When mum or dad gets sick
Children who grow up with a parent with mental illness or addictions can be greatly affected, but who explains to them what's happening? Beck Eleven looks at an emerging area of mental health awareness.
When Melissa McCreanor was a child, she remembers her mother as "gorgeous, intelligent and incredibly creative". She was brought up near the beach at Cass Bay with two loving parents and two siblings. Then she turned 10 and her mother's behaviour became increasingly erratic - and frightening.
"Looking back, I had a fortunate childhood, " McCreanor, now 44, says. "I had 10 good years before things started to unravel. Then my grandmother, Mum's mother, died and it was a huge trigger for her. She developed late-onset schizophrenia."
There was a renewed and heavy connection with the church, a sudden, uncompromising stance on vegetarianism and more tension in the home.
McCreanor's parents were one another's first loves and, before settling with children, they had travelled the world - including a visit to Auschwitz concentration camp. As the schizophrenia intensified, her mother became convinced she was Anne Frank, that other people - including her husband and children - were Germans seeking to take her captive.
She gave away belongings and emptied her jewellery into mission bins.
There was an obsession with cleanliness. The children were urged to bathe several times a day.
Sometimes the television would be blaring or they would come home from school to find a wall completely pasted over with magazine and newspaper clippings.
"It was very scary for a young person, " McCreanor remembers. "Unpredictability was the worst. You never knew what you were coming home to."
Over the years, her mum had several stints in Hillmorton Hospital (formerly Sunnyside), times which McCreanor remembers as extremely unsettling. "I just desperately wanted to know Mum was safe and that she had a room to herself where she could keep the pictures we'd drawn for her."
One of McCreanor's worst memories was when, at the age of 17, she had to sign papers to have her mother committed. She felt guilty seeing the medication initially fail, and for sometimes wishing her mother simply didn't exist.
Then she stumbled across an article in an overseas publication, explaining how important it was for the child or sibling of someone with mental illness to learn to separate the person from their condition.
"I learnt to love Mum, but hate schizophrenia; that it wasn't my fault and that it wasn't my responsibility.
"We're just these invisible children. Doctors and nurses explain it to the adults and the patient, but it impacts on everyone in the family. An ill person with children needs to be seen in the context of a parent, not just a person with a mental illness. All through her treatments, she really did need us to stay connected.
"And the other parent needs to be educated as well. Right up until my mid-30s I worried I was going to be unwell, too. Dad needed to know how to talk to us kids about our fears and worries. We needed to know who our support network was and who to contact when she wasn't so great."
While conditions such as depression are more accepted in polite society, other sometimes debilitating mental illnesses, such as bipolar disorder and schizophrenia, are less understood.
The acronym "Copmia" is used in New Zealand to explain an area of support needed in mental health. It stands for Children of Parents with Mental Illness or Addiction, and as awareness of mental health issues grows it, is apparent the ripple of mental illness reaches more people than solely the person affected.
Diane Issacs, Supporting Families in Mental Illness Canterbury branch manager, says demand for services has tripled over the past 18 months. There are 19 branches of Supporting Families in Mental Illness throughout New Zealand. They aim to boost a child's resilience and reduce risk factors.
Emma Dore, from the Auckland branch, says international studies, including those from here and Australia, show children who have a parent with a mental illness or addiction are up to five times more likely to experience some form of psychological disorder - a psychological impact or psychiatric diagnosis.
They suffer increased risk of abuse and neglect, depression and anxiety, homelessness, poorer education outcomes, social isolation and social stigma. One-fifth of New Zealanders are affected by mental illness during their lifetime and a third of our Child, Youth and Family cases present with at least one parent with a mental illness or addiction.
As New Zealand services adapt to include children, they have used Australian services as a model.
Elizabeth Fudge, a former director of Copmi Australia (they do not include the A for addiction) says their government provides specific funding to this area because it is considered "prevention and early intervention".
As yet, there is no targeted government funding in New Zealand.
Fudge says, in most cases parents are very protective of their children. "They hold it together enough to feed their kids and get them off to school, but this can often go undetected because if the child is turning up to school - even erratically - they are invisible to mental health services.
"In more extreme cases there can be neglect and in rare cases the parent involves the child in their delusions - perhaps the television is spying on them or the curtains must remain pulled and the lights off due to paranoia.
