The effect of a mental health issue on a parent’s behaviour can depend on how long the parent has experienced the issue, how severe it is, and how long a parent may be unwell for.
It can also depend on other stresses in the home, such as poverty, isolation, domestic and family violence and substance use.
Mental health issues can affect a parent’s behaviour in different ways:
- extreme worry, anxiety
- obsessional routines
- lack of motivation and energy
- reduced interest or pleasure
- withdrawing from people
- not comfortable in crowds
- not wanting to leave the house
- suicidal thoughts or actions
- inappropriate, intense anger
- difficulty regulating emotions
- disturbed sleep, appetite and concentration
- impulsive behaviours (spending money, drug use)
- panic attacks (difficulty breathing, distressed)
- extreme mood swings — from the lows of depression to mania
- disorganised (tasks such as making meals, paying bills, washing clothes)
- chaotic (moving house frequently, children constantly changing schools)
Learn more in the Working with parents part of this kit.
‘The people I was working with … saw me as a whole person, and not just as a person, but as a mum. I’m mum first. I’ve got two little people who rely on me, no matter how unwell I am, no matter how good I’m going, or how bad….’
A mother’s perspective from supporting recovery in families affected by parental mental illness
Explore strengths and vulnerabilities with parents
Use this table for some ideas about how to explore strengths and vulnerabilities with parents:
|Practice considerations||Conversation ideas|
Explore the parent’s history of mental health issues.
Talk about times when the parent has been unwell. Ask about frequency, severity and impact of major events. Ask what this changed in their life and in the lives of others.
Explore times when the parent has been well. Be curious about what was different and what this meant for their life and the lives of others.
Be mindful that the parent may have been asked this information before. Check in with them about this. If they are struggling to talk about it, decide what you need to know from them and what you can learn from other sources like files, other family members and interagency colleagues.
I’d like to understand more about what life has been like for you and [child] to have [use family’s language to describe the mental health issue].
Tell me about when you first had [use family’s language to describe the symptoms of the illness].
When was the last time?
How often does this happen for you?
Would you mind if we started to draw a timeline to help me understand better?
Tell me about the time when ... (refer to timeline).
I’m wondering what was that like for you. (discuss symptoms)
What was it like for [child]?
Did it change how you looked after [child]? How? What do you think about those changes?
Did [child] go somewhere else when you became unwell? What did this mean for [child] and you? What was it like for others?
What did it mean for your role as a parent? Your relationships? Job? Social activities? Money? Housing?
I’m curious about who or what helped you? Who or what helped [child]? Why?
Tell me more about who or what didn’t help you? Who or what didn’t help [child]?
Understand how the symptoms and behaviour affects their functioning.
How does the mental health issue affect day-to-day routines?
Be curious about the parent’s description of their mental health issue. Is this consistent with other information? For example, records, how the parent seems to you, school reports and attendance, housing, household tasks, the children’s care.
Look for exceptions or times when the parent has been able to continue to parent a child even when they have felt unwell. This is something to notice with the family and build on in your future work.
What is a typical day for you like when you’re feeling well?
Where do you usually spend your day?
Where do the children spend their day?
How do they get to school?
Can you tell me about mealtimes and bedtime?
What is a typical day when you’re not feeling great or beginning to get unwell?
How do you manage on a day when you don't feel well?
What changes for you and the children on these days?
What is a typical day for you like when you feel unwell?
Where do you usually spend your day when you're feeling unwell?
Where do the children spend their day?
Do the children get to school?
How do they get to school?
Who makes meals at home?
When do you usually eat?
Is there anything you have been able to still do well during those times?
Can you tell me a bit more about this? What did this mean for [child]?
It sounds like you ways to keep going and look after [child] when things got hard. How did you manage that even though it was difficult?
Explore how their current behaviour affects their parenting and their children.
Find out what parts of their behaviour the parent is worried about and what they are doing well.
Ask about the parent’s main concerns. Explore their biggest concern and find out if they feel able to address and seek help for it. Find out where the mental health issue fits with their biggest worry.Note: For many parents, mental health issues can co-occur with other problems and it might not be the parent’s biggest worry, or even a worry at all. This is essential for you to understand so you can start to talk about change.
What are you most worried about ... for both you [child]?
What else are you worried about ... for both you and [child]?
Is it okay if we write your worries onto this scale of 0 to 10, where 0 is not worried at all and 10 is extremely worried?
How well do you feel right now? Tell me where that sits on this scale...
It seems from what you’ve told me that [family’s language to describe mental health] can go up and down. Can you show me on the scale where you were sitting right now? Can you remember a time when it was higher or lower? How were they different?
Note: This conversation and scaling tool will help you begin to plan change with the family. Learn more about creating change in the Case planning part of this kit.
Find out more about the family’s safety and support networks.
Explore formal and informal supports and the parent’s ability to seek help.
What previous progress and engagement with mental health services has the parent had? Look into both voluntary or community treatment orders, their pattern of accessing services and any previous hospital admissions, both voluntary and involuntary.
A previous willingness to work with services can demonstrate periods of stability, wellness and insight. It may also generate a better understanding of engagement and non-engagement – for example, do they tend to drop out of services during a period of stability and then re-engage in crisis?
Who helps you in your family ... is it your partner, friends, neighbours or people in the community? Do they do anything unhelpful?
What services have you worked with before? How helpful did you find them?
How was your experience working with mental health services?
How did the referral come about? How did you find the service?
What hasn’t worked in the past and why?
What are your worries about ... school, work, neighbours, health services or going to hospital?
What support would you like or need?
Source: Supporting recovery in families affected by parental mental illness, Australian Institute of Family Studies
Get more tips on working with parents from the COPMI website's advice for child protection workers.
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