The following table explores how parental mental health issues 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.
(0 to 8 months)
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 that 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.'
(9 months to 3 years)
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.
'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 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.'
(3 to 5 years)
Autonomy and mastery.
Child needs safety to explore the environment.
'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 am learning so much from you. I learn new activities that you teach me, like how to hold a crayon or how to make cookies.'
'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 really 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.'
'I’m growing up but I still need you to help me with lots of things, like my homework or when something is worrying me. If you can’t do this sometimes I feel angry, especially when I notice that my friend’s parents can help them.'
'I tend to believe what people say. If I hear you use words I don’t understand, I will try to work out what they mean.'
'When I see you worried about everything, I don’t know if it’s real or not — that makes me scared.'
(6 to 12 years)
Development of rational and logical thinking about physical objects.
Children become less dependent.
Increased association with friends.
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.'
'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.'
(12 to 15 years)
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.
'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 that 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 that it’s not always bad, but I wish that 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 past their curfew. I need to know that you notice these things. When you put in boundaries, it lets me know that 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 that I’m 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 at the moment. 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 drugs. '
‘There’s 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.'
(15 to 19 years)
Achieving emotional independence from caregivers and other adults.
Preparing for an economic career.
Preparing for significant intimate relationship and family life.
Developing their sexual identity.
'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 that I might get unwell too. Every time I feel a bit down I am scared that I might be getting depressed.'
To learn more about working with children, refer to Working with young people with mental health issues and Risk assessment .
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