When a Parent Has a Mental Illness: Interventions and Services for Families

Practical interventions and access to quality care are critical issues for parents who live with mental illness and their families. Appropriate interventions and services are essential to mitigate risk and enhance healthy relationships between parents and their children. Support services should help families prosper by addressing individual characteristics of the parent and child, strengthening family bonds, improving family interactions, increasing social supports, and expanding access to services.1 This fact sheet describes the types of intervention strategies that can help families to thrive, and summarizes the limits of the current service delivery system.

Designing Effective Interventions

Families in which a parent has a mental illness may need a range of intervention strategies and services to maintain a stable environment and ensure positive outcomes for their children. While parents with a mental illness share many similar concerns, some concerns are specific to individual diagnoses. In addition to considering individual diagnoses, and goals, individual strengths and stressors should be considered in designing an effective intervention strategy, as well as the needs of the children and the demands of parenting. Further, the range of experiences of parents and children must be considered and a flexible definition of family considered, in order to reflect the diversity of formal and informal care giving arrangements. Therefore, comprehensive interventions for parents with mental illness should include:

An assessment of parenting strengths, needs, and goals
Comprehensive case management
Peer support
Self-help
Parent mentoring
Medication management
Pregnancy decision making and support
Crisis and respite care
Foster care support
Trauma and abuse counseling
Substance abuse treatment
Marital and family counseling
Housing and independent living assistance
Child development and parenting skills training
Assistance with school issues
Benefits and public entitlement counseling

Parents' Needs

Parents' needs must be identified to create effective interventions strategies that build upon their core strengths. Some of these central needs often include:

Reassurance about the quality of their parenting strategies
Parent support groups
Better understanding of mental illness in the community and in their own families
Service systems that actively engage families in supporting and sometimes confronting the parent
Better public education regarding mental illness, the relationship of mental illness to parental competence, safety and risk issues for children who have a parent with a mental illness, and the impact of the termination of parental rights on children and adults
Individual and family therapy for depression, substance abuse, marital conflict, budget planning, problem solving and strategies for giving and receiving support
Identification of primary issues and challenges for parents, such as: reproductive decision making and prenatal health care; coping with custody loss, visitations and placements; understanding normal child development and how to interact with children; building a set of child management skills; and developing supportive family and social networks

In many cases, parents who have received a diagnosis of a mental illness may need assistance in clarifying their parental role and setting realistic expectations for their children. Service providers and advocates need to help parents distinguish the normal stress of their parenting role from symptoms of their mental illness; they may also need help differentiating normal development in children from early signs of a mental health problem.2 Clear and structured support should be provided to alternative caregivers and grandparents, as well as to the parents themselves, so that parents may relate to their families in more positive ways.3

A critical need for children who have a parent with a mental illness is the opportunity to build competencies including social problem solving, critical thinking skills, assertiveness, communication skills and stress management. Based on the parent's illness, children may also need specific help in areas related to the parental illness such as, getting to school regularly and coping with school work.

Interventions that focus on ensuring a safe, stable environment for children, reducing parent-child stressors, and supporting children's resilience can improve outcomes for parents and children. Efforts to enhance children's understanding of mental illness and parents' understanding of children's needs have shown promising results.

Current Service Delivery System

Addressing the needs of families in which a parent has a mental illness requires a fundamental change in the way most health and human service systems operate. The current services system is fragmented with gaps in aspects of organization and administration. A lack of funding for services present barriers to service utilization for parents with a mental illness. For example, services for adults and children that may be provided in different locations and treatment settings may not allow adults with children to participate, (e.g., residential treatment programs, or emergency shelters).4

Funding streams and program eligibility requirements may also limit a parent's ability to get assistance. Parenting services in the public sector may be available only through the child welfare system, and in order for the parent to be eligible for support, she or he may have to be determined abusive or neglectful.5 In order for families to receive needed support, comprehensive services must be developed that are relevant to their needs and are family-centered and strength-based. "Adult" and "child" services must be integrated across and within systems to reduce service fragmentation or duplication, and to ensure that services are as accessible and as effective as possible.

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.
Network practical tools for changing environment. Making the Invisible Visible: Parents with Psychiatric Disabilities. National Technical Assistance Center for State Mental Health Planning. Special Issue Parents with Psychiatric Disabilities. Spring, 2000.
Ibid.
Ibid.
Ibid.

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