14 Parental Mental Health and Its Effects on Children

This chapter is based on the Social Ecological Model.

Parental distress greatly impacts children regardless if it stems from economic hardship, divorce, social isolation, and/or acute or chronic mental illness (Regis College, 2020). As a result, children may be vulnerable to developing mental illnesses themselves (Bernet et al., 2016). Homlong et al. (2015) found that adolescents aged 15 to 16 who reported their parents having mental health problems were associated with a higher risk of long-term dependence on financial welfare in early adulthood. These children have an increased risk of mental illnesses themselves, which can impact their overall well-being and functioning. (Homlong et al., 2015).

A parent’s mental health can influence the quality of their interactions with their child (Milward et al., 2018). When a parent avoids uncomfortable conversations in regard to their mental illness, they tend to use excuses such as “being exhausted” or “having a headache”, instead of directly addressing and explaining their mental illness (Kristensen et al., 2022). As a result, these children are unaware of their parents’ issues and may be confused as to why their parents behave abnormally.

Individual

Parental mental health can significantly influence a child’s mental, cognitive, and social development (Regis College, 2020). The type of disorder suffered by the caregiver, its severity, age of onset, and symptoms all play a genetic role in the potential development of a disorder within a child (Lopes et al., 2021). Common mental health issues present in adolescents include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD) and eating disorders (US Department of Health and Human Resources, 2021). These children may show more behavioral problems, such as internalizing issues like anxiety, or externalizing behaviors like aggression and deviance (Queensland Government, 2021). These challenges can impact their ability to form healthy peer relationships and form a supportive social circle (Queensland Government, 2021).

To better prevent and help children manage the symptoms associated with the onset of mental health disorders, child-specialized therapists should have extensive training in the assessment of risk methods, such as screening for mental health symptoms (Acri et al., 2014). However, a “checklist” approach alone is not sufficient for predicting risk (Cantrell et al., 2024). Prevention efforts that focus on teaching children to recognize and name their emotions help children understand and process their feelings in a healthy way (National Institute of Mental Health, 2021). A 2024 study concluded that the optimal child therapy approaches include building a relationship of trust, involving the family, and taking on a patient-centered, holistic approach (Cantrell et al., 2024).  Seeking professional help, such as psychologists or other behavioral health professionals, allows the child to have a safe space to develop coping strategies and emotional regulation (Weir, 2023).

Relationships

The interactions between parents and their children are significantly influenced by the parents’ mental health (Millward et al. 2018). According to the Parenting Research Center (PRC), parents with poorer mental health were more likely to use harsher discipline (smacking and yelling) compared to those with better mental health (Millward et al. 2018). Research has shown that the lack of emotional regulation displayed through harsh discipline directly affects children’s ability to regulate emotions (Chang et al. 2003). Emotional dysregulation can lead to many social problems within schools, such as modeling the poor regulation strategies that they have learned from their parents through interactions with peers (Chang et al. 2003).

The impacts that mentally ill parents have on their children can be lessened by the parents seeking mental health treatment as soon as possible (Barankevych, 2023). By seeking professional help, the family environment can be stabilized, thus reducing the negative impacts on the child. According to the Mental Health Commission of Canada, it is recommended that parents with mental illness utilize talk therapy, medication, or join support groups (Barankevych, 2023). A study conducted in 2012 found that a combination of parental attendance to cognitive behavioral therapy in conjunction with pharmacological approaches improved the treatment of depressive symptoms in bipolar disorder, anxiety disorders, and obsessive-compulsive disorder. (Hofmann et al., 2012). Additionally, parents can maintain an open line of communication between parent and child in regard to mental illness. Psychologists should encourage parents to model good behavior and create a comforting environment, and explain how it can impact their child in the long run (Weir, 2023). Creating a secure, trusting relationship between the parents and the children is essential because children learn from people they trust (Weir, 2023).

