Reprinted from "Parenting" issue of Visions Journal, 2004, 2 (2), p. 34
I was sitting in a psych class when it all came together for me. The professor had just finished an overview about schizophrenia. “Oh my God!” I gasped to myself, “That’s what my father has.”…Numbed, I waited for the class to end. There was so much I wanted to ask the professor. Was I in danger of getting it? Would I be doomed to a life of being institutionalized? I was working in nursing school, working part-time as an aide at a psychiatric hospital in New York City, familiar with the pain and horrors of the disease, but never for a moment connecting it to my father’s illness, much less to my possible vulnerability to it...
P.Stein, Journal of the Calfornia Alliance for the Mentally Ill, Vol.7, No.3
Why didn’t you tell me?” is the title of the article from which this ‘moment of truth’ is excerpted. The reader might well wonder if this is a common scenario. Surprisingly, and unfortunately, the answer is yes. A recurrent theme running through the writings of offspring of parents with mental illness is this sense of being shut out from the truth about their past family life and unprepared for the effects that the illness might have on their future.
When offspring are kept in the dark, they tend to blame themselves, internalizing responsibility for the otherwise inexplicable upheaval that they often experience. Unaware of ‘the facts’ of mental illness, they nonetheless pick up the unspoken message that whatever it is, it would be a complete catastrophe if it struck their own lives.
The fact is, however, that an offspring of a parent with schizophrenia is at increased risk of developing the illness in later life. If one parent has the illness, the chances increase to over 10%, compared to the lifetime risk of 1% for the general population. If both parents have a serious mental illness, the odds increase to around 35%.
Another fact is that with improved medications, and with earlier, more sensitive interventions, developing a mental illness such as schizophrenia is no longer as catastrophic as it was once seen to be.
Part of the early intervention equation relates to the nature of the intervention: using lower medication doses, minimizing the trauma of the care setting, and counselling the person with the illness about how to come to terms with and live with the illness. Supporting the person to resume their life plans is also a key part of the support package.
The other part of the equation relates to the timeliness of the intervention, which in turn relates to the ability of the person in question, and his or her family, to recognize potential early signs and take steps to get help. Unfortunately, offspring are usually uninformed, and incredibly fearful about the possibility of mental illness striking them directly.
What should be done? Since offspring are at higher risk and are often so poorly informed, it makes sense to make them a special focus for any community-wide public education initiatives. Simply providing the facts, though, is not enough. When educating offspring who are moving into their adult years, as much attention should be devoted to undoing the unspoken messages they have already picked up, as to giving them basic information about mental disorders. They need to know that things are different, and that their parent’s experience, especially if it was particularly negative or disruptive, does not doom them to the same fate.
A truly preventive approach would be to educate the offspring of parents with mental illness as soon as they are old enough to understand. As the Kids in Control program shows, even young elementary school children can benefit from age-appropriate information and peer support. We must develop more programs of this nature. We must sensitize school counselors to the unique needs of offspring. We should also develop support groups for offspring in elementary and high school settings.
Finally, mental health professionals have to help parents with mental illness themselves engage in direct, healthy dialogue about the illness with their sons and daughters. Mental illness is an extremely sensitive subject, and is very difficult to broach within the family. Nonetheless, offspring want to be told. As mental health professionals and advocates, it our responsibility to help them find out the truth, and prepare them to lead healthier lives.
About the Author
Eric is the Director of Policy and Research for the Canadian Mental Health Association (CMHA) BC Division.
Reprinted with permission and adapted from Family Connections Sring 2000. Focus on Children Whose Parents Have Mental Illness, published by the BC Council for Families. For more information, visit www.bccf.bc.ca, email [email protected] or call (604) 660-0675 or 1-800-663-5638