Questions and Suggestions for Early Childhood Workers

 

How will I know?

What can I do?

Partnerships and Collaboration

Links to Fact and Tip Sheets for Early Childhood Workers

Newsletter 'Snippets'

 

How will I know if a child in my care is affected by their parent's mental illness?

Many people with a mental illness fulfill their parenting role very well. Sometimes their children are affected by their parent's illness but this may be hard to identify for some of the following reasons:

• Due to the current stigma attached to mental illness in society, many parents and children choose not to reveal parental mental illness to others.
• The parent may not wish to reveal that they have a mental illness because they are concerned about the confidentiality of that information.
• Some parents (and their children) try to keep their illness a secret, fearing that the child/ren will be taken into care.
• The parent may not believe they have a mental illness.
• Many younger children simply do not realise that their parent is unwell as their knowledge of adult behaviour may be limited.

Some parents may wish to protect their children from worrying about the mental illness and so keep important information from them.

There are a range of indicators that may alert you to the child experiencing adverse outcomes related to their parents illness. These include:

• Failure to thrive.
• No sign of distress or protest when the young child is separated from the parent.
• Poor attendance and/or interaction with others at early childhood programmes (e.g. child care, playgroup, pre-school).
• Regression of development,
• Emotional immaturity, or
• Disturbed or self-destructive behaviour.

However, many children will not be so obviously affected. For both the parents and their children appearances are often unremarkable. It's also important to note that the indicators listed above may also be observed in children with a range of other individual or family changes or problems (e.g. a child or parent with a learning disorder, a parent with an alcohol or substance abuse problem, changing family structures and circumstances, personal physical or psychological health issues) so it may be difficult to identify the cause of the child's difficulties.

If a child or parent reveals information about an on-going mental illness there are a number of things you can do.

 

What can I do?

• Listen in a non-judgmental way and value each person's experience
• Assure the child/parent that they are not alone and that many parents have mental health problems at some time in their life.
• Ensure confidentiality - except in situations where you hold concerns for the safety of the child, parent or others, when you should refer the family to your local child protection service or speak to your service or centre director. Assure the family that:
  • you only need to know how the parental illness may impinge on the child's attendance or behaviour and how the centre/staff can offer support where appropriate.
  • information will remain confidential and will only be provided to staff who the parent believes need to know in order to assist the child or family.
  • other families will not be informed by staff except in the unlikely event that the parent expressly requests this to occur.
• Encourage planning for times when the parent may be unwell - A plan for ongoing care of the child should the parent become unwell or require hospitalisation is extremely important. It can be shared with their family or other support network, GP, health worker and the early childhood centre where relevant. Depending upon their age and comprehension level, it may be useful for children to be involved in determining where possible what will happen to them in such a situation. A plan can help reassure children about things such a where they will be living, who will look after them and their pets and how they'll maintain their regular routines. See the 'Supporting Our Family' kit for a downloadable example plan for the child http://www.howstat.com/comic . This kit also contains a sample letter for parents to inform their child's school about their illness - this may be able to be adapted for other early childhood settings. A Western Australian version of this package is available from the WA Office of Mental Health website, Resources section http://www.mental.health.wa.gov.au/one/aboutus_resources.asp The COPMI site http://www.copmi.net.au also has an downloadable example Baby Plan suitable for children under 2 years of age.
• Ask the parent about their and their child's socialisation needs (e.g. Are they involved in any activities? Do they have any friends?) If they wish, help them meet other parents or direct them to local services. Reinforce the value of children having socialisation and play experiences as well.
• Help correct any obvious misconceptions the child may have about their parents' mental illness For example, young children often mistakenly believe that they are the cause of their parent's illness and/or that changing their behaviour will cause their parent to be well or ill. (Royal College of Psychiatry Fact Sheet for Teachers No. 17 and 'Family Talk' page re common questions children ask in the 'Whole Family' section)

NOTE: The following issues may be best explored with the family by a senior early childhood worker (e.g. Child Care Centre Director) or support service staff such as psychologists, social workers or others with counselling skills as some of the issues involved may be very sensitive for the parent. However, early childhood workers can suggest that the parent access these services and assist them to do so if necessary.

