Parents Don’t Have to Justify a Child’s Mental Health Treatment
In my line of work I run into many people engaged in the mental health system in different ways. Many people are patients, naturally, but many are the loved ones of patients as well. And some of these loved ones are parents. And some of these patients are children.
I have publically stated previously how shaky I am on the concept of children and mental illness; which is to say that I’m very critical of labelling children with a mental illness when we don’t even have formal diagnostic criteria for mental illness in children (except for things like ADHD/ADD). I’ve also said that I’m even more critical of putting children with their growing brains on psychotropic medication when we aren’t even fully aware of what these medications will do to adult brains long-term, let alone developing ones.
Nevertheless, parents don’t have to justify their child’s mental illness or the treatment of that mental illness to me or anyone else.
Children and Bipolar Disorder
We know very little about most mental illness in children. One of the things we do know, though, is that about 20-30% of adults with bipolar disorder showed signs of the illness before adulthood. Also,
- About 1% of adolescents have bipolar I (same as adults)
- About 0.2% - 0.4% of children have bipolar
- These numbers appear consistent across cultures
And while I hate the idea of labeling a child with a mental illness, sometimes it is appropriate.
Children and Bipolar Disorder Treatment
The treatment of children with bipolar disorder is much like the treatment of bipolar disorder in adults, mostly because we just don’t know of anything better at this point in time. Childhood treatment includes:
- Inpatient treatment
- Behavioral therapy
- Electroconvulsive therapy (this is rare)
- Environmental changes
And keep in mind, most parents try the least invasive forms of treatment, often for years, before they’re willing to try anything like medication. And while I’m highly against medicating children – in some cases it is the best choice.
Judging Parents of Children with Mental Illness
The fact is that you can be the very best, most caring and most well-adjusted parents in the world and still have a mentally ill child.
And it’s important to remember that parents don’t cause mental illness. Yes, bad parents can increase the chances of mental illness in offspring, but no, they don’t cause it and it’s not fair to blame them like they do. I’m the first one to blame parents for bad parenting – believe me – but it’s not fair to tar and feather all parents with this brush just because some parents don’t know how to, well, parent.
Justifying the Treatment of Mentally Ill Children
And from the parents I talk to, it seems that people do judge them. Judge them very harshly. People assume that parents are to blame for the child’s mental illness and that the treatment being applied to the child isn’t “right.” I understand what facing this judgement is like. People judge me for my illness and my treatment, and it's even worse for parents of mentally ill children.
But my point is, and it’s an important one – it’s not fair to judge parents for the diagnosis of their child or the chosen treatment. These people do not have to justify their choices to anyone and you cannot possibly understand what it’s like to be them or what it’s like to be a mentally ill child. You have no idea what it’s like to face a severely ill child. You have no idea what it’s like to have to make the impossible choices that these parents face. You have no idea what these people have been through. You have no idea how hard these parents have tried.
In short, the only people capable of making accurate diagnosis and treatment decisions for a child are the doctor, the parent and possibly the child (if they’re old and mature enough) and that’s it. They’re the only ones who truly understand the situation and the rest of us should just learn to be supportive, as that’s what people facing this crisis really need – not more judgement.
Tracy, N. (2012, August 28). Parents Don’t Have to Justify a Child’s Mental Health Treatment, HealthyPlace. Retrieved on 2020, June 6 from https://www.healthyplace.com/blogs/breakingbipolar/2012/08/parents-dont-have-justify-childs-mental-health-treatment
Author: Natasha Tracy
Re: "it's not fair to judge parents of mentally ill children" Nor is it fair to diagnose and medicate mental illness in children when the main or usually ONLY evidence is the complaints of a frustrated (sometimes inept, dysfunctional) parent or teacher. The clinician goes into the process of evaluating the child already having been influenced by the adult. Parents and teachers who refer children for ADHD evals should be required to submit to a comprehensive inventory and eval themselves to cross check for any issues with their own behavioral, parenting, or teaching styles. Wonder how quickly those referrals would plummet if that were the case?
Remember when people beat their kids "for their own good", it was and is still widely accepted as decent parenting, and hardly anyone cared. Now when people try to treat their kids medically, other people need to have opinions and worse than that, they think their opinions have to be paid attention to by everyone else. Why can't we tell people to mind their own business? More and more, outsiders get to call the shot on abortion, parenting and sex lifestyles when this doesn't effect them. Ironically these are usually the people who claim to be religious and who scream that they don't want intrusions into their own lives. I'm not a pill popper, but I support parents who are trying to have normal lives with their kids using medicine. I hope things get better for all of them and they should not have to face backlash from people who need to mind themselves more.
Well said! I couldn't agree more - I am a professional psychotherapist who works with children, teens, and their families and I can honestly say, every situation is different. Every child and every parent comes with their own unique set of needs, wants, beliefs, education, and history. It is deeply unfair for school professionals, extended family, and friends to judge these families. The depth of their struggle is something they wouldn't wish on anyone and all they ask for is support and acceptance for their child. Not even for themselves. The blame/shame game helps no one but hurts everyone and it needs to talked about openly. A culture of secretiveness only makes people sicker - thank you for bringing this issue to the conversation!
I'm a parent of two sons who were diagnosed with psychotic illnesses over the past 2.5 years. I've sometimes felt like a variation of the Oscar Wilde line from the Importance of Being Ernest: "To lose one parent is understandable, to lose both is simply careless!" I've sometimes felt guilt that if both sons have mental illnesses - there must be some fault of the parents at play! Was I too stressed, anxious, angry, or simply incompetent as a parent? These have been my own misgivings - no one else has put them on me (at least, in my hearing!) In fact, friends and family have been very supportive - including many comments about how fortunate our boys are to have such loving and supportive parents to assist them in their healing. We can only go forward, giving our children as much love and support as we can.
I also agree with Sarah's comment that "secure people don't judge". I also think a lot of judgements are based on ignorance. so good on Natasha and others for talking openly about mental illness!
I think many times people do this out of fear. Not out of fear of the child that has mental illness but of the fear of reality and the unknown. The reality being that their child, future child or grandchild could develop a mental illness. That there is no cure for the inflicted child nor is there a cookie cutter treatment that will ensure a normal carefree childhood for such child. There is no way to know whether a child will develop a mental illness or not. When faced with fears that people don't want to face many times they behave in negative ways. Ignore it, deny it, blame someone..."children don't get mental illnesses they just don't behave due to bad parenting, parents put kids on meds cause the parents are lazy and don't want to deal with their kids not because their kids are ill, good parents know their kids and know what is the treatment that will make their kid all better so if current treatment doesn't work then they must be bad parents."
I am not saying that having these fears make it ok to judge others, it doesn't. I am just stating an observation. A very sad observation at that cause as you stated these parents need support. I think instead of judging and blaming others people should admit their fears and face them by educating themselves about mental illness, demand and fight for more funding for research into mental illness in children from the government, be supportive of these families to try to help these kids have the carefree, fun lives that all children deserve to have as much as possible. Be a part of the solution instead of the problem. If they are not capable of that then at the very least they should follow the golden rule, "do unto others as you would have them do unto you." In other words, keep their mouths shut.
I've learned that people judge others because of their own insecurities. Secure people do not judge. Therefore, the judgements have little to do with the actual situation and more to do with the internal state of the judger.
I have two children and one of them inherited Bipolar from me. Sometimes I feel terribly guilty but overall she's such a great person, in her 20's now. She holds a good job with a lot of responsibility and she's doing well I wouldn't wish Bipolar Disorder on anyone, but we caught it early in my daughter's life and with treatment she's doing fine. I couldn't be any prouder of her.