Out-of-home care: Talking about mental illness with children in your care

Why is talking about mental illness important?

Talking about parental mental health difficulties with children helps them to make sense of changes they may have noticed in their family. It also lets them know they are not responsible for the wellbeing of their loved one and that the illness is not their fault.

Children and young people benefit from reassurance through open, age appropriate, consistent conversations to help them understand:

• what different diagnoses mean for them, their parent and their situation
• the help their parent is receiving with recovery
• who they can talk to if they have questions or need support and resources
• their situation is not uncommon
• they can’t catch the mental illness; and
• it’s not their job to fix it.

Talking with children about mental health difficulties early can help remove stigma and let them know you are someone they can come to when they need support or to ask questions.

What children might notice

Children understand the world around them in different ways, depending on their age and stage of development. Babies and toddlers might not understand everything we say, but they notice our tone of voice and facial expressions. School-aged children and teenagers will make their own meaning from facial expressions and body language. For example, if they notice a parent has low energy and
flat facial expression when engaging with them, a child may think this behaviour is their fault.

Try to think about what the child in your care might have seen or heard, and how this might impact on how they’re feeling. Some questions to consider include:

• Might the child be worried about any of the behaviours they noticed in their parent?
• What have you noticed about how the child refers to their parent?
• If the child is in contact with their parent, how is the child’s daily life impacted by their parent’s behaviours (e.g. changes in the child’s routines)?

As a caregiver, it can be challenging to think about how children view what is happening. When navigating difficult times as a foster or kinship carer, children will need you to help them to feel safe and make meaning of their experiences. Helping children to talk about what they notice, hear and feel can help keep them on track, even when things are tough.

Starting the conversation about mental illness

A child’s need for information will change as they grow. For example, there’s no need to explain mental health challenges to babies but older children may come to you with their own questions or ideas about what is going on. It’s helpful to think of this as an ongoing conversation. By creating a safe and supportive environment, children can feel comfortable starting initial discussions that will lead to future conversations over time.

Practical tips

Infants

Babies need to feel comforted and secure.

• Smile while looking at them.
• Maintain eye contact with baby until they look away.
• Hold baby close and cuddle them.
• Smile and nod when baby makes sounds.

Toddlers

Toddlers and preschoolers need help to make sense of the world around them.

• Use simple and consistent language – e.g. ‘You may feel sad you cannot be with Mummy/Daddy right now but this is not your fault. Mummy/Daddy needs time to get some support at the moment.’
• Encourage and allow children time to play – this can help you make sense of their experiences and give you insight into their world.

Primary school-aged children

Primary school-aged children thrive with strong carer-child relationships.

• Create a safe and supportive environment where children can feel comfortable to share what’s on their mind.
• Explain what’s happening in words they understand.
• Remind them there are no silly questions and set up regular times to check in with them.
• Reassure them it’s not their fault, nor their job to fix it.
• Remind them of other support people they can talk to if they’re feeling worried or concerned.

Teenagers

Teenagers may have developed their own views from their friends, social media and the world around them.

• Encourage conversation when you’re both feeling ready and calm.
• Be as (age appropriately) honest as you feel comfortable being with them.
• Let them know they can ask questions at any time.
• Let teenagers know it’s not their fault.
• If you don’t have all the answers let them know you will find out and come back to them, or let them know where they can get further support and information.

Self-care

It can be incredibly rewarding and challenging caring for a child whose parents have difficulties so it’s important to look after yourself.

• Take time out for yourself even if it’s only for a short time to do something you enjoy.
• In trickier times take a moment to manage your own feelings – e.g. take a few deep breaths to settle yourself.

Talking about mental illness with children of any age can be challenging but having open and honest conversations as early as possible has important benefits. You will help to raise children who are resilient in the face of harder times, and who will respect and admire their loved one’s strength as they navigate the difficulties they are experiencing.

Further resources

Children can play out ‘what if’ scenarios in their minds. Their active imagination can create distress about real or imagined events. By talking to them you can try to understand their worries, dispel myths and make plans to help reduce their concerns. Completing one of our care plans will help with learning more about the child you care for, and support you in having these conversations.

Download the care plan template and check out other resources on communicating with children about parental mental illness, following.