mental illness & parents 26.2% adults suffer from a diagnosable mental illness 26.2% adults...

Solchany Copyright 2012

Mental Illness & Parents

26.2% adults suffer from a diagnosable mental illness

66% of women are mothers

50% of men are fathersOver a million parents

suffer from mental illness


Parents & Mental Illness

More likely to be involved in public mental health services

More likely to struggle financially

Often struggle to get the services they need

Hospitalizations can disrupt family functioning


Parents & Mental Illness

Medication can complicate things—symptomatically and financially

Maintaining employment can be a challenge

Substance abuse in individuals with mental health issues is on the rise

Spiegelhoff & Ahia, 2011


Impact on Children

Children of parents with mental illnesses have a higher risk of delayed or deviant development

Children also have a higher risk of emotional and behavioral problems

Increased likelihood child will be removed from home at some point

More likely to have children with mental health issues, 30-50% vs. 20% in standard population.

Oyserman, et al. 2000


Common Parenting Impacts

Normal parent stress is amplified

Amplification is more intense when the children are struggling with their own mental health or developmental issues

Consistent and appropriate discipline can be a major challenge

Parents who are mentally ill often had early difficulties of their own learning how to relate and cope well these difficulties may persist well into adulthood


Common Parenting Impacts

Challenge balancing meeting own needs with meeting family needs

Symptoms can be triggered by any stressor, large or small

Stability can be fragile and unpredictable, regaining stability can be challenging

Control of symptoms does not guarantee adequate ability to parent


Common Depressive Symptoms

Withdrawn behavior Hypersomnia Insomnia Lack of joy/positive emotion No animation Lack of connection Lack of care of self Isolation Avoidance of eye contact Indecisive Poor judgment Little insight


Potential Impact

Disinterest in child Unable to meet child's basic

needs of food, protection, hygiene, etc.

Isolating child and self Avoids eye contact Does not talk to child No playfulness Exposure to crying Own cries not met or

consoled dysregulation Sleeps through child’s needs Uses child to meet own

needs


Manic Symptoms

Tangential thinking Unpredictable and/or

violent behavior Rapid speech Little or no sleep for

days Unable to communicate

well Possible associated

psychosis Suicidal Perceptions skewed Acts in unpredictable

ways


Potential Impact

Violent to child Creating environment of

fear Keep child up/interfere

with child’s sleep Overwhelms child with

stories, information or demands

Creates environment of chaos and lack of safety

Creates confusion No routines No emotional containment


Lability

Rapidly changing emotions

Unpredictable Unable to pick up on

emotional cues of anyone Mood changes are not in

sync with environment Easily angered Anger Outbursts Lashes out Impulsive Self Centered


Potential Impact

Unpredictable environment

Confusing presentation of feelings and behavior

Chaos Inconsistency Lack of stability Unable to meet child’s

basic needs Fear Trauma Inability to link cause and

effect


Anxiety

Panic attacks Obsessions Compulsions Frozen/fear Agitation Too little or too much

sleep Refusal to leave house Isolation Unable to get to work Rigid


Potential Impact

Isolation Rigidity Unsafe environment Creation of a fearful

environment Lack of care Lack of meeting basic

needs Unable to support child in

socializing Unable to participate in

child’s school Creates anxiety in child Overprotective


Psychosis

Not in touch with reality Misunderstands Misinterprets Attributes inappropriate

meaning to typical things Acts on disordered

thinking patterns Hallucinations Unable to speak

coherently Confused Hears command voices to

hurt child


Potential Impact

Cannot reality test for child Cannot connect child to

real life events Unable to interpret events Multiple separations Confusing care Lack of care Safety issues Does not communicate

with child Avoids and isolates Safety risks


Delusions

Believes they are someone they are not

Believes things happened that did not

Believes things are true that are not

Believes others have roles or are people they are not

Lives in fantasy created

Paranoia


Potential Impact

Unable to protect child/put child at risk

Ignores important or critical things

Bases decisions within relationship on lack of facts/reality

Trusts those they shouldn’t Does not trust those they

need Refuses to let others in

home/isolates Tries to put child in a

specific imagined role


Incoherence

No knowledge of self No knowledge of

others Struggle to make sense

of anything Unable to communicate

and make sense Answers to questions

do not make sense


Potential Impact

Unavailable Not able to protect Unable to communicate Lack of connection Lack of awareness of

child’s presence Unable to be a

resource for child Cannot help make

sense of the world


Disconnected with Reality

In wrong day/timeOperating in a

different realityMisidentifying

facts/personsIntense fearsUnable to manage

daily needs


Potential Impact

Chaos Confusion Safety issues Creating trauma Lack of judgment Scaring child Not providing

