Mental Illness & Parents 26.2% adults suffer from a diagnosable mental illness 26.2% adults suffer from a diagnosable mental illness 66% of women are mothers 66% of women are mothers 50% of men are fathers 50% of men are fathers Over a million parents suffer from mental illness Over a million parents suffer from mental illness Solchany Copyright 2012

Parents & Mental Illness More likely to be involved in public mental health services More likely to be involved in public mental health services More likely to struggle financially More likely to struggle financially Often struggle to get the services they need Often struggle to get the services they need Hospitalizations can disrupt family functioning Hospitalizations can disrupt family functioning Solchany Copyright 2012

Parents & Mental Illness Medication can complicate things—symptomatically and financially Medication can complicate things—symptomatically and financially Maintaining employment can be a challenge Maintaining employment can be a challenge Substance abuse in individuals with mental health issues is on the rise Substance abuse in individuals with mental health issues is on the rise Spiegelhoff & Ahia, 2011 Solchany Copyright 2012

Impact on Children Children of parents with mental illnesses have a higher risk of delayed or deviant development Children of parents with mental illnesses have a higher risk of delayed or deviant development Children also have a higher risk of emotional and behavioral problems Children also have a higher risk of emotional and behavioral problems Increased likelihood child will be removed from home at some point Increased likelihood child will be removed from home at some point More likely to have children with mental health issues, 30-50% vs. 20% in standard population. Oyserman, et al More likely to have children with mental health issues, 30-50% vs. 20% in standard population. Oyserman, et al Solchany Copyright 2012

Common Parenting Impacts Normal parent stress is amplified Normal parent stress is amplified Amplification is more intense when the children are struggling with their own mental health or developmental issues Amplification is more intense when the children are struggling with their own mental health or developmental issues Consistent and appropriate discipline can be a major challenge Consistent and appropriate discipline can be a major challenge Parents who are mentally ill often had early difficulties of their own learning how to relate and cope well these difficulties may persist well into adulthood Parents who are mentally ill often had early difficulties of their own learning how to relate and cope well these difficulties may persist well into adulthood Solchany Copyright 2012

Common Parenting Impacts Challenge balancing meeting own needs with meeting family needs Challenge balancing meeting own needs with meeting family needs Symptoms can be triggered by any stressor, large or small Symptoms can be triggered by any stressor, large or small Stability can be fragile and unpredictable, regaining stability can be challenging Stability can be fragile and unpredictable, regaining stability can be challenging Control of symptoms does not guarantee adequate ability to parent Control of symptoms does not guarantee adequate ability to parent Solchany Copyright 2012

Common Depressive Symptoms Withdrawn behavior Withdrawn behavior Hypersomnia Hypersomnia Insomnia Insomnia Lack of joy/positive emotion Lack of joy/positive emotion No animation No animation Lack of connection Lack of connection Lack of care of self Lack of care of self Isolation Isolation Avoidance of eye contact Avoidance of eye contact Indecisive Indecisive Poor judgment Poor judgment Little insight Little insight Solchany Copyright 2012

Potential Impact Disinterest in child Disinterest in child Unable to meet child's basic needs of food, protection, hygiene, etc. Unable to meet child's basic needs of food, protection, hygiene, etc. Isolating child and self Isolating child and self Avoids eye contact Avoids eye contact Does not talk to child Does not talk to child No playfulness No playfulness Exposure to crying Exposure to crying Own cries not met or consoled Own cries not met or consoled dysregulation dysregulation Sleeps through child’s needs Sleeps through child’s needs Uses child to meet own needs Uses child to meet own needs Solchany Copyright 2012

Manic Symptoms Tangential thinking Tangential thinking Unpredictable and/or violent behavior Unpredictable and/or violent behavior Rapid speech Rapid speech Little or no sleep for days Little or no sleep for days Unable to communicate well Unable to communicate well Possible associated psychosis Possible associated psychosis Suicidal Suicidal Perceptions skewed Perceptions skewed Acts in unpredictable ways Acts in unpredictable ways Solchany Copyright 2012

