How to Help a Young Child with a Mentally Ill Parent

The American Academy of Child & Adolescent Psychiatry reported in 2008 that having a parent with a mental illness puts a child at real risk. Compared with kids whose parents are well, these children are more likely to develop a mental illness of their own. The odds double when both parents are affected. A parent living with bipolar disorder, clinical depression, schizophrenia, a phobia, an anxiety disorder, PTSD, OCD, or a similar condition usually cannot parent well unless they are in active treatment, meaning medication and counseling. The condition has to be stable enough for that mother or father to actually show up for the child.

Think about what a parent is supposed to do day to day. Feed the child, keep a roof overhead, help with schooling, play, set limits, offer affection. Sit through a long story about recess, help with a math worksheet, put dinner on the table, hand out a consequence after bad behavior, kiss a scraped knee, stay up with a feverish kid at two in the morning. A parent is the person who makes things feel okay again. When a mental illness is untreated and unstable, those ordinary acts of care start falling through the cracks.

Until the parent can care for the child properly, the people around that family have to fill the gap. Friends and relatives need to step in and protect the child from the loss, the sense of being left, and the plain confusion that comes with watching a parent struggle. A child in this situation should feel loved and safe every single day. That is the job that falls to you. Mental illness is hard on grown adults; for a small child it can be crushing. You can still change the course of that child's life, and the suggestions below are meant to help you build the steady, warm environment the child badly needs.

Start by reaching out to the wider circle of family and friends. Even a close relative can't carry this alone. Phone other people who care about the family and tell them plainly what is going on between this parent and child. Parents who aren't in remission often hide the illness. They fear being judged, or worse, they fear the child will be taken from them. Keeping loved ones in the dark, though, keeps help away from both parent and child. Relatives often sense that something is off without being able to name it, and some are already worried but have no idea how to approach the situation. Spell it out for them: this child needs extra love, extra support, and plenty of fun distractions from what is happening at home.

Which brings up activities. Plan things the child will genuinely enjoy, and make sure you and other loved ones take part rather than just dropping the child off. Bring along the child's own friends and cousins, and ask them what they'd like to do. Miniature golf, bowling, a skating rink, an amusement park, a movie, a picnic in the park, the zoo, a pizza arcade like Chuck E. Cheese, a children's museum. None of it has to be elaborate. The point is for the child to feel like a kid again for a few hours.

Above all, stay available. Be the person who is around when the child feels like talking. The child may want to discuss the parent's illness, or may not, and either way is fine. A very young child might not grasp what is wrong at all, which is also fine. A school-age child, on the other hand, is often frightened and puzzled and may bring it up again and again. When that happens, just be present. Answer the questions in words a child can handle. Expect things like "What's wrong with my mommy?" or "Is my daddy going to get better?" If you don't know the answer, say so, then soften it by reminding the child how many people love him or her, yourself included. Let the child hear that the people who love them will keep taking care of them no matter what. And make it clear the child is not the cause. A child needs to understand, in simple terms, that nothing he or she did made the parent sick.

A support group built for children of mentally ill parents can be one of the most useful resources you offer. Go with the child, especially if the child is shy or very young. Gauge whether the child is old enough and settled enough to join you there; this isn't a one-size decision. Before the first meeting, explain in plain language that the group is for kids whose parents are sick, and that it's a place to meet new friends.

Counseling is the last piece, and it matters if the child isn't already seeing someone. A counselor helps protect the child's mental health and helps the child adjust to upheaval: a new household, the swings of living with a mentally ill parent, tangled feelings, stress, maybe a new school. Call a licensed mental health counselor and set up a consultation. If the child is old enough to protest, enroll him or her anyway. Frame it as someone whose job is to help the child feel better and make sense of what's happening with the sick parent.

A few cautions. As tempting as it is, don't put a date on when the parent will recover. Tell the child truthfully that you don't know when things will improve, but that praying or holding onto good thoughts can help. Don't promise that everything will turn out fine, because you can't know that, and a promise like that can leave the child expecting a recovery or a role in their life that may never come. Keep in mind that an older child probably already senses the truth, so pretending all is well only deepens the confusion and frustration. Keep reminding the child of one thing that stays true: the parent loves them, illness and all.

- Dr. R. Y. Langham

References: American Academy of Child & Adolescent Psychiatry. (2008). Children of parents with mental illness. Mental Health Gov. (2015). Talk about mental health. Tartakovsky, M. (2015). Tips for parenting with a mental illness. Psych Central.