Talking and Making Meaning About Parental Mental Health Problems: the Role of Children's Family Caregivers

Abstract

When parents with severe and enduring mental health problems (MHP) are less able to meet their children’s needs, other family members often help with childcare. Research with children and parents with MHP has pointed to the vital role family caregivers play in helping children make meaning and communicate about their parents’ MHP. The caregiver’s perspective on this, however, is barely known. The purpose of this study was to examine how children’s family caregivers contribute to children’s meaning-making about parental MHP. In-depth interviews were conducted with 19 adults living in England and Wales who supported at least one related child aged 4-17 who had a parent with MHP. A substantive theory was developed using constructivist Grounded Theory. It was found that participants engaged in a core social process of providing protection in uncertainty, through which they sought to protect the child, the parent, the self, and the wider family. In making meaning and communicating with children, participants were concerned with shaping the interactional space, communicating through the developmental process, and engendering a sense of safety. Participants appeared to position themselves to the childcare role by assessing the child’s needs, the parent’s needs and their own needs. This was conceptualised as developing a caregiver identity, and seen to shape their contributions to children’s meaning-making. A large amount of communication was found to occur nonverbally, and seemingly without caregiver intent or awareness. The findings support the agenda for family-focused provision of mental health and social care. Clinical recommendations are made for better psychoeducation for caregivers and their inclusion in interventions with children and parents with MHP.