Community

Schools and local organizations can prevent negative outcomes for children of parents with mental health concerns (Substance Abuse and Mental Health Services Administration, 2023). Teachers may identify behavioral and academic changes in their students, such as poor performance or emotional issues, and refer the child to the school district for further evaluation (Substance Abuse and Mental Health Services Administration, 2023). Some common warning signs could include: students who struggle academically or perform poorly in school, students with learning disabilities, students with social or emotional issues, as well as students who have been exposed to trauma or have unstable home lives (Concordia University, 2023).  Support strategies, such as extended deadlines, tutoring, and creating a safe, distraction-free learning environment, can make a significant difference for children struggling academically or emotionally due to home life instability (Concordia University, 2023). When possible, teachers can be flexible and act as role models, helping children with mentally ill parents feel understood and supported (Substance Abuse and Mental Health Services Administration, 2023). By creating safe environments and encouraging timely interventions, schools can reduce the negative impacts of mental health struggles on children’s academic and emotional development (Substance Abuse and Mental Health Services Administration, 2023).

Community partners can support children whose parents have mental health disorders. Local health departments and community clinics often offer behavioral health services, including therapy and counseling, for both parents and children (Substance Abuse and Mental Health Services Administration, 2024). These services address the family’s comprehensive mental health needs, ensuring that support is available within the community (Substance Abuse and Mental Health Services Administration, 2024). Healthcare systems can also focus on integrated care approaches that address the child’s mental health needs (Graif et al., 2021). For example, promoting communication between individual medical and psychiatric providers, primary care clinicians and specialists, and pediatric and child psychiatry systems. This improved coordination can include shared access to medical records, co-locations, and communicating how their specialty works, as well as their goals of treatment (Graif et al., 2021). Similarly, in New York, the “HealthySteps” program integrates child development specialists into pediatric care teams to support families where mental illness or stress may impact parenting (Wagoner, 2025). This program has now expanded to 24 other states (Wagoner, 2025).

Additionally, workplaces can implement supportive programs, such as Employee Assistance Programs (EAPs), to help employees manage stress, anxiety, and depression by providing confidential access to licensed mental health professionals (Greer & Romano, 2022). EAPs maintain a workplace presence, so they are able to offer parents easily accessible support from coaches, counselors, parent educators, and work-life specialists (Greer & Romano, 2022). EAPs work in conjunction with Employee Resource Programs, which are employee-led sessions that foster inclusivity and help build community in the workplace (Greer & Romano, 2022). For example, the Mass General Brigham EAP serves about 80,000 employees and sponsors a monthly virtual “Mother’s Group” to support working mothers in balancing work and motherhood (Greer & Romano, 2022). These initiatives help create a supportive environment that not only benefits parental mental health but also indirectly supports the mental health of children (Greer & Romano, 2022).

Societal

Government policies play a critical role in shaping mental health support for families. The U.S. Surgeon General’s Advisory on the impact of parental mental health on child development calls for enhanced support systems to strengthen family resilience (Murthy, 2024). However, a lack of consistency exists regarding whether it is mandatory for mental health service patients to also reveal parental status. For example, Byrne et al. (2000) found that in one Australian state, two-thirds of adult mental health providers routinely recorded parenting status, while in another state, it was not required. In the United States, practices vary, from not at all to complete documentation of parental status (Mowbray et al., 1997; Nicholson et al., 2006). While many adult mental health professionals support assisting clients’ children, role limitations often hinder their ability to do so effectively (Slack & Webber, 2008). Additionally, some parents may not recognize the potential impact of their illness on their children (Maybery & Reupert, 2006), and others may avoid the topic due to fears of child protection services involvement. These findings highlight the need for policies that promote supportive, not-punitive approaches and clearly define confidentiality and information-sharing boundaries to build trust between clients and providers (Maybery & Reupert, 2006).

To address the needs of children whose parents have mental illnesses, several national- and state-level policies have been implemented. At the federal level, the Family First Prevention Services Act allows states to use Title IV-E funds to support mental health and substance use treatment for parents, with the goal of keeping families safely together (Administration for Children and Families, 2025). On the state level, California’s Mental Health Services Act funds prevention and early intervention services, some of which are aimed at families where parental mental illness may place children at risk (California Department of Health Care Services, 2019). These policies aim to support early identification and promote prevention through family-centered care. Continued development and expansion of similar policies are essential for protecting children’s and parents’ well-being.

References

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