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Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

When it's time to discuss a family member's mental illness or alcohol/drug problem

Nicole Chovil, PhD

Reprinted from "Parenting" issue of Visions Journal, 2004, 2 (2), p. 35

When mental illness affects a family, the children–including the offspring or siblings of people with mental illness–are just as confused and scared as the adult family members. They know something is wrong. They see that their family member has changed and are aware when there is tension in the home. They need information and explanations to help them understand what is happening. Children often imagine things that are worse than reality.

Parents, older siblings and other family members can help dispel fears and anxieties. Help your child to be supportive of their family member by talking to them about mental illness. Be honest but optimistic.

Talk to your child using language and explanations that are appropriate to their age level and maturity (see ‘age-appropriate explanations' box on the next page). Look for books and handouts that are written for children. Movies sometimes offer examples that can be used to help children understand. For example, in The Lion King, Simba suffers from depression after the death of his father, Mufasa. Simba's appearance, loss of energy, and lack of interest as he slowly proceeds through the desert provide a concrete example for children to visualize.

Comparing mental illness to other physical illnesses can help normalize the illness. If they have some knowledge of another chronic illness such as asthma, you can use it as an example to help children understand that ongoing care is needed and that people have re-occurrences of symptoms.

It is important to be educated about the particular disorder you're dealing with. If your child asks you a question you don't know how to answer, be honest and tell them you don't know. Let them know you will try to find out.

If a child has seen violent or suicidal behaviour, situations requiring police intervention or any other traumatic incident, don't underestimate how terrifying the experience can be. Help your child to express their feelings.

What you say and do regarding your family member's illness will probably influence your child more than anything you tell them to do.

Suggestions for What to Talk About

Ask your child what they think is the reason for why their family member has been acting differently. Use their response as a way to begin talking about mental illness. Children, especially young children, often believe that if something happens in their world, it is linked to something they did. Ask your child if they somehow feel they are to blame for their family member becoming ill. Reassure your child that their family member's mental illness was not their fault. Mental illness is nobody's fault.

Explain that mental illness can make a person act in strange, confusing or sometimes scary ways. Using alcohol or street drugs can make people do things they would not normally do. Ask your child about the way their family member acts and how it makes them feel. Help your child to express their feelings. Let them know that feelings are neither right nor wrong. It's okay and natural for them to have the feelings they're having.

Here are some other suggestions:

  • Reassure your child that adults in the family and other people, such as doctors, are trying to help their family member get better.

  • Make sure your child knows what to do and who to call if they don't feel safe.

  • Explain to your child that many people still don't understand what mental illness is – an illness of the brain. The brain is an organ of the body just like the heart, liver and kidneys. Sometimes it can get sick, just like other organs.

  • Help your child to realize that when they try to talk about their family member's illness, their friends (and even adults) may make fun of it. They may say things that aren't true or they may not know what to say. Practice with your child what they might say to their friends and other people.

  • If your child witnesses your family member being taken to hospital involuntarily, help them to understand what happened and why it happened. For example, "Your brother suffers from an illness that prevented him from knowing what was best for him. Just like you have had to do things you didn't want to but we knew were good for you. Sometimes when a person is ill, other people need to decide what is best for them."

  • Always remember to let your child know that you are there to listen if they do want to talk.

Here are some questions children commonly ask:

  • Why is my [family member] acting this way?

  • Is it my fault?

  • Can I catch it?

  • Will they always be this way?

  • Do they still love me?

  • Why it this happening to our family?

  • Who will take care of me if my mom/dad gets sick?

Age-appropriate Explanations

Toddlers and preschool children can understand short, simple sentences that provide concrete information. For example, "Do you remember when you had [cold, chicken pox, measles]? You didn't feel like doing anything and you were sometimes grouchy. It wasn't because you didn't love us or wanted to be that way, but because you didn't feel good. Mommy sometimes doesn't feel well right now and she needs to sleep to help her get better. She still loves you and me, but she can't show it right now." Or "When Daddy is sick, he has difficulty going to work." Abandonment is a major childhood fear, so children need frequent reassurance they will be cared for no matter what happens.

School-aged children can understand more information. They can likely understand the concept of various disorders (e.g., depression, anxiety), but may be overwhelmed by details about medications and other types of treatment. For example, "You know how parts of our bodies get sick sometimes, like when you get a stomach ache or a sore throat. Sometimes a person's brain can get very sick and the sickness can cause a person to feel badly inside. It also makes a person's thoughts get all jumbled and mixed up, so they can't think clearly. These illnesses have names, such as [schizophrenia]."

Teenagers have the ability to understand more complex explanations about mental illness and how it is treated. They are better able to express their own thoughts and feelings. Concerns they may have include: "Will I inherit this illness?" or "What will others think?" (stigma).

Important Messages Children Need to Hear

  • Mental illness is a medical illness

  • With treatment and support, their family member will get better

  • They did not cause this illness to happen

  • They cannot make the illness better

  • Mental illnesses affect the way a person thinks, feels and behaves

  • Reminders that it is the illness speaking, not their parent, when they say hurtful or frightening things

Adapted from Helping Children Cope, Mood Disorders Society of Canada

About the author
Nicole is Director of Education for the BC Schizophrenia Society.
Excerpted from How You Can Help: A Resource for Families. Also known as the Family Toolkit, this resource is available on the HeretoHelp website


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