Emotional Support for Young Carers

A report prepared for the Royal College of Psychiatrists by

The Children’s Society Young Carers Initiative

 and

The Princess Royal Trust for Carers

Executive Summary by

Jenny Clarkson

Jenny Frank

Luisa Lucantoni

Alex Fox

I feel really guilty if I talk about her. I can’t tell anyone because you can’t trust people. So I keep it inside and it becomes a big secret. But then I snap and people don’t know why. It’s very difficult.”

The Children’s Society National Young Carers Initiative provides information, advice and training on young carers for professionals including DfES funded Principles of Practice. http://www.youngcarer.com/

The Princess Royal Trust for Carers provides quality information, advice and support services to nearly a quarter of a million carers, including 13,000 young carers.

http://www.carers.org/; http://www.youngcarers.net/

The Royal College of Psychiatrists is an organisation that works towards making mental illness less isolating for the person, and less frightening for everyone involved. Mental illness affects not just the individual, but also family and friends. 

Introduction

Young carers are children and young people under 18 who provide, or intend to provide, personal care, assistance or support to another family member on a regular basis. They carry out significant or substantial caring tasks and assume a level of responsibility, which is inappropriate to their age. Caring tasks can involve physical or emotional care, or taking responsibility for someone’s safety or well being.  The impact of taking on an inappropriate caring role can include underachievement or absenteeism at school, mental or physical ill health, and poverty. Most children of parents with health conditions will not become young carers, but many do, often because families lack flexible, whole-family support.

All young carers can need emotional support, but some are particularly vulnerable due to the nature of their caring responsibilities. Young carers who care for parents who have mental health can have more complex emotional support needs of their own.

“It’s not just the caring that affects you…. What really gets you is the worry of it all” 

The Statistics

• There are 175,000 children under 18 years providing unpaid a care within their family
• 13,000 care for more than 50 hours each week.
• 250 000 young people live with parental substance misuse.
• 1.3m children live in homes where one or both parents have an alcohol problem.
• 29% of young carers care for someone with a mental health problem but 82% provide emotional support and supervision.
• 18% provide intimate personal care and 11% also provide child care.
• 27% of all young carers of secondary school-age have educational problems.
• 40% of children caring for someone who misuses substances have educational difficulties.
• % have been caring for 6-10 years and 3% for over 10 years.

(from UK Census and Young Carers in the UK 2004 Report, Dearden and Becker)

Identifying a young carer

Research and evidence from practice has shown that, for a range of reasons, young carers are often hidden and their needs and those of the person for whom they are caring are only identified when there is a crisis. Even then, the extent of their caring role and the impact that it has on their own development, may not be recognised quickly or fully assessed.

“Identifying young people with caring responsibilities for a relative at home is difficult – they may not have the language, confidence or self-awareness to relay the physical and/or emotional impact of living with a relative who requires care, let alone identify themselves as having caring responsibilities”. (Baker, PRTC, 2002)

 “Even when all the practical and physical care needs of the person who has along term illness or disability are being met, children still say that they care emotionally and worry about the person”. 

Caring for parents with mental illness

Mental illness is often episodic and unpredictable. Changes in the behaviour of parents with mental ill health can be traumatic for the children, and all the more so if they are trying to take on some or all of the caring responsibilities. Children caring for a parent with mental ill health can feel a great sense of responsibility and loyalty to their parent and some go to great lengths to conceal the illness and its effects and to make up excuses for their behaviour.

"When she can’t do stuff that she usually can do, or she stays in bed more than she usually would do, that’s when I know she’s really poorly or she starts moaning that she’s seeing them, then I have to give her another tablet"

Parents think their children are more likely to develop mental illness because of their own illness but both parents and children feared interventions from professionals. Divisions between adults and children’s services mean that children are rarely consulted about their needs. Family support is rarely offered to parents and many professionals are completely unaware that their clients are parents. Professionals think that caring for parents with mental illness is wholly negative and damaging for children but some young carers felt that caring had positive aspects.

Long-term effects

Professionals tend to think that parental mental illness is wholly negative, while young carers see some positives such as developing life-skills, compassion and understanding. However, the negative aspects of caring outweigh the positives with young carers missing out on the life chances, personal and physical development and educational and social opportunities. Both parents and children fear that asking for help will result in negative outcomes and children are rarely consulted about their needs

“I want to join the army but I’m not leaving her [mum] until my brother is old enough to take care of her.”

The emotional well-being of young carers

The Royal College of Psychiatrists commissioned The Children’s Society and The Princess Royal Trust for Carers to find out about the emotional support needs of young carers.

In total about 800 young carers have contributed, most at the annual Young Carers Festival via workshops, poster boards and poetry writing, with some more via a questionnaire sent to young carers projects, an online poll, directed webchat session and two young carers focus groups. It was only possible to break down the population for a small sample of respondents. For this sample, two thirds were aged between 10 to14; the vast majority were White/British with some responses from Black African and Chinese young people; 64% were female and 46% male. The consultation sought to answer questions on four key themes:

1.    When you need emotional support, who do you talk to?

When young carers are at home they are most likely to talk to their parents (44%); in settings where friends are likely to be, friends were the most popular answer. At school 21% would talk to a teacher; over half would talk to young carers workers when available. In the online poll, 84% said they like to talk to young carers workers but most did not like to talk to a social worker.

Half of the young people wanted to talk to someone in their own home, the remainder at a Young Carers’ project or a private room in school. Young carers said they would only talk to someone in private and if they inspired confidence and trust. Young carers’ family members gave similar answers where they were asked about their requirements.

2.    What helps you most when you feel angry or stressed?

By far the most popular answers were to “talk to someone” or “be on my own somewhere quiet”. Other popular answers were to “be with a friend”, “play music”, “go to a young carers service”, “write or draw”.  Some responded that they would self-harm. In the online poll, 81% said that caring made them feel stressed, 88% down and 53% angry.

3.    What works and what does not?

Young people said that they coped with their relative’s mental health problem by doing fun things for themselves and “letting it go over your head”. They tried to calm the person down when they were distressed but sometimes felt like “beating them up”. Young carers particularly value peer support: “ It gives me more confidence to know I’m not alone”. Schools that had made links with young carers services were felt to be helpful, but most young carers said they felt that schools did not understand and that teachers were often too busy to talk.

4.    How can we help reduce the stigma of mental illness for you and your family?

The young people wanted to see more information about mental illness and more efforts to explain it to the people of all ages, for instance showing videos in schools. They wanted more opportunities for people with mental health problems to meet and make friends. In the online poll, 48% said caring made them feel proud, but 40% said it did not. 60% said they had been bullied due to caring.

Recommendations

1.    Offer timely, well-structured and flexible support to the person in need of care – this could prevent a child undertaking inappropriate levels of care.

2.    Provide family friendly information about mental ill health and how to access help.

3.    Inform children and young people about family illness appropriately.

4.    Work with schools and the media to promote more understanding of mental ill health.

5.    Offer training and support to young carers workers in listening skills.

6.    Disseminate learning from peer support projects.

7.    Help children and families to deal with stigma.

8.    Children’s and adults’ mental health agencies should link with young carers projects.

9.    Help schools to promote understanding of the emotional needs of young carers.

Prepared by The Children’s Society, Young Carers Initiative

Tel: 01962 711511. Email: young-carers-initiative@childrenssociety.org.uk

September 2008