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How to parent when you're in a crisis
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Why do families reach crisis point?
What can I do about it?
What help am I entitled to?
Can my children be taken into care?
When might a child be taken into care?
How can I help my children to cope?
What happens if I have to go into hospital?
How can I get through a crisis?
How else can I prepare in case there's a crisis?
Useful organisations
Further reading
"I just wasn't coping and the problems were mounting up. I couldn't work, and we were getting into debt. I thought I must be a terrible mother - I couldn't even look after myself, let alone my daughter. I don't know how we managed."
This book aims to help parents who are going through a difficult time to avoid reaching crisis point. It looks at some of the problems that can arise for parents and children, and suggests strategies for overcoming them. It also explains how you and your family can get further support and assistance, should you want to.
Why do families reach crisis point?
Bringing up children is a rewarding experience, but it also presents challenges. The pressures of modern life place enormous demands on families, and nowadays it's rare to have an extended family of grandparents, aunts, uncles or cousins to rely on in times of need. Yet, we may have very high expectations. Both women and men may expect to earn a living and contribute to the household.
At the same time, we are bombarded with images of 'model' families – happy, healthy and well off – adding to the pressure to be perfect parents. The reality is very different for many of us, trying continually to balance the demands of complicated lives and to ensure the wellbeing of our children. This responsibility can seem overwhelming when we are under additional stress from mental health problems or other significant life events.
Ordinary situations can reach crisis point if there is additional pressure, especially if people are trying to cope alone. Emotional problems, physical ill health, domestic violence, poverty, debt, relationship problems, employment difficulties, and drug or alcohol misuse may all contribute. Seeking help and trying to deal with these problems can help prevent a crisis. Although difficult at first, it may improve the whole family's quality of life, in the long term. Sometimes, it's not clear whether it's the emotional distress of the parent that is causing a crisis in the family, or whether problems affecting the family are causing the psychological difficulties in the parent. What is clear, and what matters, is that each makes the other worse. Guilt or blame are not helpful and will only make the situation harder for everyone. People need to take steps to help themselves feel better, to sort out their emotional and practical needs, and to ensure that their family's needs can also be met.
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What can I do about it?
Putting time and effort into looking after your own mental health will make it easier to look after your children, and will benefit you all. There are many ways to cope with emotional crises. Talk to your GP about what options you have. This could be counselling or psychotherapy (including family therapy), community support, specialist mental health services, and medication, if appropriate.
Many people find complementary therapies, such as Chinese medicine, aromatherapy, spiritual healing and massage helpful. You could also consult some of the self-help books available through local libraries or booksellers. (See Further reading for relevant publications.)
New parents
Adapting to a new baby changes your life. It places a great deal of strain on relationships and can seem overwhelming. If you, or your partner, have already experienced mental health problems, this may have dented your self-confidence. Well-meaning relatives and professionals may offer 'help' in a way that can undermine you further. It's important to bear in mind that it's perfectly natural for first-time parents to doubt their ability to cope. If you or your partner have recently given birth and are feeling very low all the time, or anxious, you may be suffering from postnatal depression or the 'baby blues'. Tell your health visitor or GP how you are feeling, so that they can help you through this. (See Understanding postnatal depression.)
Your health visitor can be an important source of support, particularly for help with children under five. He or she can visit you at home and offer advice on any problems you may be having. They can also tell you about other help or support in your area, such as parent and toddler groups or playgroups. If you don't already have a heath visitor, your GP can put you in touch with one.
Older children
As children get older, they can understand more about what is happening and can take more responsibility within the family. Sometimes, this can mean a child becomes overburdened, emotionally and practically, within the home.
Teenagers are likely to be grappling with their own problems, such as exams, relationships, and self-identity, and may feel or even resent the impact of parental problems more than younger children usually do.
Getting appropriate help If you feel your relationship with your children is suffering, you might consider some extra support and help. With your child's agreement, if possible, you or someone you both trust could approach an appropriate service. Many areas have counselling services for young people, for example. Another option could be a service aimed at supporting families in difficulties. This could be a specialised service run by mental health services or a more general project, maybe run by a voluntary agency.
Talking to the school
Schools appreciate knowing if children are having problems at home that might be affecting schoolwork or behaviour, so that they can take this into account. If you are thinking of talking to the school, try to get your child's agreement first. They may have a preferred teacher who they particularly trust. Or there may be a nurse attached to the school who may be an acceptable alternative, especially for older children who could be reluctant for you to contact the school.
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What help am I entitled to?
The Children's Act 1989 emphasises that the best way of helping children is to support the family as a whole. It requires the local authority's social services department to provide a whole range of services that take into account a child's race, religion, culture and language.
The help might include advice or counselling, and family aides to do household tasks like cooking, cleaning or looking after the children. It could also include providing day-care, by arranging a childminder or a nursery and, for older children, supervised youth clubs or outings.
Some families will not be eligible for help from social services, and may have to pay for any help they receive. People sometimes prefer to organise their own help and support in any case, because they feel they will be more in control of the situation, or because they fear there's a stigma attached to being involved with social services. There are many national and local services offering help with various aspects of family life. (For more information, see Useful organisations.)