"Kids can get drawn into the delusional behaviour and if the child is very young, they often don't know that it's not true. With addictions, there are legality problems, and they can witness violence."
Secrecy around why a parent is in hospital only compounds the problem.
"If there is a vacuum of information, a child will often dream up something worse than reality. They might think the parent is dying. Their ideas can be more harmful than the truth."
Explaining in age-appropriate language, more suited to the child's cognitive ability, is a start.
"They have different questions at all stages of development. They need hope that their mum or dad is getting better; not all situations end in despair. There can't always be a professional around to answer their questions so we try to include extended family or teachers."
Mental illness can lead to isolation for both the parent and child. "The fear of losing their child to family services often keeps the parent from asking for help, and the child is terrified of being taken away.
"In the past, some people just thought that if the child ended up with mental health issues it was genetic - you know that comment that comes up: "Well, their family is all mad" - but there is more and more evidence to show that there are a lot of environmental factors that contribute.
"So if you are brought up in a house that is very chaotic and your parent's thinking is chaotic then it will be very difficult for you to develop a good sense of self and organisation. It's not just genetics at play."
Fude recommends children be told it is OK to have fun, that they can laugh and stay after school to kick a football around. "They don't have to rush home and be caregiver to a parent while their peers are carefree."
Emma Kelly wishes such services had been available to her as a child. The 36-year-old grew up in Auckland, the youngest of three sisters. When she was 4 years old, her mother was admitted to Carrington Hospital (now closed).
What her mother went through was variously called a "breakdown" or "manic depression". Today it is known as bipolar disorder, characterised by depression followed by extreme highs.
Their mother's illness was not discussed. Not by their father, not among the siblings, and the children were not spoken to by medical experts.
As a result of the illness, her parents split up. While their father steered clear of conversations, he always made sure the girls visited their mother in hospital and, once she was set up in a state housing complex, he dropped them off at the gate for weekends.
"Sometimes Mum was lovely, " Kelly says. "Sometimes she was uncommunicative and sometimes she was batshit crazy.
"One weekend she must have been quite sick. We walked in and there was talcum powder all over the place. She had this bottle of talc with the lid off and every time she made an emphatic point, the talc would fly.
"And she'd had the slow cooker on for three days with just one orange in it. It was burning. She hadn't emptied the kitty litter and there was cat poo everywhere. There were often strange people in the house because when she was high she would party for days and that would attract strangers who liked to do that, too."
The children were between 10 and 14 by the time they admitted to their father how bad their weekend situation had become.
"So we'd have these crazy weekends at Mum's and go back to school where the other kids would ask what we'd been up to for the weekend and I'd just lie. I had two different lives: this insane weekend life with my mother and this conservative life with my father during the week, and I found it very difficult to reconcile."
Eventually, Kelly moved to Melbourne to get away. There, she started counselling and when she moved back to New Zealand she discovered Supporting Families.
Kelly is so passionate about situations similar to hers that she sat down with a young person living with a parent who is bipolar. She wrote the story using his words and language and the young man drew the illustrations. The result is David's Story, a book regularly used by Supporting Families.
Since moving back, Kelly has found the support group invaluable.
"We can tell our stories and have a laugh. There's always someone in crisis who might need a good cry but sometimes it's just OK to be able to say 'Oh my god, my mother is flipping crazy' and people just nod.
"Kids need a space to be able to talk about what's going on at home. There's no way they would tell their mates at school that mum or dad has just pulled the house apart and there are strangers around all the time.
"It's appalling that there is no funding for kids. I've seen someone being taken away to prison or hospital, or catatonic, and their kid sees that. It's illogical that the children are not intrinsic to the process and being helped. That kind of thing can affect generations."
"I love my Mum. She's funny and tall and always thinking of new things to do.
"Mum gets sick sometimes. When Mum is high she always says yes, and when she's low she always says no. This is how I know Mum is sick.
"When Mum is sick I stay with my Aunty who is also funny and tall.
"I don't like to talk about Mum being sick. I know what to do; I just leave her alone when she is very sad and doesn't want to get out of bed. "I love my Mum more than anyone else in the world."
David's Story, the true story of a child's view of having a parent with mental illness, is a book available on the Supporting Families website supportingfamiliesnz.org.nz or copmi.net.au.