• Ask about safety (e.g. Does the parent ever feel that their child has felt unsafe/scared because of their parent's illness? If so - do they have a plan now for what to do if it happens again or to prevent it reoccurring?) See the reference to planning above. Reinforce protection planning with the child if able to comprehend simple safety measures their parent may have put in place (eg go to a neighbour's house or direct dial to relatives' phone numbers). NB CHILD PROTECTION: Check the mandatory child protection requirements in your state but if you have concerns about the safety and well-being of a child as a result of the parental mental health problem and/or of any treatment contact your local child protection service.
• Reinforce the parent's valuable role with their child.
  • Help the parent reflect on their strengths as a parent and those of their family/support network.
  • Reinforce the fact that all parents find the task of parenting stressful at times and that they need to especially take care of themselves in order to parent as best as they can.
  • Reinforce the importance of early attachment.
  • For people with a mental illness who are parents of young babies the booklet 'The Best for Me and My Baby' has been developed.
  • For families with older children the 'Family Talk' booklet has been developed.
  • After periods of illness some parents may experience loss of skills or confidence in their parenting so increased support and encouragement may be required at this time.
• Ask about areas where they may require support in their parenting role. Local support services may be able to assist the family with domestic chores, respite etc. to support their parenting - Phone Commonwealth Carelink Centre for information about local services (Ph: 1800 052 222). Parenting partners may be able to gain support and information about services though the Carers Resource Centre (Ph: 1800 242 636).
• Help the child (and/or family) access information about mental illness (See listing of age appropriate books and videos).
• If a child has behavioural problems that interfere with their lives and don't seem to be improving, seek specialist help. They may require referral to the local child and adolescent mental health service. They may value the chance to talk about their parent's illness, and their fears, with a professional who is familiar with these things. They may also need help in overcoming their own emotional and behavioural problems. However, suggesting the child be referred to a mental health service when a parent has a mental illness must be done sensitively as it may invoke strong feelings of fear or panic.
• If you or the parent need information relating to family law go to the Family Relationships Online website provided by the Australian Government at http://www.familyrelationships.gov.au/ or contact the Family Relationships Advice Line on 1800 050 321.

Don't assume that mental illness always affects people's ability to do a great job in parenting. Many people provide a supportive and nurturing family environment for their child/ren despite very challenging circumstances.

 

Partnerships and Collaboration

Each family in which a parent has a mental illness has unique strengths and needs which may change over time and as the child enters different developmental stages. Workers involved with the family from fields such as education, justice, child protection and health need to work together with the family and the family's support network to ensure that services provided meet the family's needs and the in particular the needs of the children.

As an early childhood worker you have an important role to play to ensure the child receives care, protection and an opportunity to develop commensurate with their peers.

 

Links to fact and tip sheets for Early Childhood Workers

The resource ‘Helping To Piece The Puzzle Together’, available for download or order from www.copmi.net.au provides a number of suggestions for people working in the early childhood area who are supporting children and families where a parent has a mental illness. Here are some further links.......

Early Head Start Tip Sheet No. 22 What does Infant Mental Health (IMH) mean? And, how do EHS programs implement quality IMH services? http://www.headstartinfo.org/infocenter/ehs_tipsheet/tip22.htm

Social and Emotional Learning fact sheet ? ResponseAbility  http://www.responseability.org/client_images/489644.pdf

Grief and Loss http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=141&id=1662

Dealing with a crisis http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=141&id=1560

Policy http://www.nccp.org/publications/pdf/text_791.pdf Reducing Maternal Depression and Its Impact on Young Children; Toward a Responsive Early Childhood Policy Framework (2008) Jane Knitzer,  Suzanne Theberge, Kay Johnson. National Centre for Children in Poverty, Columbia University, New York. (see excerpt below)

Defining Depression through a Parenting Lens. In the context of parenting, depression can be defined as:

• a combination of symptoms that interfere with the ability to work, sleep, eat, enjoy and parent (italics ours) and that affects all aspects of work and family life;
• an illness that frequently starts early in life, that may have a biological component and that produces substantial disability in functioning (whether it is defined as Major Depressive Disorder or depressive symptoms);
• a common but invisible pathway to a cluster of adversities for adults who are parents, and their children, particularly mothers and their young children;
• a condition that responds to prevention and treatment.

 

Newsletter 'Snippets'

These newsletter 'snippets' are useful for inclusion in early childhood centre's or service's newletters or notices.

 

 

 

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