In June 2014 Barnardos published a report outlining the experiences of children of parents with mental health difficulties, reviewing current levels of support and making recommendations for enhancing services.1  The report reviews the relevant literature and draws on discussions with parents, carers and professionals in the mental health area. 

The report emphasises that parental mental health difficulties alone present little risk of harm to children but that a lack of appropriate supports can compromise a child’s ability to cope. However, parental mental health difficulties are often associated with other risk factors such as poverty or addiction, which can have a huge impact on family life.  As a result, a child’s social, emotional and cognitive development can be adversely affected.  Children are affected by their parents’ mood and can become anxious and unsettled, particularly if the situation has not been explained to them by a supportive adult in an age-appropriate way.  Moreover, many children take on an unrecognised caring role in the family. 

Entrenched societal attitudes and discrimination mean that parents are often reluctant to ask for help as they fear that their capacity to parent their children will be questioned. Moreover, the current, predominantly medical, approach to mental health leads to a reliance on medication and does not adequately address broader family support needs.  As a result, parents and children can feel isolated and the root cause of the distress can be overlooked.  Side-effects of medication can further compound problems, for example when parents who are taking benzodiazepines or other medication experience drowsiness and slowed reactions which compromise their ability to respond to their children’s needs. 

The report calls for a holistic approach to supporting families facing complex challenges, whereby each family member is heard and their needs considered. Barnardos believe that the present family, health and child support systems need to move from a traditional approach of working in isolation to an integrated inter-agency working model which recognises patients as parents and sees parents and children in a family context, i.e. a family model approach.  Key recommendations include:

• challenge mental health prejudice and discrimination,
• adopt a family model approach,
• talk to children,
• expedite the roll-out of community-based services, and
• consult with parents affected by poor mental health.

1 Barnardos (2014) Patients. parents. people. Towards integrated supports and services for families experiencing mental health difficulties. Dublin: Barnardos. www.drugsandalcohol.ie/22129