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Can my children be taken into care?
It may be a great worry to parents who are already in emotional distress that they will be seen as unfit parents and their children taken away. This fear sometimes stops families asking for the help they need and are entitled to. But only very occasionally is a child taken into the care of the local authority, and this is very much as a last resort (see below). The primary concern of social services is the welfare of the child. They recognise that the best safeguard is usually to support the family and keep it together, rather than removing the child, which could be very traumatic for everyone.
Voluntary agreement
If you and your social worker should feel that the crisis is such that your child would be better off living away from home for a while, the local authority can look after the child under a voluntary arrangement with the parents. The child could be placed with relatives or friends, with foster parents, or, if your child has a disability, in suitable, high-standard accommodation, for example.
Your local authority must find out the views and wishes of you and your child and take these into account when considering this 'placement'. Placements have to be as near to home as possible and, if more than one of your children is being looked after, they should be kept together, as a rule. The local authority must ensure that a good standard of care is provided. Parents can take their children home at any time.
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When might a child be taken into care?
In exceptional cases, when there is serious concern for the welfare of the child, a Child Protection Conference may be called. This is a meeting set up by social services and involves other people, such as doctors, teachers, health visitors and the police. The parents will be involved and are usually invited to attend the conference. You can bring to the conference a friend or advocate, who could speak for you if you like, and you are entitled to legal assistance. (Consult Mind's Legal Unit for advice and information.) The Conference is chaired by an independent person, who should interview parents in private, first, to explain the process and discuss how they can put their views forward. There are a number of possible outcomes from this meeting, including a decision to carry out an assessment if more information were needed.
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How can I help my children to cope?
Children can be surprisingly resilient, but it's usually best to be honest and explain things to them. Even very young children have the concept of mummy or daddy being sad or not well. More than anything, children need reassurance that it's not their fault, and that their parent is going to get better. Keeping to routine as much as possible is reassuring for children.
Spend time just being with them in a way that's not too demanding for you. You could watch a film and eat pizza, or go for a walk in the park. Sometimes, children keep quiet about what's bothering them, especially if they are afraid of upsetting their parents. Try to keep the channels of communication open.
Children as carers
Some children take on the role of carer for their parent. If this is happening, it might be time to ask social services for practical help with the housework or cooking, for example, so that your child is not overburdened. The needs of your children should be fully assessed and catered for, if you receive services from the specialist mental health services, particularly if you are on the Enhanced level of the Care Programme Approach (CPA). In England and Wales, everyone referred to the psychiatric services should have their needs assessed and care planned within the CPA, or its equivalent. This should provide you with an assessment of your social and health care needs, a care plan, a care coordinator and regular reviews. If you want to discuss caring for your children, talk to your care coordinator or the person from the services with whom you have most contact.
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What happens if I have to go into hospital?
Very occasionally, a parent becomes too unwell to look after their children or even themselves. Going into hospital or having your children looked after by someone else should not be seen as a failure. Instead, see it as a positive step towards getting yourself well and back to normal. Some families make regular use of foster carers, often the same carers, to prevent a major crisis.
If you are admitted to hospital, your children will normally be free to visit you. Ask about a dedicated room for these visits, so your children do not have to come on the ward itself. While you are in hospital, your needs as a parent should be taken into account as part of your care plan or CPA, and will be particularly important when your discharge from hospital is nearing.
If you feel your needs as a parent are not being addressed adequately, it may be worth contacting the advocacy service, which can help put your views forward or put you in contact with the appropriate help and support.
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How can I get through a crisis?
It can be daunting enough getting yourself through each day, if you're in crisis, let alone looking after your children as well. There are many ways of approaching this problem.
Prioritise
Make a list of things that need to be done. Decide which ones are urgent or important. Cross the rest off or, if you can't bear to do this, put them on hold. Of the things that are left, decide which ones are urgent, and focus on ways to accomplish them.
Structure your day
A simple structure can help you to keep going through the day and get a few things done. You could divide your day into morning, afternoon and evening, for example, putting in the essential daily activities, such as cooking dinner or bathing the children. You could also add one or two of the urgent things from your list above, taking into account when you are likely to be at your best during the day. Be realistic and set yourself achievable goals or tasks to encourage you. Doing the washing or going to the shops can be significant achievements when you are not well.
Make time for yourself
Make sure you have some time for yourself during the day. It can be very therapeutic to talk about your feelings if you are experiencing emotional distress. But it's easy to overlook things like this when you are a parent. Try to make time to talk through your worries and problems with your partner, if appropriate, taking advantage of your children being at school or in bed. Telephoning a friend or a support line are alternatives. You could also listen to music or a relaxation tape, watch a video, go for a walk, or have a massage. Or you could arrange a babysitter for a couple of hours and benefit from some time out.
