Early Childhood · Primary School Children and Adolescents
· Role Statement
When the person presenting is the child (under 18) of the person with the
mental health problem
Early Childhood
For any child, but especially for children who are yet to commence
school, the main thing to remember is to ask them how they are feeling
about what is happening/has happened.
Many conclusions about safety, growth and development will
need to be based on observation of very young
children or checking with caregivers (see examples below).
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| Risk Area: Health and Safety |
Failure to thrive, regression to immature behaviour for age and/or poor
growth and development for age (eg lack of language development ) and/or no sign
of distress or protest when the young child is separated from the parent may
indicate rejection, neglect or abuse.
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| Risk Area: Social Interaction |
Check if the child has any opportunities to play and mix
with others. Are there any barriers to attendance at playgroup, childcare
etc.? (eg transport, cost, lack of parental motivation/energy to get them
there, parental concern that seeking child care may be viewed as
a sign of an inability to cope)
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Primary School Children and Adolescents
| Risk Area: Health and Safety |
| Example Prompt Questions |
Assessment |
Intervention |
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Do you ever feel unsafe/scared because of your parent's illness?
(If they have felt unsafe/scared in the past - do they have a plan
for what to do if it happens again or to prevent it reoccurring?)
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If you have concerns about the safety and well-being of a
child/young person contact your local child protection
service.
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Work collaboratively with the child/young person and with their family
and other agencies to develop a
safety plan for any child/young person assessed to be at risk of neglect
or maltreatment with regular monitoring with a nominated child protection
case manager.
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Do you have people you could call upon to talk to or to help out if
things get tough, apart from your parent/s?
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Check if the child/young person has any 'significant adults'
who they can trust.
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Explore ways in which the child/young person could access supportive
adults or peers. Kids Help Line 1800
55 1800 is accessible all hours - encourage children/young people
to stay on the line - many give up if their call is not answered
within 45 seconds.
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Are you worried about your own mental health?
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Assess for any early warning signs of mental health
problems.
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| Risk Area: Lack of Information |
| Example Prompt Questions |
Assessment |
Intervention |
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Do you know what sort of mental health problem/s your parent has?
Can you describe your parent's mental health problem as you see it?
Do you think you might inherit or catch your parent's problem?
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Check and correct any misconceptions.
Check with parent first for permission to discuss their illness in a simple
way if the child/young person wants more specific information.
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Whilst respecting the right to privacy of the person with the mental
illness, invite the child/young person to ask questions about the impact of
mental health problems or illness and associated treatments.
The 'Family Talk' booklet contains
answers to questions commonly asked by children of parents with a mental
illness. (Also available are listings of age appropriate
literature.)
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Do you know where you could get more information about mental health
problems?
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Ascertain information needs and resources. |
Help the child/young person clarify questions they may like to ask
their parent's treating mental health professional/s and support their
efforts to meet with these people if they wish to (given parental
permission).
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CAUTION: As the young person passes through different
developmental stages remember to
re-check their information needs. |
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| Risk Area: Social Participation & Support |
| Example Prompt Questions |
Assessment |
Intervention |
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Do you sometimes feel like you're the only one who has a parent with a
mental health problem?
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Check for bullying/harassment or social isolation.
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Reassure that many parents have mental health problems.
Some states run programmes for young people who have parents with
a mental illness. (Check for information about your
state/territory.)
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Do you worry about what might happen if your parent has to go to hospital or can't
look after you (or your brother/s and sister/s) for some reason?
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Check support needs and if family have a plan in place for emergencies.
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Suggest that the child/young person participates in making a plan for times when their parent
may be unwell or hospitalised - see the 'Supporting Our Family' kit for
a downloadable example plan http://www.howstat.com/comic.
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Do you have to do more around the house than other kids your age because your
mum/dad isn't well sometimes?
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Check care-giving burden and social support needs.
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Advise those who are providing care for their parents about young carer support
group/services (Commonwealth Carer Resource Centre. Freecall: 1800 242 636).
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Do you ever miss school because you are looking after your parent?
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Check school attendance and performance.
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With parental permission, suggest that the school be advised of the
general circumstances with a view
to gaining support from the school. A sample letter to schools is
downloadable from the COMIC website http://www.howstat.com/comic.
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What sort of things do you do (apart from school)?
Do you have many friends?
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Explore reasons for any lack of active participation with peers.
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Explore ways in which the child/young person could access activities with
others of their own age. Respond to the reasons for any poor social
participation.
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Role of General Practitioners
Children of parents with a mental illness are at increased risk of
experiencing mental or physical health problems due to a combination of
possible factors such as genetic inheritance, attachment difficulties,
poverty, social exclusion and discrimination (See facts). Some
children of parents with a mental illness will not experience difficulties
as a result of their parent's ill health, others may appear resilient but
in need of support, and others will be more vulnerable and in need of
services. A small minority of offspring, especially infants, may be at
risk of death through neglect or abuse.
A GP is in a prime position to have contact with the range of people
affected by the poor mental health of a parent and to assist in:
identifying risk factors (e.g. health and safety concerns, lack of
information and/or social support)
strengthening and supporting families and children to enhance protective
factors.
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