The role of early childhood services in supporting families where a parent has a mental illness: How can early childhood services help?

• Author: Stella Laletas, Child Psychologist and Lecturer (Early Years) Faculty of Education Monash University
• Series editors: Andrea Reupert and Darryl Maybery (Monash University) on behalf of the COPMI national initiative

Quick facts

• Between 21-23% of Australian children have at least one parent living with a mental illness.
• These children have a greater likelihood than other children of developing their own mental health issues.
• Early childhood services are an ideal setting for prevention and early intervention.
• Various resources are available for early childhood educators and caregivers working in this area.

Research summary

The Early Childhood, Education and Care (ECEC) system plays a critical role in supporting vulnerable children. While children are particularly vulnerable when exposed to the risk factors associated with parental mental illness, these children are not widely recognised as children ‘at-risk’ within the ECEC sector.

Although not all children living in families where a parent has a mental illness will experience problems, some may experience behavioural and/or emotional difficulties either during school or later in life. Early childhood setting sites can potentially create stability for children, support parent-child interaction, encourage families’ engagement in the community and provide accurate information and support to these families.

The national Early Years Learning Framework

Recent policy reforms in the ECEC sector emphasise the importance of early childhood educators and caregivers working in partnership with families and communities in guiding practice. The national Early Years Learning Framework (EYLF) ‘Belonging, Becoming and Being’ provides an overarching framework that is closely aligned with holistic and family-orientated approaches. Nonetheless, working in partnership with families where a parent has a mental illness can be extremely challenging for early childhood educators and care givers. Unless issues relating to neglect or abuse exist and/or the child presents with their own issues, these children may subsequently be ‘hidden’ and not identified as requiring additional assistance. This ‘hidden’ status enables opportunities for prevention and early intervention to often be missed.¹ Early childhood educators and care givers can however, promote protective factors to children and families living with parental mental illness.

Early childhood services can help by:

Working in partnership with families and other professionals

Both the EYLF and the mental health literature advocate for practices and processes that promote a shared understanding of children by building relationships and collaboration between parents and staff. Findings from an Australian study suggest that early childhood educators and care givers are not linking the EYLF focus of ‘Being, Belonging and Becoming’ when they work with children and families experiencing mental health difficulties.²

Early childhood services can help by endorsing the EYLF principles and practices when working with vulnerable families impacted by parental mental illness.

For example:

• Family-centred practice

A family-centred model of practice recognises children benefit when the expertise of staff and parents is shared in a complimentary and non-judgemental way. Family-centred practice is widely accepted in the ECEC sector for supporting children with physical and developmental disabilities, enabling educators and carers to employ similar practices to maximise the positive outcomes for children living with parents with mental illness.

• Holistic approaches to learning and educational planning

The knowledge and expertise of early childhood educators and caregivers can help to promote protective factors for children. This is achieved by sharing their understanding of childrens’ development with parents. For instance, implementing an Individual Learning Plan in partnership with families can be utilised in instances where children are identified as vulnerable and ‘at-risk’ of not meeting their developmental milestones. Early childhood services provide support to these families by widening the definition of ‘vulnerable children’ to consciously include children of parents with a mental illness.

Building staff capacity

Building the capacity of early childhood educators and care givers to develop the skills and understanding of the impact of parental mental illness on children has been well documented as being critical.³ Early childhood educators and care givers often feel inadequately trained to work with children and families experiencing difficulties associated with mental illness.^2,4 Many early childhood educators and care givers experience high levels of anxiety and emotional discomfort when working with parents experiencing difficulties such as mental health issues, substance abuse and domestic violence.²

Community partnership programs in the United States of America³ and Australia⁵ that were designed to build collaborative partnerships between staff and vulnerable families, highlight the importance of the following key professional development components (to support and build the capacity of early childhood educators and care givers):

• Multi-disciplinary team approaches that foster collaboration and professional partnerships with professionals from community services and the health sector.
• Training and access to resources that provide information on mental health issues, referral procedures for families and support for staff (see resources below).
• Reflective practice with an emphasis on strategies for engaging parents and building reciprocal and trusting relationships when working with vulnerable families.

Limitations of research

While there are many mental health promotion programs available in early childhood settings with a relatively solid evidence base,² there has been limited research that has focused specifically on how early childhood settings could address issues associated with parental mental illness and provide support to children and families. Given the importance of improving the outcomes for children living in families where a parent has a mental illness, more research is needed into the design and subsequent evaluation of interventions for families in these critical settings.

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1. Rishel CW. Pathways to prevention for children of depressed mothers: A review of the literature and
   recommendations for practice. Depression Research and Treatment. 2012;2012.
2. Sims M, Davis E, Davies B, Nicholson J, Harrison L, Herrman H, et al. Mental health promotion in childcare centres: Childcare educators’ understanding of child and parental mental health. Advances in Mental Health. 2012;10(2):138-48.
3. Beardslee WR, Ayoub C, Avery MW, Watts CL, O’Carroll KL. Family Connections: An approach for strengthening early care systems in facing depression and adversity. American Journal of Orthopsychiatry. 2010;80(4):482-95.
4. Giannakopoulos G, Agapidaki E, Dimitrakaki C, Oikonomidou D, Petanidou D, Tsermidou L, et al. Early childhood educators perceptions of preschoolers’ mental health problems: Aqualitative analysis. Annals of General Psychiatry. 2014;13(1):1-6.
5. Aylward P, O’Neil M. Through the looking glass: A community partnership in parenting. Invest to grow final
   evaluation report Adelaide. 2009.