Potential Impact Violent to child Violent to child Creating environment of fear Creating environment of fear Keep child up/interfere with child’s sleep Keep child up/interfere with child’s sleep Overwhelms child with stories, information or demands Overwhelms child with stories, information or demands Creates environment of chaos and lack of safety Creates environment of chaos and lack of safety Creates confusion Creates confusion No routines No routines No emotional containment No emotional containment Solchany Copyright 2012

Lability Rapidly changing emotions Rapidly changing emotions Unpredictable Unpredictable Unable to pick up on emotional cues of anyone Unable to pick up on emotional cues of anyone Mood changes are not in sync with environment Mood changes are not in sync with environment Easily angered Easily angered Anger Outbursts Anger Outbursts Lashes out Lashes out Impulsive Impulsive Self Centered Self Centered Solchany Copyright 2012

Potential Impact Unpredictable environment Unpredictable environment Confusing presentation of feelings and behavior Confusing presentation of feelings and behavior Chaos Chaos Inconsistency Inconsistency Lack of stability Lack of stability Unable to meet child’s basic needs Unable to meet child’s basic needs Fear Fear Trauma Trauma Inability to link cause and effect Inability to link cause and effect Solchany Copyright 2012

Anxiety Panic attacks Panic attacks Obsessions Obsessions Compulsions Compulsions Frozen/fear Frozen/fear Agitation Agitation Too little or too much sleep Too little or too much sleep Refusal to leave house Refusal to leave house Isolation Isolation Unable to get to work Unable to get to work Rigid Rigid Solchany Copyright 2012

Potential Impact Isolation Isolation Rigidity Rigidity Unsafe environment Unsafe environment Creation of a fearful environment Creation of a fearful environment Lack of care Lack of care Lack of meeting basic needs Lack of meeting basic needs Unable to support child in socializing Unable to support child in socializing Unable to participate in child’s school Unable to participate in child’s school Creates anxiety in child Creates anxiety in child Overprotective Overprotective Solchany Copyright 2012

Psychosis Not in touch with reality Not in touch with reality Misunderstands Misunderstands Misinterprets Misinterprets Attributes inappropriate meaning to typical things Attributes inappropriate meaning to typical things Acts on disordered thinking patterns Acts on disordered thinking patterns Hallucinations Hallucinations Unable to speak coherently Unable to speak coherently Confused Confused Hears command voices to hurt child Hears command voices to hurt child Solchany Copyright 2012

Potential Impact Cannot reality test for child Cannot reality test for child Cannot connect child to real life events Cannot connect child to real life events Unable to interpret events Unable to interpret events Multiple separations Multiple separations Confusing care Confusing care Lack of care Lack of care Safety issues Safety issues Does not communicate with child Does not communicate with child Avoids and isolates Avoids and isolates Safety risks Safety risks Solchany Copyright 2012

Delusions Believes they are someone they are not Believes they are someone they are not Believes things happened that did not Believes things happened that did not Believes things are true that are not Believes things are true that are not Believes others have roles or are people they are not Believes others have roles or are people they are not Lives in fantasy created Lives in fantasy created Paranoia Paranoia Solchany Copyright 2012

Potential Impact Unable to protect child/put child at risk Unable to protect child/put child at risk Ignores important or critical things Ignores important or critical things Bases decisions within relationship on lack of facts/reality Bases decisions within relationship on lack of facts/reality Trusts those they shouldn’t Trusts those they shouldn’t Does not trust those they need Does not trust those they need Refuses to let others in home/isolates Refuses to let others in home/isolates Tries to put child in a specific imagined role Tries to put child in a specific imagined role Solchany Copyright 2012

Incoherence No knowledge of self No knowledge of self No knowledge of others No knowledge of others Struggle to make sense of anything Struggle to make sense of anything Unable to communicate and make sense Unable to communicate and make sense Answers to questions do not make sense Answers to questions do not make sense Solchany Copyright 2012

