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

Mental illness in children affects more than just the children—it impacts the entire family. Parents become both caregivers, managing the fluctuating moods and behaviors of their children, and case managers, coordinating the services needed by their children. Parent caregivers of children with mental illness struggle to meet the needs of their entire family by balancing the needs of their child, other family members, and themselves. They may face challenges such as financial burden, sibling rivalry, stigma, self-doubt and blame, marital stress, and difficulty accessing services, in addition to dealing with the symptoms their child is experiencing (Commonwealth Institute, 1999). Family caregivers have been described as stressed, with the potential of having more problems than the persons for whom they care (Lefley, 1997). Family involvement in mental health treatment and service can empower parents to more successfully manage their children’s illness and to be educated advocates for their own children and for others, leading to more positive outcomes for the entire family. Children of caregivers who perceived themselves as competent and knowledgeable in one study functioned better than children of caregivers who felt less empowered (resendez, Quist, & Matshazi, 2000). Despite the impact mental illness can have on the entire family, many therapeutic approaches do not recognize or address the strengths and needs of the parents or whole family. Families not only struggle with the symptoms and impairment of their child’s mental illness but also struggle to get appropriate services from treatment providers (MackinawKoons & Fristad, 2004). A review of intervention studies for children and adolescents suffering with depression found that only 3 of 14 of the interventions studied included a family component (Kaslow & Thompson, 1998). The focus has been primarily on the impact mental illness can have on children’s functioning in areas such as home, school, and peers, and less literature focuses on how mental illness in children impacts the functioning of those closest to them such as their parents and siblings. This article reviews the literature on the biopsychosocial impact of mental illness in children on their parents who are acting as caregivers. The review describes the impact of the caregiver experience on various spheres of life, including mental and physical health, work, and social and family relationships, and summarizes the predictors of the presence and nature of caregiver strain as found in previous research. To conclude, the authors describe some of the available parentfocused interventions and supporting research for use with families of children with mental illness.