Talking to Your Children about Mental Health

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According to a study, one of three Canadians will experience a mental health disorder in their lifetime. (1)

That’s just one of the many indicators that mental health conditions are common within family units.

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When mental illness affects a family, the children can become confused and scared, knowing that something is wrong but not knowing what it means for their home life. What they may witness is a family member’s behaviour changing, slowly or quite rapidly, and could worry about the potential of losing this family member. What they need at this time is information and explanations to help them understand what is happening. In this article, we go over some of basic principles of mental health within family units, as well as communication prompts to help you talk to a child through the mental health issues in their family dynamic.

Can a history of mental health run in the family?

Mental health disorders are caused by a combination of different things. A person's genes can make them more likely to develop a mental illness, but there is plenty of literature to indicate that mental health issues can affect members of the same family without there being a genetic cause. For instance, two children who have gone through a traumatic ordeal may both develop symptoms of post-traumatic stress disorder (PTSD) even though their symptoms are vastly different. One child may show symptoms resembling obsessive compulsive disorder (OCD) while the other may have disruptive and violent moods.

The important thing to remember is that regardless of genetic factors, mental illness has an impact on family members. (2) Furthermore, it can have a unique impact on children. (3)

Just as family myths and recipes are passed down, so should the information surrounding common and likely mental health conditions, especially when children are affected.

Is mental health hereditary?

From our example in the last section, early childhood trauma resulting in a mental illness is different from having a genetic predisposition to a certain mental illness, though the two factors can be active at the same time.

Certain mental health conditions, like schizophrenia, psychosis, Alzheimer’s, depression, and others have been found to have a genetic link, though not all disorders are automatically passed down from parent to child.

When explaining this to a child, remember children will fear the worst if they are told that they may be at risk of developing a mental health disorder. This may be compounded if they are watching a parent struggle with a condition. Children must be reassured with compassion that mental illness is not a life sentence, and that there are ways to create a healthy mental health profile within themselves by using tools and strategies that can be readily learned.

When is the right time to bring this up to your children?

Individual opinions differ about at what point in the mental health journey should children be brought into the conversation about mental illness and how it is affecting their family. Wait until they ask? Wait until treatment is being sought?

Generally speaking, as children are old enough to understand that the family member is different in some way, it's time to have a talk. All children develop and mature at different paces, and there is no definite age in which this should be brought to a child’s attention. To better understand what children can hear and comprehend at different stages in their lives, it may be best to consult your family physician. Although, age will play a factor in the words used to describe the condition and what it means, but using compassionate language is always a key no matter how old the child is and how mature they are—two very different things. In addition to this, it will be important to take into consideration the conversations the child will have with their siblings and peers going forward. Mitigating miscommunications from child to child could help to keep the spirit of these conversations in focus. Children will need guidance as per what is okay to talk about with friends, and what is information is private talk between the family, and associated family therapists or mental health counsellors.

Explaining what mental health is to your child

Mental health is something we all deal with in some way—talking to kids should be in a positive, empowering manner and should almost never get too personal or graphic about the metal health troubles of our family members. It will be important to explain to children that there are various types of mental health conditions. (3)

Beyond explaining what mental health conditions exist, and that many people deal with mental challenges at some point in their lives, it is important for the child to understand that there are ways to develop and nurture their own good mental health. (4)

This starts with good mental health habits — sleep, nutrition, socializing, games, sports, and school engagement — and other protective factors that can decrease the risk to children. (5)

Then, there are psychological treatments that come in all forms, from art therapy to talk-therapy, to a family therapist and engaging in these forms of help can be very helpful for children who are finding it difficult to understand how mental illness in their family affect them and their feelings surrounding mental illness.

Key messaging for families with a history of mental health disorders

It’s never too early to begin the conversation about mental health. Parents, older siblings and other family members can help dispel fears and anxieties. Help your child to be supportive of their family members by talking to them about mental illness early, often and with compassion. (7) Here are five useful prompts for talking about mental illness within the family unit, and they involve the children and adults of the family together.

  • Be honest but optimistic. Take stock of the family’s mental health issues but don’t forget to also highlight the strengths of the family unit. Perhaps the family loves to travel, or learning new things, they may be die-hard sports fans, or are just really good at making time to have family dinners together.
  • Talk about the future outcomes, but keep these forward-looking statements general and avoid fear-based speculations about what may happen to the family member with this condition.
  • Use the three Cs with the family to remind them that they are not responsible for a mental health condition except for how they deal with it: “I can't cause it. I can't change it. I can care for myself!”
  • Model good coping skills and regular self-care, including getting enough sleep, eating regular healthy meals, fitting in physical activity, time with peers, and even some alone time pursuing hobbies.
  • Furthermore, help your family find the options, programs, and support systems that will help them navigate the challenges of mental illness in the family.

Many children and youth will exhibit different moods, thoughts and behaviours at various times that can be part of normal childhood development. These include: (8)

  • receiving significantly lower marks than expected in school
  • avoiding friends and family
  • having frequent outbursts of anger
  • changes to sleeping or eating habits
  • acting out or rebelling against authority
  • drinking a lot and/or experimenting with drugs
  • not doing the things they use to enjoy
  • worrying constantly
  • experiencing frequent mood swings
  • not concerned with his or her appearance
  • obsessed with his or her weight
  • lacking energy or motivation
  • increased risk-taking behaviour
  • feeling very down

But these characteristics and behaviours may be signs of an underlying mental health concern or disorder if they:

  • are intense
  • persist over long periods of time
  • are inappropriate for the child’s age
  • interfere with the child’s life

How to talk about your family’s past with mental health and how to move forward

Moving forward, remember that just as mental health conditions change and evolve, so will the conversations around it. As the children in question grow older and more mature, the types of information you can share with them too will become more sophisticated.

While it is important to keep lines of communication open at home, remember the other arenas in which to talk about a family’s past with mental health—doctor, family counsellor, group therapy, other family members—and how to use our own stories to create an open and honest dialogue.

References:

1. Mental Illness.Government of Canada. 2017.. www.canada.ca › public-health › services › about-mental-illness

2.The impact of mental health problems on family members. Caryn Pearson. Statistics Canada. 2015. https://www150.statcan.gc.ca/n1/pub/82-624-x/2015001/article/14214-eng.htm

3.Effects of Family Structure on Mental Health of Children: A Preliminary Study. Aniruddh Prakash Behere. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559994/

4.For Young People Who Have a Loved One with Mental Illness. BC Schizophrenia Society. 2019. https://www.heretohelp.bc.ca/infosheet/understanding-mental-illness-in-your-family

5. Family & Caregiver Support. Canadian Mental Health Association.
https://cmha.ca/mental-health/finding-help/family-caregiver-support

6.Mental Illness in Families. American Academy of Child and Adolescent Psychiatry. March 2015. https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/children-of-parents-with-mental-illness-039.aspx

7. Help for Families Dealing with Anxiety, Depression, Addiction or PTSD. Dr. Steven M. Melemis. 2019. https://www.addictionsandrecovery.org/family-support/families-anxiety-depression-addiction-ptsd.htm

8. Child and Youth Mental Health Signs and Symptoms. Canadian Mental Health Association. 2020.
https://ontario.cmha.ca/documents/child-and-youth-mental-health-signs-and-symptoms/