How a parent's mental health condition can affect their child

A child 's development and life experiences are influenced by their parent's mental health and wellbeing. When assessing safety in families where one or both parents experience a mental health condition, it is important to think about both the child's and parent’s strengths, and any potential risks a parent's mental illness symptoms might pose.

When we seek to understand how a child experiences their parent’s mental health difficulties, we are better able to:

• understand the emotional impact parental mental illness can have on the child
• learn which parental behaviours might create risk or cause harm to their child
• recognise a child’s strengths and how they cope with their parent’s poor mental health
• help the child and family to build on strengths to create strong safety and support networks.

Poverty or social isolation

A parent may be unable to maintain regular employment due to their mental illness.  This may mean that the family lives in poverty, has unstable housing, lack of access to essential resources such as healthy food, communication, adequate health and dental care and reliable transport. The absence of these secondary factors also impact on a child’s health and development.  For a variety of reasons, a person with a mental illness may not be in contact with family, and have difficulty making and sustaining friendships.  In this way they are socially isolated, and this poses its own risk to a child’s healthy development, as it may reduce the child's access to their safety and support network.

The child’s world might be unpredictable

Children do well and feel safe when they have routines, boundaries and structure. Some parental mental health issues can get in the way of a parent’s ability to provide this security and predictability.

A parent’s mental health issue may impact their emotional, social and physical states in ways that affect their own life and the lives of their child. Their behaviour can fall on a spectrum that changes when they are well or unwell, including:

• feeling energetic or feeling lethargic
• feeling happy or feeling sad and hopeless
• being overly strict or permissive
• being interested and focused on their child or being emotionally unavailable and avoidant of their child.

These shifts in mood and parenting styles can be very confusing and destabilising for a child. A child's sense of confusion can be exacerbated if their parent is regularly going to hospital due to the severity of their mental health condition.

The child’s thoughts and feelings may be affected

A child may worry about their parent who has a mental health condition. They may feel:

• responsible for their parent's mental health or general wellbeing
• stressed about their own wellbeing
• scared of their parent, if their parent is hostile or acting irrationally
• worried they will 'catch' or inherit their parent's mental health issues
• like they have to be on constant alert for signs their parent is becoming unwell.

When a parent becomes well, a child can be distant or scared as they fear their parent will become sick again.

The child’s family relationships may be affected

Mental health issues can put a lot of strain on families. The child of a parent with a mental illness may find the other adults in their life are less able to spend time with them or care about their needs. Other adults may also be stressed by their increased caring responsibilities and be less patient or tolerant than usual. Whether real or perceived, children can feel overlooked and ignored.

The child’s friendships may be affected

A child may feel they need to keep their parent’s mental health condition a secret. They may not feel free to express themselves or talk about their experiences with friends or other adults. They might put off social activities such as having friends over to their home because of worries about what their friends will think of their parent with a mental health condition. A child sometimes take on carer roles in their families when a parent has a mental illness and this impacts their capacity to spend time with friends or take up a hobby.

The child’s behaviour may be affected

Changes in a child’s behaviour may be one of the first signs something is different at home. If a child’s parent has a mental illness that emerges or deteriorates, a child might become withdrawn, anxious and upset (internalising behaviours), or angry, defiant and aggressive (externalising behaviours). The child may also regress in their development, losing skills they previously had.

The child’s learning may be impacted

If a child is worried about what is happening in their home, it might be hard for them to focus at school. If a child is looking after their parent who is unwell or siblings in the place of their parent, they might be going to bed later than usual and may be tired at school. The child may miss school because they are staying home to look after their parent or siblings or because they are worried about leaving the parent when they are unwell. The child may not have a stable routine that includes regular meal times or bed times. A parent may not encourage and support a child to do homework.

The child’s physical health may be impacted

A parent experiencing compromised mental health may find it difficult to maintain routines in the household or attend to their children’s physical health needs. This might impact on their capacity to attend medical appointments, reliably provide nutritious meals, or maintain appropriate levels of supervision, including sleep routines.  

The child may be at increased risk

A child living with a parent with a mental health issue may experience neglect, particularly if the parent is unable to manage daily tasks and routines. Some parents find they can manage the physical care tasks, but struggle to connect emotionally with their child. If a parent’s mental health condition causes them to be out of touch with reality or to have disordered thoughts, they may physically harm their child or put them in situations that are dangerous to the child.

A parent with a mental health issue may use alcohol and other drugs as a way to manage their feelings or self-medicate. Alcohol and other drug use can exacerbate mental illness symptoms. 

A research report on the children of mentally ill parents found that these children are at increased risk of developing mental health problems themselves. This may be due to:

• genetic risk factors
• environmental factors such as the impact of mental health issues on the way the child experiences the world
• the impact the illness has on the child’s ability to form a safe and secure emotional bond with their parent.