Q How can I best support my niece and nephew who are 11 and 13 years old? My sister, their mother, has had ongoing mental health difficulties for the past year and it doesn’t look like she’s getting any better. She has been in and out of hospital recently. What can I do for them and for their father?
This is a great question but, in practical terms, you are asking the wrong person. Your sister’s family, her husband and children will know what they need best on a daily basis. Do they need meals, laundry or lifts to activities? Ask them what they need and be clear about what you can offer, structuring your support so that it is consistent and reliable.
On an emotional level, there’s lots you can do to help the children to manage with parental mental illness. There have been several studies about what factors contribute towards children’s resilience when they are experiencing adversity. Research suggests that the support of another adult who is outside the immediate family is invaluable. Your relationship to your niece and nephew at this time can play a key part in their emotional well-being. Or if you feel as though you’re not best placed to be that adult to both of them, you can connect them to somebody else.
When parents are mentally unwell, the children are often caught up in caring for them, feeling responsible or somehow to blame for their illness. For example, if your niece’s misbehaviour coincided with the onset of her mother’s depressive episode, it is easy for her to draw erroneous conclusions. An external adult can re-orientate them, reminding them that they are still children and that their mother’s illness is not in any way their fault. An adult’s views hold authority in a child’s eyes and you can keep explaining key concepts from a healthy perspective. Children often feel disloyal when speaking to other adults about their parents, but you can reassure them that it is OK to do so and they can talk to you about their worries and fears. If you are a fun uncle, you can also take the children on trips so that they have an opportunity to feel carefree and looked after.
The most confusing part of mental illness is that it is invisible. I was once treating a family with one child who was physically disabled and another child who was suffering from anxiety. It was so much easier for the family to show compassion to their child in a wheelchair as they could see and therefore believe their struggles. But it is much more difficult not to take mental illness personally and not to think that it is in the patient’s control.
It is important to find a good, age-appropriate explanation about your sister’s mental illness to tell her children, so that they can manage their anxieties about what is happening to her. Mental illness can be uncertain, scary and can feel out of control. If adults don’t explain it appropriately to children, they end up concocting much scarier stories and can become very worried. Even though each episode will still be extremely difficult, it helps when children know what is happening to their mother and why and are clear about what to do and where to turn in a crisis.
Children might also have other worries such as being scared that they will inherit their mother’s mental illness. These need to be attended to sensitively and honestly, listening well. There are usually a variety of factors that cause mental illness and explaining this sets children’s minds more at ease. Alternatively, children might feel their mother’s illness is intensely shameful and be embarrassed about being different from their friends. These problems cannot be magicked away, of course, but if they can tell you their concerns and you can empathise and think about small changes to make things easier, it makes the children feel less isolated.
There are several multi family support groups where your niece and nephew can meet other families with parental mental illness. These are invaluable and support all members of the family through this difficult time. I highly recommend the group Kids Time which is a helpful resource for families like your sister’s.
Finally, it is important to maintain reasonable hope about the trajectory of you sister’s illness. I don’t know the details of her condition and it could be that this is something she will have to live with for a long time. But there are often periods in which people are more well and then it is important to find the family support so that they have opportunities to connect and to rebuild reasonable trust between them. Wishing you the best of luck!
