Hearing Young VoicesCity Hall Conference - 30th January 2019

Dr Alan Cooklin

#BeingSeenAndHeard

Parental mental illness – a timeline

• 1966 – Dr, later Professor, now Sir Michael Rutter: Monograph - Children of parents with

mental illness improve resilience if helped to appraise their situation

• 1993 – 1st Study of Young Carers by Aldridge and Becker, identified 146,000 for all

parental illness

• 2008 – SCIE Research Briefing estimated 2,000,000 children living with a parent with

mental illness

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• 2011 – National Census still identified only 166,000 Young Carers for all parental

illness

• 2018 – Ernst & Young report commissioned by Our Time estimated 3.4 million

children living with parent with mental Illness, and that failure to intervene would

cost at least £33 billion (Sources available separately)

• 2018 – Report of the ‘Toxic Trio’ survey by The Children’s Commissioner increases

the likely prevalence of children affected by severe and moderate mental illness to

3.7 million children from 0-17 years of age

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Parental mental illness – a timeline

•Much variation in what adverse effects in children

measured in research

• 1996 – Rubovits reported 70% of children suffered at

least moderate mental health problems or other

disruptions based on aggregated data

•Mowbray et al (2004) estimated that one third of all

children were using mental health services, but not

accounted for ‘hidden’ children or loss of attainment.

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Mental health and social impacts

•Many researchers such as Manning and Gregoire (2009)

highlighted loss or attainment in school and lowered life

opportunities.

• Keshaven et al. (2008) identified 60% of children as having

one or more ‘lifetime’ significant psychiatric diagnoses

•Many researchers (such as Reupert 2013) have stressed that

diagnosis is not a predictor of the impact on children – rather

function and chronicity

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Mental health and social impacts

•All the impacts identified repeatedly for young carers:

• Lost school time

• Attainment and life chances

• Depression

• Social isolation

• Stigma and bullying

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What is the impact?

• In addition specific impacts on the child’s mental and emotional

development – depending on child’s age at onset and chronicity:

• Fears of following or ‘catching’ the parent’s illness

• Being invaded by or adopting the ill parent’s perceptions and ‘world view’

• Self doubt about child’s own emotions and perceptions

• Disorders of attachment

• Self blame

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What is the impact?

•Very small investment of time and money can make

huge difference - possibly the most economic of all the 10

Adverse Childhood Experiences (ACEs) in terms of

prevention

• Repeated surveys by young people have identified the

most significant factors for improving resilience as:

• Having a good explanation of the illness and understanding

of what is happening

• An adult who can be a mentor or advocate

• Lowering social isolation by meeting a group of children

with similar experiences.8

What can we all do?

• Our Time offers these elements through the

KidsTime Workshops for affected families

and in schools through the ‘Who Cares ?’

programme.

•Hear from some young people about the

impact

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What can we all do?

[VIDEO]

VIDEO

ReferencesAldridge,J.andBecker,S.(1993)ChildrenwhoCare:InsidetheWorldofYoungCarers.YoungCarersResearchGroup,Loughborough:LoughboroughUniversity

Beardslee R,Bemporad J,KellerM,etal(1983)Childrenofparentswithmajoraffectivedisorder.Areview.AmericanJournalofPsychiatry140:825–32.

Bilsborough S.,(2004)Whatwewantfromadultpsychiatristsandtheircolleagues:‘Tellingitlikeitis’.InParentalPsychiatricDisorder:DistressedParentsandTheirFamilies(eds MGöpfert,JWebster&MVSeeman):3–7.CambridgeUniversityPress.