Potential Impact Unavailable Unavailable Not able to protect Not able to protect Unable to communicate Unable to communicate Lack of connection Lack of connection Lack of awareness of child’s presence Lack of awareness of child’s presence Unable to be a resource for child Unable to be a resource for child Cannot help make sense of the world Cannot help make sense of the world Solchany Copyright 2012

Disconnected with Reality In wrong day/time In wrong day/time Operating in a different reality Operating in a different reality Misidentifying facts/persons Misidentifying facts/persons Intense fears Intense fears Unable to manage daily needs Unable to manage daily needs Solchany Copyright 2012

Potential Impact Chaos Chaos Confusion Confusion Safety issues Safety issues Creating trauma Creating trauma Lack of judgment Lack of judgment Scaring child Scaring child Not providing basics for child Not providing basics for child Solchany Copyright 2012

Aggression Symptoms To self Cutting Suicide attempts Risk taking behaviors Gun play To others Homicidal behavior Domestic violence Child abuse Potential Impact Safety Loss Physical injury Risk of death Certain of trauma Solchany Copyright 2012

Drug Use Symptoms Drug seeking Connection with risky others Choosing drugs over other opportunities Use to get high Use to calm down/sleep Unable to connect or unavailable Potential Risks Risk to safety Lack of connection Exposure to drugs Exposure to sexual abuse Unable to meet basic needs Solchany Copyright 2012

Dissociation Symptoms Disconnects with present Blacks out Lack of recall Flashbacks Daydreaming Self abuse Odd decisions/behavior Potential Impact Lack of connection Avoidance of child Lack of supervision Fear and disorganization Safety risks Solchany Copyright 2012

Narcissism Symptoms Puts self first Struggles or cannot see other’s needs/issues as significant Plays to Win Seeks power Control over others Potential Impact Lack of sensitivity Lack of empathy Child cannot win or succeed Cannot identify child’s needs or meet them Solchany Copyright 2012

Manipulation Symptoms Pitting one person against another Lying Taking on victim role Creating conflict Making threats, especially those connected to significant relationships Potential Impact Used as a pawn Unable to know what is true and what is not Fear and chaos Instability Solchany Copyright 2012

Grandiosity Symptoms Makes things bigger than they are Makes up stories to reflect success or accomplishments Boasting Name dropping Exaggeration Potential Impact Cannot see child as independent Struggle to see child’s needs as important Cannot easily empathize Intrusive Solchany Copyright 2012

Paranoia Symptoms Suspicious of others Thinks others are plotting or talking about them Takes benign events and processes them into something diabolical Fears being watched Fears being listened to Fears spying Potential Impact Isolation Suspicious of child Accusing Confusing Cannot meet basic needs Solchany Copyright 2012

Parenting Responsibilities Vocational Decisions Vocational Decisions Financial Obligations Financial Obligations Spousal Relationship Issues Spousal Relationship Issues Extended Family Issues Extended Family Issues Social Responsibilities Social Responsibilities Stress Tolerance Stress Tolerance Daily Care Home Cleanliness Child’s Basic Needs Met Educational Connections and Follow Through Social Connections Solchany Copyright 2012

Parent’s Level of Functioning How is this parent able to function in society & care for themselves? How is this parent able to function in society & care for themselves? Friends Friends Work Work Interact with others Interact with others Aware of community resources Aware of community resources School School Family Family Support child’s school Support child’s school Get to meetings/treatment Get to meetings/treatment Has transportation Has transportation Has housing, food, clothing, medications… Has housing, food, clothing, medications… Solchany Copyright 2012

