When a Parent Has a Mental Illness: From Risk to Resiliency--Protective Factors for Children

The effect of parental mental illness on children is varied and unpredictable.[1] Although parental mental illness presents biological, psychosocial and environmental risks for children, not all children will be negatively affected, or in the same way. The parental diagnosis of mental illness alone is not sufficient to cause problems for the child and family. Rather, it is how the diagnosis affects the parent's behavior as well as familial relationships that may cause risk to a child. The age of onset, severity and duration of the parents' mental illness, the degree of stress in the family resulting from the parents' illness, and most importantly, the extent to which parents' symptoms interfere with positive parenting, such as their ability to show interest in their children, will determine the level of risk to a child.

The Prevention Perspective

Whether or not children of parents with mental illness will develop social, emotional, or behavioral problems depends on a number of factors. These include the child's genetic vulnerability, the parent's behavior, the child's understanding of the parent's illness, and the degree of family stability (e.g., number of parent-child separations). Preventive interventions aimed at addressing these risk factors and increasing children's protective factors increase the likelihood that they will be resilient, and grow and develop in positive ways. Effective prevention strategies help increase family stability, strengthen parents' ability to meet their children's needs, and minimize children's exposure to negative manifestations of their parent's illness.[2]

Risk Factors

Children whose parents have a mental illness are at risk for developing social, emotional and/or behavioral problems. An inconsistent and unpredictable family environment, often found in families in which a parent has mental illness, contributes to a child's risk. Other factors that place all children at risk, but particularly increase the vulnerability of children whose parents have a mental illness, include:

Poverty
Occupational or marital difficulties
Poor parent-child communication
Parent's co-occurring substance abuse disorder
Openly aggressive or hostile behavior by a parent
Single-parent families

Families at greatest risk are those in which mental illness, a child with a difficult temperament, and chronically stressful family environments are all present. Many of these factors, however, can be reduced through preventive interventions. For example, poor parent-child communication can be improved through skills training, and marital conflict can be reduced through couples therapy.

Protective Factors

Increasing a child's protective factors helps develop his or her resiliency. Resilient children understand that they are not responsible for their parent's difficulties, and are able to move forward in the face of life's challenges.

Protective factors for children include:

A sense of being loved by their parent
Positive self-esteem
Good coping skills
Positive peer relationships
Interest in and success at school
Healthy engagement with adults outside the home
An ability to articulate their feelings
Parents who are functioning well at home, at work, and in their social relationships
Parental employment
A parent's warm and supportive relationship with his or her children
Help and support from immediate and extended family members

References:

Joanne Nicholson, Elaine Sweeny, and Jeffrey Geller. Mothers With Mental Illness: I. The Competing Demands of Parenting and Living With Mental Illness. Psychiatric Services. May 1998. Vol. 49. No. 5.
Joanne Nicholson, Elaine Sweeny, and Jeffrey Geller. Mothers With Mental Illness: II. Family Relationships and the Context of Parenting. May 1998. Vol.49. No. 5.

This fact sheet is made possible through an unrestricted educational grant from The E.H.A. Foundation.