When parents are mentally ill, children need help. And preferably before the condition becomes acute and a decision has to be made as to whether the children can stay in the family or have to go into a home.
What exactly do children need at what age to relieve the pressure and provide support?
How and where can they be reached effectively?
Who do children turn to when the people they trust most are not available to them?
The forgotten children
In Germany there are at least 1.5 million children whose parents suffer from psychosis, severe depression or substance dependencies. However it should be borne in mind that this figure does not include certain conditions, such as anxiety disorders, OCD or personality disorders; so it must be assumed that the actual figure is higher. Nevertheless up to now this issue has not been tackled at all or only rarely.
This could be one reason why these children are now often referred to as the “forgotten children”. Another reason for this choice of term could be that there was for a long time a “blind spot” both in adult psychiatry and in paediatric and adolescent care as regards the children of mentally ill parents. Now at least on some issues the plight of these children has been brought to public attention. Support for children and adults is offered in regional projects.
The children of the mentally ill see their parents repeatedly or over a longer period of time in a state of extreme emotion which they are unable to understand. They see their mother or father trapped in an often threatening inner world from which they are excluded, or into which the parent tries to draw them more closely. They can be subjected to often irrational attitudes to time, money or nutrition. They experience periods of separation due to hospitalisation and frequent changes of caregivers.
The children of such families are often “unusually normal”. They feel loyal to their parents and find themselves torn between the family and the outside world, between the needs of their parents and their own needs. At the same time they try to hide their pain and worries as effectively as they can. Here, a widespread social mechanism - the stigmatisation of mental illness - plays a decisive role.
Today, at least in theory, the involvement of adult partners in the treatment of mentally ill persons has become the standard of psychiatric care. But this still does not help the children of the mentally ill, or at least not adequately, even though they themselves have an increased risk of developing mental disorders due to the considerable psychosocial stress.
In summary, the situation is characterised by the following problems:
Hence the cooperation project by the self-help organisation for families dealing with psychiatric issues, Familien-Selbsthilfe Psychiatrie, together with the German umbrella organisation for associations of company health insurance funds, BKK Dachverband, which is supported and promoted by the German Ministry of Health (BMG).
The goal is
In the course of the project various information materials have been developed:
When children can’t be children
Under the heading "Advice and Services” the BKK regional association for the German state of North-Rhine Westphalia (NRW) offers videos on selected topics. These include the video "When children can’t be children“.