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Why we shouldn’t be scared to talk about how parents impact children’s mental health

Vanessa Pinfold

The Top 10 questions generated by the Right People, Right Questions project are a to-do list for researchers working on treatments and services for young people’s mental health. They are the most important, unanswered questions identified by children and young people, parents, teachers, mental health and social work professionals, and researchers. In other words, they are the questions that matter most to those most affected by a lack of treatment solutions and poor service delivery.

This blog post is part of a series responding to the questions. It focuses on Question 8: 

How do family relationships, parental attitudes to mental health, and parenting style affect the treatment outcomes of children and young people with mental health problems (both positively and negatively)?

 

I’m a mum of two girls aged 10 and 13 and I’m also the head of McPin, a mental health research charity, set up with my family. My work and personal worlds seem to be colliding more frequently these days, as my girls near adolescence and the national conversation around mental health gets ever louder. Just last week, we had the latest prevalence stats from the NHS. These revealed that 1 in 8 young people aged between five and 19 have a ‘diagnosable’ mental health difficulty. The rate was 1 in 4 for young women aged 17 to 19, with half of those who identified as having a mental health problem also revealing that they had self-harmed or made a suicide attempt.

As a parent of girls, there are lots of fears wound up in these figures. When I look at my daughters, one niggling thought is what effect my everyday parenting decisions have had on them. Small things like my tone of voice when cajoling them to help around the house or how well or otherwise I listen, support, care, build relationships and let go. Is this just me? I doubt it.

Mental health is now on our radar as a society more and more. With my professional hat on, I know that this is a good thing. But having the knowledge and skills to improve how we support our own mental health and that of others, including our kids, feels to be lagging behind our general interest and awareness of the topic.

I have no training in psychiatry, psychology, social work, occupational therapy or any discipline to guide my parenting journey – I have gone with ‘just’ common sense. I don’t read parenting books or blogs, use social media to access advice from other mums and dads, or ring helplines. So far, I’ve muddled through by chatting to friends and family, particularly to my husband, so at least it is a shared footprint that we are casting – for better or worse.

My background is in geography but I have worked in mental health research for over 25 years on things like the Mental Health Act, combating stigma, information-sharing with families and service-user involvement in research. Nothing very useful for being mum, except that it has given me a keen eye for research findings. And when it comes to the impact of different parenting behaviours or styles on your kids, my eye hasn’t been very active over the past 13 years as there hasn’t been much research published on this topic.

Despite this lack of research, I know people are interested in this topic because it was rated the 8th most important, unanswered question in the Right People, Right Questions project. Based on the public’s suggestions, the Top 10 are topics that we have judged to have been unanswered or inadequately answered by existing research. They are topics that warrant more investigation.

When it comes to Question 8, we are not starting completely from scratch. We know that trauma is a huge factor in the development of mental health problems in childhood, and that this can come from many including within the family or guardian unit. Parental mental health is another risk factor for the development of mental health problems in children, through both genetic inheritance and social factors. Parenting programmes have been shown to improve parenting and the wellbeing of children. Expressed emotion, a term used to describe the family environment and interactions in families supporting a person with mental health problems, has been well investigated. But this area is complex – there are lots of spinning parts.

Critical but neglected

The questions that came out of Right People, Right Questions were focused on mental health interventions and treatments. The fact that this question made it into the Top 10 means that we do not know enough about how parental attitudes, parenting styles and relationships within the family impact on how young people access or respond to treatments.

Kathy Greenwood is a professor of Clinical Psychology at the University of Sussex and a McPin collaborator. She thinks that these are likely important factors: “Most young people tell us that parents are critical in the help-seeking process. Different parents often have different views on mental health and treatments. How parents interact and cope while supporting their child can be a further critical factor”.

She points out that it is not just parental impact that we need to consider. We need to know more about the impact of a young person’s whole social network on their mental health outcomes. “Family relationships include the role of siblings, and other extended family, who often hold privileged information and whose views and impacts are often neglected,” she says.

In other words, this is a really important area. So why have parental attitudes, parenting styles and more generally, family relationships and their impact on treatment outcomes, received so little attention from researchers? We do not know. The McPin team who checked the existing research were surprised to find this gap. Maybe it is because public mental health research is a poor relation within the spectrum of mental health research interests. Maybe it is because we have only really started talking openly about childhood trauma, including abuse and neglect, and its contribution to mental distress in the last 5 years. Maybe there is a fear that research into this area could result in parents being blamed rather than supported.

Whatever the reasons, we are not alone in saying that researching the impact of family is important. A project called MH:2K, based on the work of 127 young citizen researchers and funded by the Wellcome Trust, recently highlighted how families need more practical mental health knowledge, as well as help to understand the challenges facing young men, and to accept and support LGBT+ young people.

I don’t think that lots of expensive research is the only response required. Common sense still has a very important place in our parental approach. But having a greater understanding of how we, as parents, affect our children’s mental health and having access to more information on the best ways to support them would be very useful. I know it would help me sleep easier at night.

 

For more information about Right People, Right Questions, including how we generated the Top 10, visit mcpin.org/RPRQ and click on the reports.