When a Parent Has a Mental Illness: Issues and Challenges
Mental illness can cause mild to severe disturbances in thought and behaviors and can result in an inability to cope with life's ordinary demands and routines. Consequently, it can have a significant impact on family stability. Parents with mental illness have lower marriage and higher divorce rates than the general population. Some parents with mental illness may face problems with parent-child attachment due to repeated separations or family instability.1 Therefore, families with a parent who has a mental illness require unique services that include both prevention and intervention services for the parent and child(ren). The issues and challenges faced by the one in four American families affected by mental illnesses, such as depression, anxiety disorders and schizophrenia, are numerous and varied.2 These issues, which are explored in greater detail in other fact sheets in this series, include:
- The impact of mental illness on parenting capacity.
- The impact of parental mental illness on children.
- The stigma surrounding mental illness.
- Legal issues—parents maintaining custody and contact with their children.
- Need for integrated services for parents and families.
Impact of Mental Illness on Parenting Capacity
Mothers and fathers with mental illness experience all of the challenges of other adults attempting to balance their roles as workers, spouses and parents. The symptoms of mental illness, however, may inhibit these parents' ability to maintain a good balance at home and may impair their parenting capacity. When parents are depressed, for example, they may become less emotionally involved and invested in their children's daily lives. Consequently, parent-child communication may be impaired.3 The severity of a parent's serious mental illness and extent of the symptoms may be a more important predictor of parenting success than diagnosis.
To be effective, intervention programs and supports for families need to be comprehensive, addressing the needs of the whole family. Services should also be long-term, supporting the family until their primary needs are addressed.
Impact of Parental Mental Illness on Children
The impact of parental mental illness on family life and children's well-being can be significant. Children whose parents have a mental illness are at risk of developing social, emotional and/or behavioral problems. The environment in which children grow affects their development and emotional well-being as much as their genetic makeup does.
Service providers and advocates working with families in which a parent has a mental illness have identified a number of challenges faced by their children. For example, children may take on inappropriate levels of responsibility in caring for themselves and managing the household. Children sometimes blame themselves for their parents' difficulties, and experience anger, anxiety or guilt. Feeling embarrassed or ashamed as a result of the stigma associated with their parents' mental illness, they may become isolated from their peers and other community members. They may be at increased risk for problems at school, drug use and poor social relationships. Children of parents with any mental illness are at risk a range of mental health problems, including mood disorders, alcoholism, and personality disorders.
Despite these challenges, many children of parents with mental illness are resilient and are able to thrive in spite of genetic and environmental vulnerability. Resiliency is directly proportionate to the number of risk and protective factors present within the family: the greater number of protective factors and smaller number of risk factors, the greater the likelihood of a child being resilient. Therefore, services for families and children should include opportunities to reduce risk and enhance resiliency.
The Stigma Surrounding Mental Illness
The most pervasive factor affecting parents' access to and participation in mental health services is the stigma accompanying mental illness.4 The stigma of mental illness is likely borne out of misconceptions of mental illness and exacerbated by disproportionate media misrepresentations of people with mental illnesses as violent or unfit. The stigma keeps many parents from seeking the help they need,5 particularly in cases where they are afraid of losing custody of their children. The stigma of mental illness is more severe than that of other serious or chronic conditions like heart disease, diabetes, and cancer. Being labeled with a psychiatric disorder can profoundly and negatively affect the experiences of parents and their family members, adults and children alike.
Legal Issues—Parents Maintaining Custody and Contact with their Children
Parents with mental illness may be quite vulnerable to losing custody of their children. Some studies have reported as many as 70 percent of parents have lost custody.6 The primary reason for custodial challenge is the stigma surrounding mental illness. Many people believe that consumers of mental health services are naturally unfit as parents. Another common misperception is that parents with mental illness are violent and are therefore at increased risk for abusing their children.
As a result, many families find themselves in a "nowin" cycle of loss. They are aware that if they openly seek help, their symptoms may give an impression of unfitness. Therefore, these families may not seek the services or supports they need, and without those services their parenting capacity is diminished. In cases where a state government determines it to be in the child's best interest to remove the child from the home, the child may end up in temporary or permanent substitute care.
Need for Integrated Services for Parents and Families
Addressing the needs of families in which a parent has a mental illness requires a shift in the way most health and human service systems operate. Providing familycentered care is essential. However, the current managed care emphasis on time-limited treatment and the narrow focus on symptom management are incompatible with a treatment approach that includes the whole family.
Treatment is most effective when multiple systems work together. For example, schools should provide more mental health consultation to students, foster social competencies, provide support for students in transition, and encourage peer support and counseling. The child welfare system could provide caseworker training related to parents with mental illness and cross-training in adult and child issues. Communities should invest in improved prenatal care and expand access to high-quality childcare to help a range of vulnerable families.
1. American Academy of Child and Adolescent Psychiatry. Children of Parents with Mental Illness. No. 39. May, 2000.
2. Context of Parenting. May, 1998. Vol. 49. No. 5.
3. Roberta Sands. “The Parenting Experience of Low-Income Single Women with Serious Mental Disorders. Families in Society.” The Journal of Contemporary Human Services. 76 (2), 86-89. 1995.
5. Virginia Child Protection Newsletter. “Parents With Serious Mental Illness.” Vol. 56. Summer, 1999. Critical Issues For Parents With Mental Illness and Their Families. Center for Mental Health Services. July, 2001.
6. 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.