Heidi Tweedie – Stigma free support needed for positive recovery parenting

19th December 2012

Mental health communicator, Heidi Tweedie, explores some of the issues facing parents who experience mental ill-health.

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Over a third of people with mental health problems in the UK are parents and with the emotional, physical and financial strain that having children can bring, there is no doubt this affects their mental health recovery alongside the positives of the role.

Margaret’s positive experience of being inspired to challenge herself is not rare, but nor is her concern that having children may have exacerbated her problems in the first place. “I don’t know if would have been as ill. A lot of fear came to the surface when I had the kids. I didn’t sleep for six months after my first child was born; I felt so undeserving of him; I was convinced he would die. Having kids precipitated a crisis, although it also showed me ways out of it.

Being aware of the mental health risks parenting can bring prior to starting a family is something many people’s recovery would benefit from. Psychiatrists, Community Psychiatric Nurses, Clinical Psychologists and specialist Perinatal Mental Health Nurses provide an important role in this; especially for women who want to conceive and must find a balance with the associated medical risks of medication for them and their baby (see, for example, this HIS and SIGN booklet, and the Beating Bipolar website).

With mental illness, such as post and perinatal depression and postpartum psychosis, currently the biggest indirect cause on maternal death, specialist inpatient services are also vital to provide treatment whilst allowing a maternal bond to grow. However, these are not geographically accessible to everyone; Scotland has two mother and baby units – St John’s Hospital, Livingston and Southern General Hospital, Glasgow.

Parenting is a lot more difficult with mental health issues,” agrees Pauline. “I wasn’t diagnosed until my son was four; by then there was a big issue of bonding and relating to him.” Suffering with post-natal depression, an illness that can last well beyond the baby years, Pauline had faced many barriers to getting the support she needed. “My ex-husband and in-laws prevented me getting help; they said just get on with it. It was not until I was alone and ended up in hospital did I realise what was wrong. I thought ‘I’m no good to him if I’m not here’.

For many parents a support network of friends and family is central to keeping well and having a balanced family life, but it can be damaging if they have poor empathy toward mental illness. Fearing being judged an unsuitable parent by her family and society prevented Pauline from seeking help; a common experience for many parents, culminating in a fear that your role will be compromised, subtly or by force.

Looking back, it would have been helpful if I had had someone who I could have talked with. Of course, I had many close friends and family, but some thoughts and emotions were just too hard to bring up with people close to me,” shares adoptive parent Jeannie Mackenzie. “Such help may have been available to me, but I think part of the reason I did not seek it was that I was concerned that he would be taken away from me. Looking back, I realise I had no grounds for this fear, as anyone involved would see that the adoption was working well and that he was safe and happy.

Indeed, experience of mental illness does not preclude becoming a foster or adoptive parent; the competencies assessment involved explores many factors that are common to recovery, with assessors looking at the individual’s resilience, insight and ability to reflect and learn from experience. With an estimated shortage in the UK of over 10,000 foster carers and 4,000 children waiting to be adopted, the importance of people exploring the alternatives to birth parenting are pressing.

Jeannie’s positive recovery experience inspired her to co-author with her son ‘As if I was a Real Boy’ in 2011. “I know that my own emotional sensitivity – part of what made me ill – also made me empathise with my son’s pain in a way that others might have found impossible. We both knew what it was to suffer and that helped create a very strong bond. Both of us have experienced recovery from mental illness.”

Fears regarding professional involvement are not without merit; social work services do have a duty to remove a child if they have concerns for their safety, but this is by far a last resort. Key to getting the right support is being upfront and honest with professionals; the problems arise if they feel something is being deliberately hidden, which tends to ring alarm bells for child protection, potentially a lose-lose situation for parents concerned about stigma for them and their child.

Children can also be keenly aware of this stigma. Harry considered accessing family behavioural therapy through his psychiatrist, but his son refused; his attitude influenced by a poor reaction to sharing his father’s experiences with a school friend. “As a family we didn’t see my illness as detracting from my role; he had been very accepting and non-judgmental. I tried to get help for us together but he didn’t want to engage. Mental illness is bewildering to children. They don’t necessarily want information but have a yearning to understand. It’s shameful and unpleasant having the intrusion of services in their family life.”

Member-led mental health organisation Stepping Stones, based in Clydebank, became aware of such a barriers through their work with Outside the Box Development. “We found 40% of people were parents and we wanted to make service more parent focused,” explains John White, Service Manager at Stepping Stones. “We thought about setting up specific groups, but there are lots locally that we can refer people on that are recovery focused.” Local availability of schemes such as Triple P Parenting, after school clubs and Sure Start centres vary, making signposting from Health Visitors, School Nurses, GPs and help-lines such as ParentLine Scotland vital.

Clearly, non-judgmental support from professionals, friends and family, makes recovery possible for parents. The first, and hardest, step is to reach out and start the process. The Scottish Government hope to influence parents’ reticence with their National Parenting Strategy launched this October, although every organisation, whether mental health or child focused, can support parents in recovery more effectively through revisiting how they approach this group.

Stigma, the usual suspect, once again raises its ugly head, but for those parents able to find the strength to challenge perceptions and to use the resources available at the most effective time, parenting can support recovery. Additionally, the experiences gained as a result can improve parenting and benefit a child’s development.

More information about parenting, recovery and mental ill-health

Science Daily, ‘Parents Experience Greater Happiness and Meaning in Life than Non-Parents, Psychologists Find’ (17th May 2012)

Support in Mind Scotland, Making Time to Talk – Advice for parents with mental illness