This section focuses on when a child or young adult is living with or caring for a family member or friend with mental health problems. When the caregiver is a child, the care giving is often hidden and the child has less possibility of receiving support from professionals or the family don´t know how to access help or support. Therefore, special attention has to be given to children and adolescents when there is evidence of parental mental distress.

After engagement with these eLearning materials

  1. You will have an understanding of how children or young adults are affected in a family with mental health problems.
  2. You will be able to discuss the impact of mental distress on the family from children and young peoples' point of view.
  3. You will be able to utilise the information and links in this section to source additional information to support their understanding of how mental distress impacts on the family from children and young peoples point of view.

When a parent or sibling experiences a mental health problem, the other children in the family might assume parental roles and responsibilities. These are often referred to as 'young carers' and this can sometimes have a negative impact on the child or adolescent. The consequences can be serious when the child or young adult takes more responsibility than their age and maturity actually allows. Young adults, between 16 and 25 years, when asked about their role as carers, said that they felt that they are "constantly on call" and that they are prepared to "pull out" to support, comfort and sometimes solve complex situations and problems. They also feel that responsibility rested heavily on them, and unfortunately they felt that they did not receive adequate support from mental health professionals. In addition they feel rejected by care-providing agencies and that there is no one else willing or able to shoulder the responsibility that affected them daily often on a 24 hour basis. They felt that they are in great need of help and support (Ali, Hedman Ahlström, Krevers & Skärsäter 2012).

When children and young people between the ages of 15 and 18 have the possibility to discuss their experiences of parental mental distress they often describe a similar story. They lack comprehensive information and often fear their parent's illness and mood, as well as the fear of upsetting the parents and thus exacerbating both their own lives and their parent’s illness. The teenagers lamented that they could not live a "normal" family life and suggest that their relationship with the parent could have been so much better if the parent did not have a mental health problem (Trondsen 2012). Providing a forum for discussion, such as an online discussion group, young people have the opportunity to describe their situation in a nuanced way and to receive and provide mutual support. In the table below you will see links to websites that provide supports for children and teenagers. Spend some time exploring the supports that are available. If your country is not represented in the table, search the Internet to discover if a support group for children and adolescents is available in your country.

Country Details Website
United Kingdom The information resource for Child and Adolescent Mental Health (CAMH) http://www.camh.org.uk/
Sweden A support site for young persons on the web http://www.suicidprev.com/livlinan/
Finland A site for early childhood http://www.lasinenlapsuus.fi/en
Finland A support site for young persons on the web https://www.mielenterveystalo.fi/en/Pages/default.aspx
Netherlands A support site designed especially for young people http://www.gripopjedip.nl/nl/Home/
Netherlands For young people with parents who have psychiatric or addiction problems. http://www.kopstoring.nl/site/Kopstoring/
Netherlands For young people with parents or other relatives who have psychiatric or addiction problems www.survivalkids.nl
Netherlands Multicultural young people with feelings of being depressed. Chat possibility with a coach http://www.depri-en-dan.nl/
Ireland The Childrens Mental Health Clinic http://www.cmhc.ie/

It is important to have an insight into the problems of the individual child and teenager when they take on parental roles and responsibilities because of parental mental distress. For people outside the family, such as a professional carer, it may look as if the child has developed the maturity and ability to deal with what it perceives as its self-evident obligation, and to compensate for the affected parent. However, when the child takes on the role of a parent over a long period, the child may end up in what the literature describes as "parentification" (Byng-Hall 2008). At this point, the situation has become noticeable and it can affect the child's health negatively with issues such as low self-esteem and depression affecting the child. It is therefore important that professional carers learn to recognize and identify situations where children and teenagers are perhaps taking on too much parental responsibility. Watch this short film which briefly explores recognizing and treating children’s mental health problem.

Children sometimes also take on the task of trying to protect their parent emotionally from anxiety and depression. By comforting parents and trying to find the cause of their parents' problems and offer solutions to them, they want to help the parents so much that they feel unable to console themselves (Van Parys & Robertson 2013). The family needs to be aware of this and provide assistance to manage it if it occurs. The whole family needs support and help to clarify their roles and disclaim child adult responsibility. It is particularly important when even adult family members are struggling to keep the sense of responsibility at a reasonable level. They may need help from outsiders, professional caregivers, or other supportive groups such as peers, to set reasonable limits on the commitment of the family member who needs support (Shor & Birnbaum 2012).

Reflective questions

Question 1: What might a child or young person experience when living with a parent who has a mental heath problem?

Question 2 : What does the concept of "parentification" means for children who are caring for parents with a mental health problems?

To be a child in a family with mental health problems there is a risk the presence of mental distress puts the child in the position of observer, thus experiencing loneliness. Often the children compensate when a family member becomes unwell and their family life might alternate between responsibility and loneliness as they wait for reciprocity distressed family member recovers. Children and adolescents require support when a family member experiences mental distress. Mental health professionals need to be open to dialogue within the family and to ensure that the needs of children and young people are considered when the parent (s) experience distress. One of the most important tasks, regardless of what health care profession involved, is to help children manage their sense of responsibility and loneliness in an adequate way and according to their age, maturity and life situation.

Ali, L., Ahlström, B.H., Krevers, B., & Skärsäter, I. (2012). Daily life for young adults who care for a person with mental illness: a qualitative study. Journal of Psychiatric and Mental Health Nursing, 19(7), 610–617.

Byng-Hall, J. (2008). The significance of children fulfilling parental roles: implications for family therapy. Journal of Family Therapy, 30(2), 147–162.

Shor, R., & Birnbaum, M. (2012). Meeting unmet needs of families of persons with mental illness: Evaluation of a family peer support helpline. Mental Health Journal, 48(4), 482–488.

Trondsen, M. (2012). Living with a mentally ill parent: Exploring adolescents’ experiences and perspectives. Qualitative Health Research, 22(2), 174–188.

Van Parys, H., & Rober, P. (2013). Trying to comfort the parent: A Qualitative study of children dealing with parental depression. Journal of Family and Marital Therapy, 39(3), 330–345.

The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.