A checklist for professionals coming into contact with
children of parents with mental health problems
Working in partnership with
psychiatrists and carers
This checklist has been designed after consultation
with young carers. It aims to help the professional give children
and young people the information they need to come to terms with
their family member’s mental health problem.
Not every young person will need answers to all
the questions, but this checklist should give you an idea of the
issues to consider.
How to use the checklist
- Consider the young person’s age, level of understanding,
preferred language, their culture and religion.
- Children should not be expected to take on adult roles.
However, their knowledge and expertise should be respected and
- When there is someone experiencing mental
health problems in their family, children and young people are
usually very aware of the symptoms, but may be confused about the
nature of the problem. This can lead to the young person feeling
scared, frustrated, anxious or guilty. They may keep these feelings
concealed if there is no-one to ask how they feel.
- In some cases, the child or young person will
be in a caring role inappropriate to their age and may have extra
needs as a result.
- The information you can share may be limited by
the wishes of the person experiencing the mental health problem.
Some adults hope that children and young people can be protected
from knowledge of a mental health problem in the family – this is
usually not the case. Even if the person with the problem does not
want the young person to be involved, it may be in the child’s
interest to give general information about mental health
- Ensure that you are familiar with your
organisation’s Child Protection procedures – if you suspect that a
child may be at risk of significant harm, you must make a referral
to the appropriate statutory children’s services. The Children Act
1989 states that the best interests of the child over-ride all
other considerations, but the parents should be involved in
decisions, unless doing so could increase the risk to the
Before talking to the young person, it would be
useful if you had:
- asked the person with the mental health problem
how much information they are willing to share with the young
- agreed to review their views on
information-sharing on a regular basis
- recorded their views on information-sharing in
You can share general information about an illness
(i.e. information about depression rather than information about a
patient’s depression) without breaking confidentiality.
At the beginning of an interview with a young
person, ensure that they know that you may not be able to keep the
Parents do not have an automatic right to know what
their children have said to you, but it is good practice to keep
parents involved if a young person under 16 is comfortable with
this, and it is in their best interests. For children under 16 who
are not able to understand the service that you offer, it is
essential to gain parental consent before offering support, unless
you are concerned that the child may be at risk of significant harm
(see How to Use this Checklist). Your organisation should have a
policy on this matter.
About the mental health problem
Explore the young person’s current level of
knowledge and any assumptions they have made. Do not assume they
would feel better not knowing the truth. Try to give age
- what problem does their relative have?
- how does this affect the way they feel and
- what is known about the causes of this
- what sort of things can help their relative get
- is the problem likely to get better or
- what can be done to keep their relative
- who else can they contact if they are
About the young person
Children and young people will often hold a range of
fears about their family member’s problem, but may feel they have
to keep some feelings to themselves. Many of their fears will be
unfounded. They may be wondering:
- can I catch it?
- was it my fault that my relative got this
- how likely is it that I will develop it when I
If there is evidence of genetic factors, ensure
that you put this in context. For instance, the young person could
lessen the risk of developing a mental health problem by talking
about their feelings, seeking help at the first signs of distress,
maintaining a healthy lifestyle, being aware of the risks
associated with drink and drugs etc.
- is there anything I can do to make them
Avoid telling the young person to behave well for
the person with the problem. It is important that they do not feel
that they are responsible for their relative’s well-being.
The young person’s feelings
The young person may feel:
- angry with the person who is ill
- frustrated or powerless
The young person may need help to express and
explore their feelings. It is important for them to understand that
it is normal to experience a range of emotions. Can they think of
ways of coping with these feelings? Who can they talk to when they
are feeling down (e.g. family members, trusted adults,
About care and treatment
- What kind of help is their relative
- How will this affect them?
- How long will it last?
- Will it help them to recover?
- Who else is, or will be, involved in helping
them? What do they do?
The young person and the treatment
Young people should never be encouraged to take on
responsibilities inappropriate to their age, such as interpreting
for parents or supervising medication, however competent they
appear to be. They should know, however, who to approach for help
if they become concerned about their relative.
