10/15/2019 Outcomes Participants will Have basic information about - - PDF document

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Working with Families: When an Adult has a Mental Illness

SAMI BRADLEY, LIMHP

Outcomes Participants will…

Have basic information about adult mental health concerns and illness.

Have

Understand how having a parent with a mental illness could impact a child.

Understand

Have some strategies and resources that are available to them

Strategies

Disclaimer

Having a mental illness does not automatically mean a person cannot be a good parent. Parents with mental illness, if given sufficient support, can be good parents, because mental illnesses are treatable.

Prevalence of Mental Illness

 Approximately 1 in 5 adults in the U.S.—43.8 million, or

18.5%—experiences mental illness in a given year.1

 Approximately 1 in 25 adults in the U.S.—10 million, or 4.2%—

experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.2

 18.1% of adults in the U.S. experienced an anxiety disorder

such as posttraumatic stress disorder, obsessive-compulsive disorder and phobias

 Among the 20.2 million adults in the U.S. who experienced

a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness.8

Adult Mental Health

 67% of women, and 75.5% of men, living with

severe and persistent mental illness in the community are parents. (Nicholson, J. et al, 2004)

 Less than 50% of them are getting help

 This is the biggest concern

 Parenting is hard work!

Why is it important to be aware?

The effect on children There may be safety considerations Important in understanding family dynamics

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For more information on Mental Illnesses

 www.nimh.nih.gov  You can print great resources 5-30

page booklets on most disorders. Also, could order a free hard copy for you lending library.

 www.samhsa.gov  Lots of free resources and

information.

 www.nhma.org  More free information, printables

and support.

This Photo by Unknown Author is licensed under CC BY-NC-SA This Photo by Unknown Author is licensed under CC BY-SA

“Families are like mobiles”

Adult Mental Health

Effects on parenting capacity

Mental Illness Symptoms Effect on parent/child relationship Depression Lack of Energy Disturbed Sleep Difficulty Decision Making Guilt/Despair Physical and/or emotional neglect Inconsistent Parenting Irritability Parent seeks comfort from child Anxiety Disorders Poor Concentration Avoidance Poor Impulse Control Vigilant Inconsistent Parenting Comfort seeking from child Minimal Experiences w/ child

Why Parental Mental Health Matters Impact on children 0-5

Babies may be neglected physically and emotionally Cognitive development and learning may be delayed through parents’ inconsistent, under-stimulating and hostile behavior. A baby’s health and development may be exacerbated by living in an impoverished physical environment Illness and injury may not be recognized, adequate medical help not sought. Diet may be inadequate and unsuitable Cognitive and Language development may be delayed

Why Parental Mental Health Matters. Let’s Talk Attachment

The person to whom a child is attached provides a

secure base, a place of safety, warmth and comfort.

A securely attached child feels confident that when

they feel anxious or have a need, their parents will respond.

• sensitivity
• regularly available and reliable
• warm
• responsive
• consistent

Why Parental Mental Health Matters. Let’s Talk Attachment

Studies have shown

• Reduced likelihood of

secure attachments, increased likelihood of avoidant and disorganized styles in children of depressed mothers.

• Link between maternal

social/marital support, more support more secure.

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Why Parental Mental Health Matters Children’s Social-Emotional Development

 https://www.youtube.com/wat

ch?v=7FC4qRD1vn8 Overall, children of parents with mental health difficulties are at a greater risk of experiencing health, social and/or psychological problems If help is not obtained

SB1

How to Help

Referrals

Make appropriate referrals

• When
• Where

Consult

Consult with professionals in your office

• Who can you talk to? (Supervisors, Mental Health Consultants, Reflective Consultants)

Understand

Understand what your role is

• Know yourself
• Focus on building relationships

What can you do as a Home Visitor?

1) Learn about Mental

Illness

• a. What you are doing today!
• b. Read further when you

encounter different disorders

• c. Consult with mental health

professionals

What can you do as a Home Visitor?

2) Avoid Stigmatizing Mental Illness

• a. Victims of severe social stigma
• b. Biological imbalance of the chemicals in the

brain.

• c. Other contributing factors

What Can You do as a Home Visitor?

3) Balance Flexibility with Firmness

Depending on condition may be

a)

Unwilling to accept responsibility

b)

Unable to remember agreements

c)

Untrustworthy

d)

Difficult to understand

e)

Inconsistent with discipline

f)

Poor at keeping appointments

g)

Unpredictable emotionally.

h)

Generally confusing behavior

Slide 14 SB1 Not sure about this talk/activity... I think it's a good way to start conversation in a different way about the difficulty parents may have

Sami Bradley, 11/1/2016

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What can you do as a Home Visitor?

