Parents of Children with Mental Illness: Exploring the Caregiver Experience and Caregiver-Focused Interventions

Abstract

Serious mental illness in children can significantly impact the parents who care for these children in both positive and negative ways. Caregiver strain and enrichment manifests in all areas of parents' lives, including work, mental and physical health, and social and family relationships.Research has identified numerous predictors of caregiver strain such as severity of child's illness and impairment, race, and social support. These parents need strengths-based, parent-focused interventions to help them care for themselves and their family in a healthy, effective manner. A brief summary describes 4 types of interventions for parents of children with mental illness and the supporting research. Education, support, and skill building are all important components in parent interventions. A parent focus for interventions and research will decrease caregiver strain and create a healthier environment for the entire family.

Parenting Stress Among Caregivers of Children With Bipolar Spectrum Disorders

“…Prior research suggests that caregivers of children with BPSD often have a partner and experience considerable stress, given the demands of caring for an impaired child (Fristad et al, 2012; Hellander et al, 2003; Nadkarni & Fristad, 2012). However, in the current study presence of a partner was associated with higher stress, potentially resulting from marital discord, which is common among caregivers raising children with psychiatric impairment (Mendenhall & Mount, 2011). In addition, couples may feel as though they should be able to manage their children’s difficulties, compared to single parents, and feel hopeless or ashamed when neither caregiver can calm or ameliorate their children’s dysregulation.…”

“…Objective factors related to the parent (e.g., balancing work and family) and child (e.g., problematic behavior), subjective parent factors (e.g., parents’ emotional experience related to the child or parenting), and characteristics of the parent-child relationship (e.g., quality of interactions) contribute to parenting stress (Brannan et al, 1997; Abidin, 1992). Thus, as a result of stigmatization and the time, energy, and coordination involved in caring for a psychiatrically impaired child, parents experience considerable stress, diminished interpersonal/family relationships, financial pressure of treatment costs and reduced ability to work, compromised self-care, impaired parenting ability, and strained emotional/physical well-being (Hellander, Sisson, & Fristad, 2003; Mendenhall & Mount, 2011; Nadkarni & Fristad, 2012). …”

“…While the relationship between parenting stress and childhood psychopathology appears to be transactional (Mackler et al, 2015; Stone, Mares, Otten, Engels, & Janssens, 2016), and thus the directionality of effects is not well understood, several predictors of caregiver burden have been identified, including: children’s symptom severity, functional impairment, and type of mental illness; and parents’ age, race/ethnicity, psychiatric history, and perceived amount of social support (Mendenhall & Mount, 2011). Specifically, parenting stress is more pronounced if caregivers are older (Schoeder & Remer, 2007), Caucasian (McCabe, Yeh, Lau, Garland, & Hough, 2003), psychiatrically impaired (Angold et al, 1998), with attention-deficit/hyperactivity disorder (ADHD) symptoms (Algorta et al, 2014; Wiener, Biondic, Grimbos, & Herbert, 2016), depressive symptoms (Theule, Wiener, Tannock, & Jenkins, 2013), or lower perceived social support (Schoeder & Remer, 2007).…”

Grief and lost potential in the parents of adult children with severe mental illness.

“…With deinstitutionalization, parents became the unprepared, unsupported primary caregivers of many adult children suffering from severe mental illness (Cook, Lefley, Pickett, & Cohler, 1994;Mendenhall & Mount, 2011). A survey conducted with 203 family members of individuals with a severe mental illness demonstrated the frustration families have had to endure (Holden & Lewine, 1982).…”

“…Caregiver burden involves caring for the adult child financially, medically, legally, and psychologically, as well as attending to the typical activities of daily living for them (Cook, Lefley, Pickett, & Cohler, 1994;Mendenhall & Mount, 2011). For many parents, this amounts to never-ending parenting.…”