- What aspects of supporting their relative do
you expect to have an impact on the young person’s life?
- How do they feel about that?
- How can they get in touch with you?
- Have you discussed confidentiality issues with
their family member?
It is usually inappropriate for a young person to be
responsible for reminding or giving their relative medication. The
family may need extra support to protect the young person from the
burden of this kind of responsibility.
- What does the young person need to know about
the medication being used?
- If there are young children in the family, how
will medication be stored safely?
- Does their relative have to be admitted to
hospital? Which one, and for how long?
- What will happen to the young person if their
relative goes into hospital?
- Will the young person be able to visit
- What arrangements will be made for visits? Will
there be a private room?
Young carers’ needs
If the young person provides, or is likely to
provide, emotional or physical care to their family member, they
may be a young carer. Their nearest Young Carers Project can be
found at the website listed overleaf.
- Is their caring role having an impact on their
relationships, education or leisure time?
- What is the emotional impact of their caring
- Who will support the young carer?
- Do they know that they are entitled to an
assessment and a care plan of their own?
An assessment is not a test, it is a chat with a
social worker or other worker where the young person can request
help and support. You can refer the young person to Social Services
with their permission.
Other services for the young person
- Are other agencies involved in supporting the
- Does the young person want you to contact
school, youth services etc?
- Do you need to contact Social Services/ The
Children’s Trust children and families team for help for the young
- Does the young person have any problems at
school (e.g. falling behind with work, staying off school to look
after their relative, being bullied)? Do they want you to talk to
- Does the young person have any health needs of
their own? Who could help them?
- Does the young person know who to contact
if they are concerned about something? Who does the young person
feel able to turn to?
- Who is the young person’s emergency
- How does the young person make a
The Royal College of Psychiatrists
has produced a training pack for professionals working with adults
with a mental illness who have children entitled ‘Being seen and heard: the needs of children
of parents with mental illness’. Cost £36. Available from Book
Sales, Royal College of Psychiatrists, tel: 020 7235 2351 ext.
The Princess Royal Trust for
Carers has a website for young carers with information
on mental health problems and can answer questions via email.
Society has a list of the contact details for all the
specialist services in the UK.
is the free 24-hour helpline for children and young people in the
UK. Children and young people can call the helpline on 0800 1111
about any problem, at any time – day or night and speak in
confidence to a counsellor.
Young Minds is the
national charity committed to improving the mental health of all
children and young people. Its website provides information on
mental health issues. The Young Minds Parents’ Information Service
(0800 018 2138) provides information and advice for anyone with
concerns about the mental health of a child or young person. Young
Minds produces leaflets and booklets to help young people, parents
and professionals to understand when a young person feels troubled
and where to find help.
This leaflet was produced as part of the Partners
in Care campaign, a joint initiative between the Royal College of
Psychiatrists and The Princess Royal Trust for Carers.
One of the aims of the Partners in Care campaign was to show
that if all
those involved in the care of people with mental health problems or
learning disabilities can work together, a trusting partnership can
be developed between carers, patients and professionals which will
be of benefit to all.
With grateful thanks to Alex Fox, Young Carers
Development Manager, The Princess Royal Trust for Carers and
members of the Royal College of Psychiatrists’ Child and Family
Public Education Editorial Board for producing this leaflet.
Series Editor: Dr Philip Timms, chair, Royal College of
Psychiatrists' Public Education Editorial Board.
© July 2012. Review date: July 2014.
Royal College of Psychiatrists. This leaflet may be
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and no profit is gained from its use. Permission to reproduce it in
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allows them to be linked to directly.
For a catalogue of public education materials or copies of our
For a catalogue of public education materials or copies of our
leaflets contact: Leaflets Department
Royal College of Psychiatrists, 21 Prescot Street, London
E1 8BB. Telephone: 020 7235 2351 x 2552.
Charity registration number (England and Wales) 228636 and in
Please note that we are unable to offer advice on individual cases. Please see our
advice on getting help.
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