Basic Needs Do they have housing or a safe place to live? Do they have housing or a safe place to live? Do they have a plan to maintain a safe home? Do they have a plan to maintain a safe home? Is it appropriate housing? Is it appropriate housing? Is it clean? Is it safe? Is it clean? Is it safe? Can they transport the child as needed? Can they transport the child as needed? Do they have food in the home, adequate and appropriate for the child? Do they have food in the home, adequate and appropriate for the child? Do they have the ability to clothe the child appropriately? Do they have the ability to clothe the child appropriately? Solchany Copyright 2012

Safety Needs Safe home Safe home Keeps away from dangerous people Keeps away from dangerous people No drug or alcohol use No drug or alcohol use Lives in safe surroundings Lives in safe surroundings Able to provide supervision of child Able to provide supervision of child Has safe toys Has safe toys Has safe foods Has safe foods Solchany Copyright 2012

Health Can appropriately care for self Can appropriately care for self Attends appointments Attends appointments Able to get child to appointments Able to get child to appointments Child is healthy Child is healthy Immunizations are up to date Immunizations are up to date Child has seen a dentist Child has seen a dentist Acknowledges and addresses child’s special needs Acknowledges and addresses child’s special needs Takes an interest in child’s health needs Takes an interest in child’s health needs Follows supportive practices, i.e. foods, dress Follows supportive practices, i.e. foods, dress Solchany Copyright 2012

Understanding Child’s Cues/Communication Can they understand what their child is trying to communicate with them? Can they understand what their child is trying to communicate with them? Are they feeding baby without any cues? Are they feeding baby without any cues? Can they read the child’s cues? Can they read the child’s cues? Do they problem solve when they are not sure? Do they problem solve when they are not sure? Do they use baby-ease talking with baby? Do they use baby-ease talking with baby? Are they patient and focused with the child? Are they patient and focused with the child? Solchany Copyright 2012

Take Child’s Perspective Can they identify what the child might be thinking? Can they identify what the child might be thinking? Can they identify what the child might be feeling? Can they identify what the child might be feeling? Do they seem sensitive to this? Do they seem sensitive to this? To they use this information for the child’s benefit? To they use this information for the child’s benefit? Do they compare the child to their own issues? Do they compare the child to their own issues? Solchany Copyright 2012

Relationship Do they talk to child? Do they talk to child? Do they allow for a back and forth to occur? Do they allow for a back and forth to occur? Do they listen to the child? Do they listen to the child? Are their interactions free from hostility? Are they respectful to the child? Are their interactions free from hostility? Are they respectful to the child? Do they avoid arguing/fighting inform of child? Do they avoid arguing/fighting inform of child? Do they provide a structure and sense of routine? Do they provide a structure and sense of routine? Do they nurture the child Do they nurture the child How does the child respond to this How does the child respond to this Solchany Copyright 2012

Emotional Well Being Can they recognize the child's needs a a person? Can they recognize the child's needs a a person? Can they recognize the child’s connections to others? Can they recognize the child’s connections to others? Can they see the impact of their actions on the child? Can they see the impact of their actions on the child? Do they dismiss what the child is feeling or experiencing? Do they dismiss what the child is feeling or experiencing? Solchany Copyright 2012

Self Sacrifice Are they willing to give up their own pleasure for that of their children? Are they willing to give up their own pleasure for that of their children? Do they have a “parent rules” attitude? Do they have a “parent rules” attitude? Are they willing to focus on their relationship with their baby? Are they willing to focus on their relationship with their baby? Do they make money decisions that put their baby first? Do they make money decisions that put their baby first? What are their options within their current standard of living? What are their options within their current standard of living? Is it realistic and/or feasible Is it realistic and/or feasible Solchany Copyright 2012

Mindfulness Can they see the practical side of things? Can they see the practical side of things? Can they see the emotional side of things? Can they see the emotional side of things? Can they be reflective of themselves and their decisions? Can they be reflective of themselves and their decisions? Can they be reflective of their child and the impact of their behaviors/choices on their child? Can they be reflective of their child and the impact of their behaviors/choices on their child? Do their words and actions match up? Do their words and actions match up? Solchany Copyright 2012