4) Good Supervision is Critical a) Consistent supervision

What can you do as a Home Visitor?

5) Remember Confidentiality

a)

Important Priority!

b)

Only information essential to the treatment of your client (the child), and the safety of staff, clients, and

• ther individuals need to be shared with other

professionals.

c)

Only people legally allowed to have such information would get it.

CONFIDENTIALITY

 Without a specific release, we

are not able to share the following about the caregivers

 Medical Information  Mental Health Information  Substance Abuse/Addiction

Information

 Criminal Reports  Child Protective Services Reports

CONFIDENIALITY

Some tips for this conversation if you to have the ability to share with a teacher, another home visitor, etc

1)

Let them know why

2)

Ask if they are willing to share

3)

Be prepared for “no”

4)

Ask for release

What can you do as a Home Visitor?

6) Focus on Strengths

• No matter how severe the mental illness, there are always

strengths to be built upon. Take the time to learn about your clients’ families and their strengths; they will appreciate it, and everyone will benefit.

What can you do as a Home Visitor?

7) Monitor Your Level of Involvement

 Offer some limited assistance  Referrals to services in the community  Safety and well-being of children is main concern  Countertransference- emotional reactions on your part

that affect your work.

 Know your hot buttons

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Countertransference

Letting your stuff get in the way

• f helping the family…

Sometimes just happens Just need to be aware that it can and does happen! Consult with other professionals if it does

This Photo by Unknown

How to Help.. Available Resources

 Child Parent Psychotherapy  Circle of Security Parenting  Parent Child Interaction Therapy  Individual Therapy  Others

How to Help (Referral Sources) Child Parent Psychotherapy

 To strengthen or repair the child-parent relationship

and attachment connection.

 To promote the child’s social and emotional

development

 To minimize harmful developmental consequences,

which may result from disruptions in caregiving because of abuse or neglect. Ages 0-5 For local providers go to http://www.nebraskababies.com/cpp-provider-list For more information on CPP http://www.nebraskababies.com/child-parent- psychotherapy-cpp

How to Help (Referral Sources) Parent Child Interaction Therapy

· Enhance your parent/child relationships and child

management skills

· Increase your child’s ability to manage

frustration

· Strengthen your child’s social skills

Ages 2-7 For more info go to www.pcit.org For a list of local providers http://magellanofnebraska.com/media/1065188/p cit_providers.pdf

How to Help (Referral Sources) Circle of Security- Parenting

8 Week Parenting Class

 Increase security of attachment of the

child to the parent

 Increase parent’s ability to read

child’s cues

 Increase parent’s capacity to self-

reflect

 Increase parent’s capacity to

regulate stressful emotional states

For Local classes and/or facilitators www.necosp.org

IMPORTANT!

REMEMBER: If there are suicidal plans, threats, and/or attempts Homicidal plans, threats, and/or attempts You have an obligation to report. Report to your supervisor or call the police!

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Suicide/Homicide

 “Sometimes I don’t want to be here anymore”  “I feel like giving up.”  Sudden change in feelings or behavior.

Asking a parent if he/she is thinking about suicide WILL NOT lead them to commit suicide.

Suicide/Homicide

Ask the person if he/she is considering harming him/her self.

Ask

If they indicate that they are, ask if they have a plan or the means to follow through with the plan.

Ask

If they report that they do, call 911 immediately.

Call

(Leave if there is a danger to you)

Leave

If they don’t have a plan, provide a suicide hotline or other mental health support referral.

Provide

Get Supervision!!!

Get

Supporting Families

 It is going to be crucial that you monitor the parent in the

• home. Report any suspected neglect or abuse.

 Referrals  Help the family develop a support system  If it’s important that the parent do something that is

difficult for them, encourage them to talk with a mental health provider. (ie. OCD and letting a child do something artistic)

Tips for Talking to Families

 When a parent lets you know that they have a

diagnosed mental illness.

 Thank them for sharing that information with you.  Conversation we practice earlier, regarding

confidentiality.

 Ask what support they need, who they have for

support

Tips for Talking to Families

 When you suspect a mental illness in a parent?

 Notice changes in their personality  Work concerns into the conversation.  Ask if there is anything you can do to help?

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Contact Information

Sami Bradley, LIMHP Nebraska Children and Families Foundation sbradley@nebraskachildren.org www.rootedinrelationships.org