Supporting students living with parental mental illness

Journalist Emily Campbell explores a recent study by Monash University researchers into Parental Mental Illness and discusses strategies found to assist when working with children who have mentally ill parents.

Parental Mental Illness (PMI) and the repercussions for the children involved has gained increased attention over the past 20 years, with research aiming to uncover how children cope with having a mentally ill parent and how it affects them socially, emotionally, cognitively and behaviourally.

Young children who are preparing for their transition to school are at a critical stage in their social, cognitive and emotional development (Bayer et al. 2011, as cited in Laletas et al. 2020) with rapid growth and change occurring, and neural pathways for learning forming in their brains.

Unfortunately, children in this age bracket who are exposed to the risk factors associated with PMI are especially vulnerable and in danger of suffering from short-term and long-term adverse effects to their own mental health.

Given the huge changes occurring in children’s brains during the ages of 4-6 years, many early childhood development and neuroscience researchers agree early intervention is vital for supporting children enduring PMI and educational settings are an optimal environment for this (Laletas et al. 2020).

In recent years, there has been extensive research exploring the emotional, behavioural, and developmental impacts of PMI on parents and children, although very little has focused specifically on how teachers are affected, particularly those working in early childhood education.

This lack of understanding as to how kindergarten teachers are affected by PMI is surprising, given the consensus among many PMI experts that early childhood education teachers and staff are particularly well-placed to identify and respond to the needs of vulnerable children living with PMI (Beardslee et al. 2010; Eismann et al. 2019; Kay-Lambkin et al. 2007; Rishel 2012 as cited in Laletas et al. 2020).

Revelatory research

A study published recently (Laletas et al. 2020) identified this gap in knowledge and so investigated the topic, seeking to examine how early childhood education teachers perceive their role teaching young children living with PMI and how it impacts their work and wellbeing.

All respondents had self-reported prior experience teaching children with PMI, with teachers either being told by a parent of their condition or informed by another family member, often in situations where a mentally ill parent was hospitalised.

Teachers involved in the study participated in semi-structured interviews, which allowed for flexibility of discussion about their experiences.

Helpful strategies for preschool teachers

Three key enabling strategies were uncovered by the research.

All respondents demonstrated a thorough understanding that preschool children are shaped by their unique family circumstances and contexts, and that these factors influenced the child’s world view.

They agreed family is critical in influencing a child’s overall development and teachers working with these families required an understanding of individual family needs.

Collaboration and engagement with family members features centrally in early childhood education practice frameworks, like the national Early Years Learning Framework in Australia.

As one respondent identified, “…understanding where the child comes from will have some bearing on how that child understands the expectations or norms around them… Being aware that families operate differently; and having a sensitive and compassionate view about the families that enter our service… we need to have an understanding that there are other things that are impacting on this family and therefore the child.”

Building relationships and engaging with families

Participants all believed building “trusting and caring relationships” with children and their parents was vital, especially when working with families who might be experiencing difficulties due to PMI.

To build these relationships, the respondents said providing opportunities for interactions between parents, teachers and other important adults in the children’s lives was vital to establishing and sustaining positive relationships.

“We invite the parents in as often as possible and try to be a welcoming place,” one respondent said.

“We try to have interactions with the family through functions that can help us develop the relationship between our families and our classroom,” they said.

Another respondent reflected on the case of a mother who struggled with bipolar disorder while her child attended kindergarten (preschool in NSW).

They reiterated the importance of providing a caring and safe environment for these parents to “just talk and have somewhere to interact with staff”.

“We have an adult space upstairs… this mother would sometimes come and sit in the space,” they said.

“We’d have a chat and she’d just debrief one of us about where she was up to with her medication or her personal management.”

Identifying children at risk

Recognising when children are at risk of failing to meet developmental outcomes is an important part of an early childhood education teacher’s role, particularly when dealing with PMI.

All study participants were confidently able to describe the way teachers might identify potentially vulnerable children in their programs.

Key indicators of concern described by the respondents included language delays, children’s emotional and behavioural responses during play and the ways they interacted with other children.

“We are able to pick up on little cues – language, play, just even the way a child presents, the way they hold their body can tell you a lot. One little girl rarely showed any affection. Other children are almost like they’ve got a protective bubble around them, not even acknowledging any kind of awareness that somebody else is even near them,” said one participant inthe study.

Transitioning to school in general is a challenging time for all children, but even more difficult for children living with PMI.

Respondents all expressed concern for children exhibiting these behaviours and signs of developmental delay, highlighting the difficulties they may encounter when transitioning to school.

According to one participant, “…there’s a huge jump between us and school… if the child hasn’t met the developmental milestones for their particular age…”

Respondents also reflected on the importance of building trusting relationships as a strategy to support children’s social-emotional development to prepare them for school.

As well as literacy and numeracy development, two participants emphasised the importance of providing opportunities for vulnerable children to practice and enhance their social and emotional skill development.

One said the emotional wellbeing of children is just as important as their academic development, if not more.

“…If children are unhappy, they’re not going to be able to learn numeracy and literacy,” they said.

What the profession needs

The experiences recounted by preschool teachers in this study highlight the workforce needs of early childhood education teachers who are teaching and supporting children living with PMI.

Several key recommendations were made by the authors and other relevant literature as to how employers, communities and governments can support and empower early childhood education teachers dealing with PMI.

Recommendations include:

  • Providing specific training and professional development to pre-service and in-service teachers to target mental health literacy, raise awareness of stigma and to build knowledge, skill and confidence in dealing with PMI.
  • Building community partnership programs designed to facilitate collaborative partnerships between early childhood education teachers and vulnerable families (Beardslee et al. 2010 as cited in Laletas et al. 2020).
  • Promoting school-based mental health initiatives to improve mental health literacy of staff, families and the wider community (Aylward and O’Neil 2009 as cited in Laletas et al. 2020).
  • Encouraging multi-disciplinary team approaches to encourage collaborative and professional partnerships between educational services and the mental health sector (MacFarlane 2011 as cited in Laletas et al. 2020).
  • Providing networking opportunities for staff to share knowledge about available resources and services for families needing support (Whitham et al. 2009 as cited in Laletas et al. 2020).
  • Establishing resources including accessible websites, apps and e-learning programs for teachers, parents and children should be widely available to help early childhood education teachers create a supportive and welcoming environment for parents.

To access the full study visit https://link.springer.com/article/10.1007/s10643-020-01131-8

Stigma sadly still strong


Despite how common mental illness is, an unfortunate stigma still exists for those suffering from mental health conditions.

According to the Black Dog Institute, one in five Australians aged between 16-85 experience a mental illness in any year, with the most common afflictions being depression, anxiety and substance abuse disorders.

Different mental illnesses can frequently occur in combination, meaning a person who has an anxiety disorder may also develop depression, or misuse drugs and alcohol to self-medicate in an attempt to ease symptoms.

Of the 20% of Australians with a mental illness in any one year, 11.5% have one disorder and 8.5% have two or more disorders.

The Black Dog Institute reports that almost half of all Australians will experience a mental illness during their lifetime.
Alarmingly, the World Health Organisation (WHO) estimates that depression will be the number one health concern in both the developed and developing nations by 2030.


References

Australian Bureau of Statistics. (2009). National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. ABS: Canberra.
World Health Organisation. (2008). The global burden of disease: 2004 update.
Laletas S, Reupert A, Goodyear, M. (2020) Exploring the Experiences of Preschool Teachers Working with Children Living with Parental Mental Illness. Early Childhood Education Journal (2020). https://doi.org/10.1007/s10643-020-01131-8