1. 1 Finding the Rhythm and Maintaining the Frame: Perceptions of Children Living with a Parent with Mental Illness

2. 2 Elaine Mordoch, RN PhD Funded by: Canadian Nurses Foundation Center of Excellence for Child and Youth Centered Prairie Communities, Health Canada

3. 3 Research Questions 1. How do children experience living with a parent with a mental illness? 2. How do children manage this experience? 3. What is helpful, unhelpful to manage this experience? 4. What are the outcomes for children?

4. 4 Literature Review 50% of people with mental illness live with children Children have 3 x the risk to develop emotional and behavioral problems Exclusion of childrens perceptions Resilience controversy

5. 5 Method: Grounded Theory (Glaser & Strauss, 1967; Glaser, 1978, 1992, 1998) Participant observation Interviews, drawings Memos Constant comparative analysis Theoretical sampling Rigor

6. 6 Sample Characteristics Children 22 children in 14 families interviewed, 10 re-interviewed 8 girls, 14 boys 11 Children Ages 6-12 11 Children Ages 13-16 Parents 9 depression, 4 bipolar, 1 schizophrenia 12 parents with hospital or crisis stabilization unit admissions 4 parents receiving care at home Families Mom ill in 11 families, dad ill in 3 families 1 family both parents ill 50% of families living in poverty

7. 7 The Basic Social Psychological Processes: Finding the Rhythm and Maintaining the Frame Its like when youre dancing, when youre I guess dancing good, like everything is okay… And then, say someone missed a step, she, like, gets depressed and then you sort of have to deal with learning that step, like, what made her depressed and then to deal with that and then you go on and on. (Interview 15/2, Girl, Age 14)

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10. 10 Fitting In A social structural condition wherein the children had to consider how they were viewed by those in the outside world Children exposed to interconnected contexts (school and peers) that influenced their views of themselves and their families Stigma surrounding mental illness created barriers for some children in sharing their experience and getting help Poverty limited their ability to fit in

11. 11 Outcomes of the Process Identity Children developed a sense of self through school, friends, extended family and community Childrens affective reactions in response to the perceptions of others influenced their sense of self Connections to Parents Most children had valuable connections with their parents which contributed to their lives. Their view of their parents came from interactions when well and unwell

12. 12 Significance of the Study Processes captured connecting to parents Subjective distress masked as resiliency Lack of knowledge regarding mental illness Services remain organized around the parents illness Importance of psychological and physical safety to children