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Talking with a child to assess risk

A risk assessment will be more holistic with a clear picture of the child’s day-to-day life and experiences of their parent’s mental health issue.

Talk to the child about their life, what it is like at home, their worries and feelings. These words help to see things from their perspective and can prove to be a powerful motivator for parents when they need to make some changes.

Remember that a child need to know why their mum or dad is behaving in a way that might be scary, confusing or different to other parents. If they do not know why they will make up their own explanations and may blame themselves or get distressed. It’s common to hear things like: ‘It’s my fault mum is acting like this because I’m a bad kid’ or ‘Dad hates me'.

Refer to the Working with children and young people who have a parent with mental health issues part of this kit to learn more about talking to children about mental health issues.

Planning to talk to a child

Whenever possible, let the parents know your plan before you speak to the child. This includes what will be discussed and the support that will be offered.

Talking about a parent’s mental health issues can be upsetting for a child or young person.

When speaking to a child:

  • plan where the best place is to talk to the child
  • ask the child if they would like an appropriate adult to sit with them
  • talk to them in an age and developmentally appropriate way
  • visit the child more than once to build rapport and trust
  • answer any questions or worries they may have about their parent’s behaviour as best you can
  • if a question can’t be answered, make a commitment to get back to them
  • talk to them about any fears, guilt or confusion they may be feeling
  • listen carefully and reflect back— check their words are interpreted correctly
  • recognise that they may feel disloyal to their parents when speaking of their own needs or worries
  • use books, resource and tools to help the child talk about their experiences 

Use these conversation ideas to guide interactions with the child:

Practice considerations Conversation ideas
Ask about the child’s relationship with their parents and family.

What’s life like in your family?

What do you like to do together as a family?

How would you describe your [mum, dad, brother or sister]?

How do you get along with [mum, dad, brother, sister]?

Do you have a lots of people in your family or not so many? Do you get to see your aunty/uncle/grandparent/etc.? How does everyone get along?

Ask about the child’s support from friends, extended family, safe adults, or the community — begin searching for family connections as soon as work starts with the child.

Do you have friends?

Do you sometimes have friends over after school?

Do you go to other kids’ houses?

Who are you able to talk to if you’re feeling worried or sad? Do they help you feel better?

Who has been there for you in the past?

Can you talk to your teacher/coach/friend’s parent? 

Who are the 3 people in your life you have the best relationship with?

Assess the child’s daily routine.

Tell me about how things work at your house…

What happens?

What and when do you eat?

Who makes you food?

How do you get to school?

Where’s mum or dad when you [come home, do your homework, wake up, want to go to bed…]?

What are your jobs around the house?

Tell me about a good day in your house.  How about a not so good day?

What happens on the not so good days?

Where’s [grandma, aunty ...]?

Does anyone help you when you’re having a bad day?  Or when mum or dad is having a bad day?

What do they do to help?

Talk about the child’s concerns.

Use the The Three Houses Tool to identify worries, strengths and hopes, and to talk about safety.

If the child talks about their parent’s mental health or illness, explore this through asking curious questions.
 

Most kids feel troubled sometimes ... can you tell me what you feel troubled about?

Do you worry about mum or dad?  What kinds of things worry you?

You told me you feel scared when mum thinks people are watching the house. Have I got this right? Tell me more about this. How long is she like this? What do you do if things get really bad?

Who cared for you when your parents could not? Who paid attention to you, looked out for you, cared about what happened to you?

Who do you go to when you are having a tough time? What does [person’s name] do to help?

Talk about the child’s response and feelings.

Be curious about any changes — How does the child feel emotionally? Does this vary and why?

How do they feel about themselves?

How do they feel about their relationships?

Try using the Bear Cards resource or app or other similar tools, to start this conversation.

(Try using the Bear Cards resource to ask children about their parent’s feelings and what this means to them)

What do you think your [friends, siblings, mum, dad, teacher] would say about you?

How do those words make you feel?

How does this change what you can say to them?

How does this change what you do around them?

What words would you use to describe yourself?

What does it feel like to be you?

What do you think about when you get [worried, sad, scared, confused or angry]?

Who or what do you feel responsible for?

Have a look at some of these bears... can you tell me which bear is closest to how you feel? Can you tell me which bear is most like you? Let’s talk about this more…

Practice prompt

Notice and talk to the child about any worrying statements. Act with urgency if the child talks about suicide or self-harm. Refer to procedure 5 Support a child in care which provides guidance around developing a suicide risk management plan. Refer also to the Policy Assessing and responding to self-harm and suicide risk. This resource is also helpful: headspace resource on self-harm. If you’re worried, take action straight away. Make sure the child’s environment is safe and someone can supervise. Talk to your senior team leader or senior practitioner about the next steps.

More information on talking to young people about mental health

Go to the following resources from Children of Parents with Mental Illness (COPMI) for more on talking to young people about mental health:

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