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Psychiatric Times. Vol. 19 No. 10
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The Patient as Parent: Family Matters

William Kanapaux
October 1, 2002

In June, the National Mental Health Association (NMHA) issued a series of fact sheets designed to address the tendency of service systems to view adults with mental illness in a vacuum. When children are not allowed to visit parents in inpatient facilities, or when community-based programs have no provision for child care, the parent's treatment progress is hindered.

Over the years, NMHA has received numerous calls from parents with mental illness and from adults who were raised by parents with mental illness, said Luanne Southern, M.S.W., the group's vice president of children's mental health services and prevention.

Often with parents, the calls concern divorce and other familial issues, Southern told PT. Frequently, parents find that their illness is being used in court to prove they are unfit parents. "There's such a tendency for society to assume that just because a parent is diagnosed with a mental illness, that automatically means they are unable or incapable of raising children."

Functioning as a Parent

Given the prevalence rates, Southern said, it is clear that many parents with mental illness are successfully raising their children. According to the U.S. Surgeon General's Report on Mental Health, one in five adults has a diagnosable mental disorder in the course of a year, 9% of adults experience some significant functional impairment as a result of their disorder, and 5.4% of adults are considered to have a serious mental illness.

Psychiatrists must remind themselves that the majority of adults with mental illness are parents and that having a diagnosis does not make a person an unfit parent, Nicholson said. Within each diagnostic category exists a wide range of parenting capacity, so that one woman with a diagnosis of bipolar disorder may function far better as a parent than does another.

More important than diagnosis alone, she explained, is gauging how the person functions on a day-to-day basis. Children often provide their parents with motivation and direction, and that is equally true for parents with mental illness. Even profoundly ill parents will rally themselves to raise their children.

Psychiatrists and health care professionals need to pay more attention to aligning treatment and supports with the basic impulse of parents to take care of their children, Beardslee said. In 20 years of research on the topic, he has found that people are powerfully motivated to be good parents. Along with treating the mental illness, psychiatrists need to help parents develop strategies for building strength and resiliency in their children. Education is a key component. The family needs to understand the illness and realize that no one is to blame for it.

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