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Advice for general practitioners
When you are working with parents, their partners and carers
Consider the advice below...
Ask everyone about children
- Ask for specific information about the age of any child the person has contact with or responsibility for. It can be helpful to offer reassurance that you are asking so that you can offer support, not to find fault and have the child removed (although you have a duty of care to report abuse or neglect to child protection services).
- If the person is separated from their child, explore possible grief and loss issues and provide or refer to counselling services as appropriate.
- If the person is pregnant or trying to conceive, find out what supports and strengths the person has to fulfill their parenting role. Look at the basic needs a child has and if a parent needs help to meet them (such as food, clothing, warmth, safety, emotional support, social support, development and educational opportunities).
- You may like to provide them with a copy of The Best for Me and My Baby booklet.
Never underestimate basic needs
It's important to work with family members, community service providers and child protection agencies (if necessary) to help families to improve their capacity to support, protect and care for their children.
This may include:
- domestic support (if you are unaware of local services, phone the Commonwealth Respite and Carelink Centre on 1800 052 222 for information)
- childcare or respite support (Child Care Hotline 1800 670 305)
- support in seeking appropriate housing
- parents' support groups
- programs to assist parents to develop skills
- counselling to support the partnership of parents
- transport assistance
- referral to a social worker to assist in accessing financial support
- referring their partner/support person to a carers support service (phone the Commonwealth Carer Resource Centre 1800 242 636).
Remember to affirm the parenting strengths of the person and be aware of their limits. Reassure them (if necessary) that parenting is a challenge for all parents. Acknowledge that many of the issues of parents who experience mental illness are generic to all parents and that others are specific to the situation of living with a mental illness.
Promote understanding of mental illness
Encouaging a parent's understanding of their mental illness through psychoeducation (including recovery concepts) can help to:
- improve a parent's insight into the impact of mental illness on their roles and responsibilities
- explore the impact of mental illness on parenting responsibilities and the impact of parenting responsibilities on mental health.
Talk about parenting and recovery
When exploring the concept of recovery with parents, remember that parenting can be related to the recovery process.
- Children often give parents the strength and motivation to 'keep going', and therefore promote hope – a key element of recovery.
- 'Being a parent' provides parents with meaning and purpose – another key element of recovery.
- Parenting may also contribute positively to parents' lives in the community by providing opportunities for meaningful interactions and activities with others.
- Supporting a person's parenting role can provide hope, a sense of independence, self-determination and meaning - all important to recovery.
Explore strengths and vulnerabilities
Explore with parents the possible impact their mental illness may be having on their child and parenting, including their strengths and vulnerabilities. Work together with parents to make plans to support strengths and address vulnerabilities.
You may also like to consider a child's:
- support networks
- school and community activities
- information needs
- safety (including risk and protective factors).
Talk about child resilience
Studies have identified resilience factors that support children to cope with or 'bounce back' from some of the stress or difficulties that they may experience when a parent has a mental illness. It can be useful to discuss these with parents to help them to identify where their children may need extra support.
Resilience factors for children are listed below:
- The parent is receiving support for their mental illness.
- The child understands their parent's mental illness.
- The child can communicate with their parents about their mental illness.
- The child knows they are not to blame or responsible for their parent's mental illness.
- The child has access to other supportive adults.
- The child participates in a range of activities outside of the home.
- The child has close friends.
- The child pursues their own interests.
- The child has a sense of hope about the future.
Support open communication
Find out if parents have enough information about their mental illness and its implications to share with family members, including their children (should they wish to).
- Discuss the benefits of open communication and the importance of discussing mental illness with their children at a level they can understand.
- See the Family Talk booklet that has been developed for families where a parent has a mental illness.
- See the tips for starting the conversation and discussing mental illness with children of different ages.
- Also available is a collection of books and other resources suitable for children of different ages which may be used to help them understand their parent's mental illness.
Talk about care plans
Encourage parents to plan while they are well for continuity of care for their children if they become unwell, or require hospitalisation or separation from their children for other reasons.
Use the templates below to help you develop your own care plans. You may like to fill these in, or just use them as a guide.
Protect children from harm
- When assessing safety, you may find this Child Development and Trauma Guide useful.
- If you are concerned about the safety or wellbeing of a young person, contact your local child protection service. Child protection services aim to keep the family together and are able to offer lots of programs and services to families to ease pressure and support parenting roles.
- If a family is referred to child protection services, remember to seek supervision and support from your team to consider how the family may continue to be supported by your service. It is important for your involvement and support to continue.