Children’sCommissionerforEngland,(2018)VulnerabilityReport2,July2018‘Estimatingtheprevalenceofthe‘toxictrio’,HMSO,London

CookA.,etal,(2005)Complextraumainchildrenandadolescents,PsychiatricAnnals35:5390-398

CooklinA(2010)‘Livingupsidedown’:beingayoungcarerofaparentwithmentalillness.Advancesinpsychiatrictreatment vol.16,141–146

CooklinA,BishopP,FrancisD,etal(2012)TheKidstime Workshops;AMultifamilySocialInterventionfortheEffectsofParentalMentalIllness:Manual.CAMHSPublications,EvidenceBasedPracticeUnit,London

CooklinA.,(2013)Promotingchildren’sresiliencetoparentalmentalillness:engagingthechild’sthinkingAdvancesinpsychiatrictreatment(2013),vol.19,229–240

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Ernst&Young,(2018)‘SizingtheProblem’– Prevalencere-analysiscommissionedbyOurTime

FalcovA.,(1999)Addressingfamilyneedswhenaparentismentallyill.InApproachestotheAssessmentofNeedinChildren’sServices(eds HWard,WRose):235–60.JessicaKingsley.

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References Contd.FalcovA.,(2004)Talkingwithchildrenwhoseparentsexperiencementalillness.InChildrenofParentswithMentalIllness.PersonalandClinicalPerspectives(2ndedn)(ed VCowling):41–56.ACERPress

Garmezy N.(1970)Processandreactiveschizophrenia:Someconceptionsandissues. SchizophreniaBulletin. 2:30–74.

Garmezy N.(1974)Thestudyofcompetenceinchildrenatriskforseverepsychopathology.In:AnthonyEJ,Koupernik C,editors. Thechildinhisfamily:ChildrenatPsychiatricrisk:III. Wiley;NewYork:p.547

Gregorowski C.,and Seedat S.,(2013)JChildAdolesc.Ment.Health25(2):105–118.Addressingchildhoodtraumainadevelopmentalcontext

JamesB.,(1996)TreatingTraumatisedChildren,TheFreePress,NewYork.

Keshavan M,MontroseDM,Rajarethinam R,etal.(2008)Psychopathologyamongoffspringofparentswithschizophrenia:relationshiptopremorbidimpairments.Schizophr Res;103:114-120

Leff J.,andHirschS.,(1970)Ahistoricalnoteontheascendingreticularformationofthebrain-stem,PsychologicalMedicineVolume 1, Issue1,13-17

ManningC., Gregoire A, 2009Effects of parentalmentalillness on children.PsychiatryVolume8,Issuel,Pages 7- 9

MartinA.,etal(2011)EvaluationReportfortheevaluationoftheKidstime Workshops2010- 2011.London,AnnaFreudCentre.

Masten A.,(2018)JournalofFamilyTheory&Review10:12–31

MowbrayC.T.,LewandowskiL.,Bybee D.,andOyserman D.,(2004)Childrenofmothersdiagnosedwithseriousmentalillness:patternsandpredictorsofserviceuse.Ment HealthServ Res. Sep;6(3):167-83.

OfficeforNationalStatistics(2011)Census,HMSO,London

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References Contd. (2)ParrottL.,JacobsG.,andRobertsD.,(2008)SCIEResearchbriefingevaluate23:Stressandresiliencefactorsinparentswithmentalhealthproblemsandtheirchildren,London,SCIE.

RaphaelB.,(1986)WhenDisasterStrikes:Ahandbookforthecaringprofessions,CenturyHutchinson,London

Reupert,A.E.,Maybery D.J.,Kowalenko N.M.,(2013)Childrenwhoseparentshaveamentalillness:prevalence,needandtreatment,MedJAust;199(3Suppl):S7-S9.

Rubovits P.,(1996)ProjectCHILD.AnInterventionProgrammeforPsychoticMothersandtheirYoungChildren.InParentalPsychiatricDisorder.DistressedParentsandtheirFamilies(eds MGöpfert,JWebster,MVSeeman):161–9.CambridgeUniversityPress.

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StreetingJ.,(2015)Whocares?Wedo,JournalofSchoolHealth,March,24-26

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Wolpert M.,HoffmanJ.,MartinA.,FaginL.,CooklinA.,(2014)AnexplorationoftheexperienceofattendingtheKidstime programmeforchildrenwithparentswithenduringmentalhealthissues:Parents’andyoungpeople’sviews,ClinicalChildPsychologyandPsychiatry1-13

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