Troubleshooting
You may have one or more significant problems that are weighing heavily. Whether they are the cause or result of your crisis, or just coincidental, leaving them unresolved is likely to cause ongoing distress. Write down the things that are worrying you, however small, and then jot down a few possible solutions to each problem, even if you're not clear exactly how to achieve them. At this point, you could think about who might be able to help you with a particular solution. It could be an individual or an organisation. If you can, try and work on the solutions and create a plan of action.
Be kind to yourself
This applies both in the emotional sense and in the practical sense. Try not to succumb to guilty feelings about the effect you could be having on your family. It's a waste of energy and will not help matters.
There are tactics to help you achieve everyday tasks. Making a list of priorities is a good way to begin. Think hard about the items on your list and decide what is really necessary. What would happen if a particular task weren't done? Of the things you feel you must do, try to think of other ways to achieve your goals. What can you do to make your life easier?
It may be by using more frozen or tinned food than usual, and keeping housework to a minimum. Or it could be by asking for extra time to complete a particular task. Perhaps your children could do something extra for themselves.
Create a support system for you and your family
Most people have some sort of informal support network of relatives, friends, neighbours or colleagues. They may be able to support you emotionally by providing a sympathetic ear. Or they could provide practical assistance by taking the children out or doing the shopping. This may be where well-meaning, but overbearing relatives can be useful. If people offer help and you feel comfortable with it, accept the offer. People generally like to help out as long as they are not taken advantage of.
You could supplement your informal support network with more formal arrangements, such as employing a cleaner for a couple of hours a week. You could also attend a drop-in centre or support group, once or twice a week, or arrange for some counselling or psychotherapy sessions. (See Useful organisations and Further reading.)
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How else can I prepare in case there's a crisis?
If you have experienced bouts of mental ill health for any length of time, it's worth working out a plan of action, together with anyone involved with your care, in case you should start to become unwell. This may involve your partner, friends or relatives, and it may include professionals, such as your doctor or social worker. Within this plan, you can draw up strategies for coping with both your emotional distress and your everyday life. Include your children in the discussions, so they know what to do and what might happen if you become unwell. Make sure you are positive and reassuring, and encourage your children to ask questions and voice their concerns. This will help equip them to weather the crisis.
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Useful organisations
The Association for Post Natal Illness
145 Dawes Road, London SW6 7EB
tel. 020 7386 0868
web: www.apni.org
Advice and support to women suffering from postnatal depression
British Association for Counselling and Psychotherapy
BACP House, 35–37 Albert Street, Rugby CV21 2SG
tel. 0870 443 5252
web: www.bacp.co.uk
Information and advice about counselling and psychotherapy
Family Rights Group
The Print House, 18 Ashwin Street, London E8 3DL
helpline: 0800 731 1696
web: www.frg.org.uk
Support for families whose children are involved with social services
Home-Start
2 Salisbury Road, Leicester LE1 7QR
infoline: 08000 686 368
web: www.home-start.org.uk
A national network of groups offering support to families
One Parent Families
255 Kentish Town Road, London NW5 2LX
helpline: 0800 018 5026
web: www.oneparentfamilies.org.uk
Promotes the welfare of lone parents and their children
Parentline Plus
520 Highgate Studios, 53–79 Highgate Road, London NW5 1TL
helpline 0808 800 2222
web: www.parentlineplus.org.uk
24-hour helpline
Pippin
Birch Centre Annex, Highfield Park, Hill End Lane, St Albans,
Herts AL4 0RB
tel. 01727 899 099
web: www.pippin.org.uk
Helps families cope after the birth of a baby
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Further reading
The burden of sympathy: how families cope with mental illness D. A. Karp (Oxford University Press 2001)
Children caring for parents with mental illness: perspectives of young carers and professionals J. Aldridge, S. Becker (Policy Press 2003)
How to cope as a carer (Mind 2003)
How to cope with hospital admission (Mind 2004)
How to improve your mental wellbeing (Mind 2004)
How to look after yourself (Mind 2004)
How to rebuild your life after breakdown (Mind 2004)
How to recognise the early signs of mental distress (Mind 2004)
Making sense of antidepressants (Mind 2004)
Making sense of cognitive behaviour therapy
(Mind 2004)
Making sense of counselling (Mind 2004)
Making sense of psychotherapy and psychoanalysis (Mind 2004)
The Mind guide to advocacy (Mind 2004)
The Mind guide to relaxation (Mind 2004)
Mind rights guide 1: civil admission to hospital (Mind 2004)
Parenting well when you're depressed: a complete resource for maintaining a health family J. Nicholson, A. D. Henry, J. C. Clayfield (New Harbinger 2001)
Postnatal depression: facing the paradox of loss, happiness and motherhood P. Nicholson (Wiley 2001)
Sheila's book: a shared journey through madness S. Harvey (Somerset Virtual College/Mind Taunton 2003)
Understanding anxiety (Mind 2003)
Understanding childhood distress (Mind 2004)
Understanding depression (Mind 2004)
Understanding postnatal depression (Mind 2003)
Understanding psychotic experiences (Mind 2004)
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This booklet was written by Kay Sheldon
First published by Mind 2002. Revised edition © Mind 2004
ISBN 1-903567-34-3
No reproduction without permission
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