It is not inevitable that living with a parent/carer with mental health issues will have a detrimental impact on a child’s development and many adults who experience mental health problems can parent effectively. However, there is evidence to suggest that many families in this situation are more vulnerable.

A number of features can contribute to the risk experienced by a child or young person living with a parent or carer who has mental health problems. These include:

• the parent/carer being unable to anticipate the needs of the child or put the needs of the child before their own;
• the child becoming involved in the parent/carer’s delusional system or obsessional compulsive behaviour;
• the child becoming the focus for parental aggression or rejection;
• the child witnessing disturbing behaviour arising from the mental illness (often with little or no explanation);
• the child being separated from a mentally ill parent, for example because the latter is hospitalised; and
• the child taking on caring responsibilities which are inappropriate for his/her age.

There are also factors which may impact on parenting capacity including:

• maladaptive coping strategies or misuse of alcohol and/or drugs;
• lack of insight into the impact of the illness (on both the parent/carer and child); and
• poor engagement with services or non-compliance with treatment.
• This list is not exhaustive. A number of other factors may need to be considered, including the attachment relationship and any instances of domestic abuse. Services involved with the parent/carer should consider the impact of these factors on the child’s needs