Caught in the middle

1st October 2004 at 01:00
Some children of mentally unstable parents are finding the support they need. Hilary Wilce reports

Imagine being a child whose mother suddenly feels the need to rescue all the frozen chickens from Sainsbury's. Or your father's violent outbursts are so terrifying you have to lock yourself away in case he kills you.

According to surveys, there are anything from 10,000 to 200,0000 children in this country who have parents who suffer from serious mental illness.

"Which probably means there are about 100,000," says Dr Alan Cooklin, consultant child and adolescent psychiatrist and one of the most experienced family therapists in the UK.

And these children suffer multiple problems. They may be frightened or depressed by their parent's illness, they may worry that it's hereditary, they may be struggling to look after the family, they may fear they are going to be sent into care, and, outside the home, they may be bullied and shunned: "Your mother's a nutter!" is just the milder kind of taunt they might have thrown at them.

Teachers may assume that in such situations someone will be making sure children are looked after and supported. But they could be wrong. Despite fine words and the new integrated approach to child welfare set out in the National Service Framework for Children and the Children Bill, many of these young people still have no one to turn to. Mental health workers don't know enough about children's needs, while child protection agencies don't know enough about mental health.

Left in the middle, children soldier on as best they can, frightened and isolated, sometimes left without money to buy food, and very commonly completely in the dark about what's going on. "Often people dealing with these situations are terrified of talking to the children," says Dr Cooklin. "They aren't trained to. They don't know how to do it."

He knows this from lengthy experience. As former director of the Marlborough Family Service, a family therapy service in north London, and former chair of the Association for Family Therapy and the Institute of Family Therapy, he has worked with troubled families for more than 35 years.

Now he has helped compile training materials on the needs of children with mentally ill parents, which he hopes will be used by everyone involved in working with children.

Being Seen and Heard includes a compelling video and a detailed CD-Rom training pack - although so far, he says, official responses have been disappointing, with no interest being shown by either Margaret Hodge, the Children's Minister, or her officials. "So it remains a secret issue, little talked about or understood."

However, the materials, he points out, are very relevant to teachers. "As the video makes clear, these children don't always show their problems.

They can, for example, be doing very well in school, so everyone will think everything is fine, but they can at the same time be feeling suicidal. I hope it gives some insight into what life is like for these children. I really hope teachers might use it as an opportunity to invite everyone involved in this area, educational psychologists, social workers, and people in the child protection services, to come together for a viewing."

The video interviews children whose parents suffer from bipolar disorders, schizophrenia, depression, suicidal tendencies or have problems with drugs.

These often wonderfully lucid and articulate youngsters talk about how it feels to live with a mentally unstable parent and know when the signs show their mother or father is going downhill again. "Her physical appearance is different, she talks too much... I can't leave her. I don't want her to feel alone," says a teenager.

Sabrina, 16, says she feels she fits in better with adults than kids. "It's made me a better person. I look at life and appreciate it," she says, but she also admits that, despite doing well at school, she feels isolated and desperate.

The video underlines that it is vital for children not to be ignored.

Adults need to ask them what is happening to them, and to allow them plenty of time to talk - maybe with a doodling game they can play while talking.

Any discussions need to be simple and straightforward, with an understanding of the kind of issues that might be preying on their minds.

Many children, for instance, believe that their parent's illness is their fault. If they had been "better", they think, it wouldn't have happened.

Teachers, like everyone who works with children, need to assume responsibility for their care and well-being. And while school obviously isn't the place for specialised medical discussions, it can offer crucial support and encouragement. On the video, one girl comments specifically on how her school "had set up someone I could speak to, and that was quite helpful".

To show how this might be done, training materials, that come with the video, set out precise scenarios for how to approach these difficult and sensitive issues with children. Don't, for example, rush in with questions that assume too much: "You must have been very frightened to see your Mum so upset." Ask the kind of open-ended question that allows them to talk - "So, when you saw your Mum like that, what was it like?"

Another video, Family Therapy Basics, from the Marlborough Family Centre, offers illuminating insights into the complexity of family problems and how they are not always what they seem at first glance. Although this video is intended primarily for those training in family therapy, it would make fascinating viewing for any teacher interested in understanding more about how pupils' attitudes and behaviour are shaped by race, gender, culture and family background. It also makes clear how our own assumptions and background directly shape how we view any difficulties we are dealing with.

In short, we can all sometimes be part of the problem - something all good teachers will bear in mind as they interact with the hundreds of different pupils who pass through their hands.


Being Seen and Heard: The Needs of Children of Parents with Mental Illness.

A video training pack. pound;35.25 from Book Sales, Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG. The pack was produced as part of the Partners in Care campaign, see for more details.

Family Therapy Basics. A video training pack. pound;200. From The Marlborough Family Service, 38 Marlborough Place, London NW8 0PJ.

A new website for young carers from The Princess Royal Trust for Carers offers information, advice and support and a chance to meet up online with other young carers:

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