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Effects on children

Assessing the impact a parent’s mental health has on a child

Mental health issues are considered in the Family Risk Evaluation (FRE) Tool. While these scales ask whether the parent has or has not had a diagnosable mental illness, or multiple presentations to mental health professionals, this will not be the only focus. For further guidance around how to apply the FRE Tool, please refer to the Responding part of this kit and the SDM Manual

Children can be affected in different ways when their parents are unwell, so it’s important to think broadly when you are assessing risk. Use the following list to help reflect on how else the symptoms and behaviours of a parent’s mental health issue may cause risk for a child.

Risks associated with a parent's mood

Symptoms: elevated mood, depressed, irritable, agitated, frequently changing and unpredictable, suicidal

What a parent might say:

  • My energy level and motivation changes. I find it hard to stick to routines. I can’t give the children the attention they need. I find it hard to make dinner/take the kids to school/help with homework/change the baby’s nappy and bath them.
  • I find it hard to get to sleep at night and wake up in the morning. Sometimes I keep the kids awake at night and then it’s hard to wake up in the morning to make them breakfast and get them to school.
  • That was the night I couldn’t get to sleep until 4 am so that’s why we missed the baby’s medical appointment again. I know the appointment was important but I’ll make another one next week. I’m too stressed and tired to do it this week. Plus the baby is fine. I’ve been remembering to wake and feed her most nights now after the nurses said they were worried about her weight.
  • I get really impatient with the kids. Sometimes I don’t want to see or talk to them. Sometimes I want to be around them all the time, but then they get too excited and I get too full on with them. I’m never sure how I’m going to react with them. Sometimes I get so angry if they do something wrong, I can be really harsh. But if they weren’t so naughty, I wouldn’t have to do that. Other times I don’t care and let them do what they want.
  • I’m not a good mum. Sometimes I think they would be better off without me. I tried to kill myself once by taking a whole packet of headache medicine but nothing happened, I just went to sleep and was groggy in the morning.
  • The kids are the only ones who can help me. I can’t help but talk to them about how I feel. They know everything that’s going on.

What a child might say:

  • I have to get up really early to get my little sisters ready for school and make them breakfast because Mum can’t get out of bed.
  • I’ve run out of tablets to stop my seizures. Dad keeps saying he’ll get more but then he forgets.
  • I get scared when Mum wakes me up in the middle of the night and she’s crying.
  • I can’t stay awake in class ‘cause Mum keeps waking me up through the night saying she wants to kill herself.
  • I sometimes feel angry and mixed up — one minute Dad loves me and says I’m doing really well at school and then the next he doesn’t seem to care and sleeps in bed all day.
  • I love my Mum but she scares me sometimes. I don’t know if she’s going to be really angry, sad or happy. When she’s in a bad mood she hits me and it really hurts, I sometimes get bruises. But when she’s happy we have lots of fun.
  • Dad’s always saying he’s crap and worthless. It makes me wonder if he ever wanted to have kids and if he loves me. He’s never happy with anything I do.
  • I’m scared Mum’s going to kill herself and I’ll never see her again and I’ll be all alone and no one will take care of me or love me.
  • I miss a lot of school. I’m scared if I leave Dad alone he may hurt himself.

Risks associated with a parent's perceptions, thoughts and memory

Symptoms: hallucinations, delusions, and paranoia

What a parent might say:

  • I’m scared all the time. I think people are watching me. I don’t trust anyone, even people in my family. It’s terrifying. It takes over everything.
  • Someone is trying to hurt us. I think we’re being poisoned. I’ve thrown all the food in the cupboard in the bin.
  • I can’t remember important things. I forgot the kids’ birthdays. I forgot to pay the electricity bill last month. The kids try to help me remember but it’s hard.

What a child might say:

  • I feel like I’m walking on eggshells all the time. I never know how Mum’s going to act. I can’t invite any of my friends to come over — I’m worried she’ll go off.
  • Mum keeps saying that someone is watching us so we never open our curtains or let anyone see into the house. I’m really scared this person is going to come get us.
  • Dad smashed all the electrical stuff in the house yesterday. There was glass everywhere. He’s now putting holes in the walls and pulling out all the electricity cables.
  • School has to call Mum all the time because she forgets to pick me up. It’s really embarrassing when no one comes to get you.
  • Mum and Dad promised they’d come to my school concert but they never came. They said they forgot.

Risks associated with a parent's organisation

Symptoms: obsessive thoughts and routines, difficulty organising daily life, difficulty regulating emotions

What a parent might say:

  • I just can’t manage the family. I can’t organise myself to cook, pay bills. The clothes don’t get washed.
  • I get so stressed out. I get angry and yell at the kids. I call them names. I know it upsets them. Sometimes I get so angry I hit the kids hard.
  • We keep getting kicked out of rentals. I’m not sure where we’re going to sleep tonight.
  • Jeremy gets so mad at me when he has to change schools. He’s getting so hard to handle.
  • Sophie hates my counting. She yells at me when it makes her late for school. If she interrupts I need to start from the beginning. It doesn’t feel okay until I’ve finished and done it right.

What a child might say:

  • The other kids tease me at school. They say I smell and my clothes are dirty.
  • Mum makes me clean the toilet whenever I use it. It’s so hard to remember exactly how she needs it done. She gets mad at me if I don’t do it right.
  • I’m always in trouble at school but I don’t care. Who cares! No one gives a shit about me anyway.
  • I don’t need friends. I’ve never had any friends.
  • I love my mum and dad but they make me so angry sometimes. I know they’re different from other mums and dads and I really love them but this makes me angry — I don’t know why.

Risks associated with a parent's confidence and sociability

Symptoms: withdrawn, fearful, over-confidence, inappropriate behaviours, forms relationships quickly with unsafe people

What a parent might say:

  • I don’t trust myself to get it right. I’m scared of making the wrong choice. I ask Jasmine what she thinks but she’s still only little. Pete does his own thing now which is a relief.
  • I hate taking the kids to school and having other mums judge me.
  • I get panic attacks when I go shopping. They’re getting worse. I hate the crowds. Everyone looks at me.
  • I love making new friends, it’s so easy for me. We have lots of parties at home.
  • Oscar doesn’t need school to get educated. I know what to teach him.

What a child might say:

  • My big brother Pete keeps coming home drunk and Mum asks me what she should do — how would I know? I’m only 10. Sometimes I feel like the mum.
  • I get really sad when I see my mum stressed and nervous when we go out. I love my mum so much and I wish I could help her. It makes me feel really anxious, too.
  • Last week Dad got into a fight with this really big man. He said he felt like Superman and could beat any bloke. I was so scared Dad was going to get really hurt.
  • Mum and Dad make friends with anyone and bring them back to our place and they drink beer and smoke. Me and my sisters just hide in our room.

(Ruah Community Services, 2008).

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