A number of features can contribute to the risk experienced by a child or young person living with a parent or carer who has mental health problems. These include:

  • the parent/carer being unable to anticipate the needs of the child or put the needs of the child before their own;
  • the child becoming involved in the parent/carer’s delusional system or obsessional compulsive behaviour;
  • the child becoming the focus for parental aggression or rejection;
  • the child witnessing disturbing behaviour arising from the mental illness (often with little or no explanation);
  • the child being separated from a mentally ill parent, for example because the latter is hospitalised; and
  • the child taking on caring responsibilities which are inappropriate for his/her age.

There are also factors which may impact on parenting capacity including:
maladaptive coping strategies or misuse of alcohol and/or drugs;
lack of insight into the impact of the illness (on both the parent/carer and child); and
poor engagement with services or non-compliance with treatment.

The stigma associated with mental health problems means that many families are reluctant to access services because of a fear about what will happen next. Parents/carers may worry about being judged and that they will be deemed incapable of caring for their children. Many will therefore view asking for services or support as a high-risk strategy.