basics for child


Aggression

Symptoms

To self Cutting Suicide attempts Risk taking behaviors Gun play

To others Homicidal behavior Domestic violence Child abuse

Potential Impact

Safety Loss Physical injury Risk of death Certain of trauma


Drug Use

Symptoms

Drug seeking Connection with risky

others Choosing drugs over

other opportunities Use to get high Use to calm down/sleep Unable to connect or

unavailable

Potential Risks

Risk to safety Lack of connection Exposure to drugs Exposure to sexual

abuse Unable to meet basic

needs


Dissociation

Symptoms

Disconnects with present

Blacks out Lack of recall Flashbacks Daydreaming Self abuse Odd decisions/behavior

Potential Impact

Lack of connection Avoidance of child Lack of supervision Fear and

disorganization Safety risks


Narcissism

Symptoms

Puts self first Struggles or

cannot see other’s needs/issues as significant

Plays to Win Seeks power Control over

others

Potential Impact

Lack of sensitivity Lack of empathy Child cannot win or

succeed Cannot identify child’s

needs or meet them


Manipulation

Symptoms

Pitting one person against another

Lying Taking on victim role Creating conflict Making threats,

especially those connected to significant relationships

Potential Impact

Used as a pawn Unable to know what is

true and what is not Fear and chaos Instability


Grandiosity

Symptoms

Makes things bigger than they are

Makes up stories to reflect success or accomplishments

Boasting Name dropping Exaggeration

Potential Impact

Cannot see child as independent

Struggle to see child’s needs as important

Cannot easily empathize

Intrusive


Paranoia

Symptoms

Suspicious of others Thinks others are

plotting or talking about them

Takes benign events and processes them into something diabolical

Fears being watched Fears being listened to Fears spying

Potential Impact

Isolation Suspicious of child Accusing Confusing Cannot meet basic

needs


Parenting Responsibilities

Vocational Decisions

Financial Obligations

Spousal Relationship Issues

Extended Family Issues

Social Responsibilities

Stress Tolerance

Daily CareHome CleanlinessChild’s Basic

Needs MetEducational

Connections and Follow Through

Social Connections


Parent’s Level of Functioning

How is this parent able to function in society & care for themselves?

Friends Work Interact with others Aware of community resources School Family Support child’s school Get to meetings/treatment Has transportation Has housing, food, clothing, medications…


Basic Needs

Do they have housing or a safe place to live?

Do they have a plan to maintain a safe home?

Is it appropriate housing?

Is it clean? Is it safe?

Can they transport the child as needed?

Do they have food in the home, adequate and appropriate for the child?

Do they have the ability to clothe the child appropriately?


Safety Needs

Safe home

Keeps away from dangerous people

No drug or alcohol use

Lives in safe surroundings

Able to provide supervision of child

Has safe toys

Has safe foods


Health Can appropriately care for self

Attends appointments

Able to get child to appointments

Child is healthy

Immunizations are up to date

Child has seen a dentist

Acknowledges and addresses child’s special needs

Takes an interest in child’s health needs

Follows supportive practices, i.e. foods, dress


Understanding Child’s Cues/Communication

Can they understand what their child is trying to communicate with them?

Are they feeding baby without any cues?

Can they read the child’s cues?

Do they problem solve when they are not sure?

Do they use baby-ease talking with baby?

Are they patient and focused with the child?


Take Child’s Perspective

Can they identify what the child might be thinking?

Can they identify what the child might be feeling?

Do they seem sensitive to this?

To they use this information for the child’s benefit?

Do they compare the child to their own issues?


Relationship

Do they talk to child?

Do they allow for a back and forth to occur?

Do they listen to the child?

Are their interactions free from hostility? Are they respectful to the child?

Do they avoid arguing/fighting inform of child?

Do they provide a structure and sense of routine?

Do they nurture the child

How does the child respond to this


Emotional Well Being

Can they recognize the child's needs a a person?

Can they recognize the child’s connections to others?

Can they see the impact of their actions on the child?

Do they dismiss what the child is feeling or experiencing?


Self Sacrifice

Are they willing to give up their own pleasure for that of their children?

Do they have a “parent rules” attitude?

Are they willing to focus on their relationship with their baby?

Do they make money decisions that put their baby first?

What are their options within their current standard of living?

Is it realistic and/or feasible


Mindfulness

Can they see the practical side of things?

Can they see the emotional side of things?

Can they be reflective of themselves and their decisions?

Can they be reflective of their child and the impact of their behaviors/choices on their child?

Do their words and actions match up?

mental illness & parents 26.2% adults suffer from a diagnosable mental illness 26.2% adults...

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