental health illness. Instead take time to understand their perspective and what may be driving their emotional response.
Recognise that these reactions are often natural responses to fear, shame, disempowerment, or distress, especially when a parent feels judged or misunderstood.
Parents reactions can also be viewed through the lens of trauma:
- Focus on creating a safe and respectful space where the parent feels supported, not scrutinised.
- Walk alongside the parent to explore their needs and concerns and remember that how a parent responds to stress or intervention can influence how their child behaves and copes.
Supporting the parent to regulate their emotions and feel heard can help reduce distress for the child and promote healthier relational patterns. (Refer to the parent-child relationship loop.)
System navigation
If a parent is experiencing a mental health crisis and poses a risk to themselves or others, immediate action is required. This may include:
- Calling Triple Zero (000) for emergency services.
- Contacting 1300 MH CALL (1300 642 255) - Queensland’s 24/7 mental health triage service.
Refer to Suicide and mental health support services.
Immediate risk of serious harm
Attention
- Call Triple Zero (000) for emergency services
- Contact 1300 MH CALL (1300 642 255) - Queensland’s 24/7 mental health triage line
- Attend the nearest hospital emergency department.
In these situations, police or ambulance officers may initiate an Emergency Examination Authority under the Public Health Act 2005. This allows the person to be taken to a health facility for assessment without their consent. An Emergency Examination Authority permits temporary custody for up to 6 hours, extendable to 12 hours, to allow for medical examination and decision-making.
If a person is determined to have a mental illness and lacks capacity, further actions may be taken under the Mental Health Act 2016, including involuntary assessment and treatment (A treatment authority) in the following circumstances:
- the person appears to have a mental illness
- they lack capacity to consent to treatment
- there is no less restrictive way to provide care
- there is a risk of harm to themselves or others.
A doctor or authorised mental health practitioner can make a recommendation for assessment, which allows an authorised doctor to determine whether the treatment authority should be made. Treatment authorities are reviewed regularly and include safeguards such as access to Independent Patient Rights Advisers and oversight by the Mental Health Review Tribunal.
In some cases, an examination authority may be issued by the Mental Health Review Tribunal, allowing a person to be examined without consent if voluntary engagement has failed and serious concerns exist. (Refer to Treatment orders.)
Treatment Options for Adults in Queensland
Queensland offers a range of treatment options for adults experiencing mental illness, including:
- community mental health teams for ongoing support
- hospital-based care for acute episodes
- psychiatrists, psychologists, and GPs funded through Medicare
- crisis support services. (Refer to Suicide and mental health support services.)
Treatment may include:
- medication management
- psychological therapies
- case management and psychosocial support
- peer support and recovery-oriented programs.
Parents may be involved with multiple systems such as:
- mental health services
- alcohol and other drug services
- domestic and family violence services
- housing and financial support
- NDIS or disability services.
Explore the full scope of services involved in a parent's life and map the service system involved to identify which agencies are currently providing support. Identify where services may overlap, where gaps exist, and where coordination could be improved.
Coordinate the professionals involved to work on shared goals and reduce duplication by arranging case conferencing and multi-agency meetings. These collaborative and integrated approaches help align interventions, clarify roles, and promote more effective support for both the parent and child.
Confidentiality in mental health care
Confidentiality is a cornerstone of therapeutic relationships and both Queensland Health clinicians and private practitioners are bound by various legislated confidentiality provisions.
Generally, clinicians require their patient’s informed consent before sharing personal information, unless:
- there is a serious and imminent threat to life, health, or safety
- disclosure is required or authorised by law (including mandatory reporting under the Child Protection Act 1999, court order or subpoena).
Tip
Always seek consent from the parent to contact external professionals.
Use alternative methods to request information if child safety concerns override confidentiality. (Refer to procedure 2 Gather information from other sources, and procedure 5 Information sharing.)
When seeking information, explain why it’s relevant to Child Safety, ask:
- ‘Is there anything you can share that would help us understand how to keep the child safe?’
If consent is refused, explore whether general information (for example, support needs, safety planning) can be shared.
Parental mental health across the child protection continuum
At the intake and assessment stages:
- Identify early signs of mental health distress in parents.
- Use non-stigmatising language when documenting concerns.
- Engage with the parent’s GP or mental health provider (with consent) to understand current supports.
- Consider whether the parent’s mental health is impacting their capacity to meet the child’s needs.
During ongoing intervention:
- Collaborate with mental health professionals to understand diagnosis, treatment, and prognosis.
- Include mental health goals in the case plan.
- Plan for relapse and crisis response, including:
- Who to contact
- Temporary care arrangements
- How to maintain the child-parent connection
When a parent is in acute crisis:
- Understand the process for involuntary assessment and treatment under the Mental Health Act.
- Coordinate with:
- Queensland Ambulance Service
- Police (if safety is a concern)
- Hospital mental health teams
- Ensure the child’s immediate safety and emotional support.
- As the parent stabilises:
- Support re-engagement with the child, where safe and appropriate.
- Encourage participation in parenting programs tailored for those with mental health challenges.
- Monitor the child’s wellbeing and attachment needs.
- Review and update the case plan to reflect progress and ongoing support needs.
During permanency and long-term planning:
- Ensure mental health history and support needs are considered in permanency planning.
- Prepare the child with developmentally appropriate explanations.
- Support ongoing safe connections with the parent, where possible and appropriate.
Parenting with a mental illness
Emerging Minds provides a national initiative that provides information for parents living with mental illness, as well as their family and friends. These resources are designed to help children and young people thrive, and many are available in a variety of languages.
Resources for parents
The websites below offer practical support, information and resources for parents navigating mental health challenges.
Website |
Support provided |
| Wellmob - Healing Our Way | Resources supporting social, emotional and cultural wellbeing for Aboriginal and Torres Strait Islander People |
| Mental health resources | Raising Children Network | A collection of articles, videos and guides for professionals and parents which includes up-to-date and evidence-based content on child, teenage and parent mental health and wellbeing. |
| For Parents - Black Dog Institute | Better Mental Health | Tools and information to help parents support their child’s mental wellbeing. |
| Indigenous Mental Health and Suicide Prevention Clearinghouse | Publications exploring the factors influencing social and emotional wellbeing, mental health, and suicide rates among Aboriginal and Torres Strait Islander communities. Includes program overviews and author perspectives. |
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