Since the mid-1990s, researchers have been studying Adverse Childhood Experiences (ACEs), defined as preventable and potentially traumatic experiences occurring before age 18. Examples of these experiences include abuse, neglect, family violence, and parental substance abuse, mental illness, and incarceration. Studies have revealed significant connections between the number of ACEs experienced in childhood and a wide array of physical and mental health problems in adulthood.

Most of the studies have used two primary research methods, namely (a) retrospective surveys of adults, and (b) parental report of their teen’s experiences. Both of these methods have some inherent problems. For example, recency bias may hinder adults’ ability to remember some childhood events, and parents may not be aware of all of their children’s experiences.

Important new research led by Dr. Elizabeth Swedo at the Centers for Disease Control and Prevention (CDC) analyzed data from over 20,000 high school students from across the United States (Swedo et al., 2024).  This report is the first national study of high school students that assessed the lifetime prevalence of ACEs; they also analyzed relationships between ACE exposure(s) and teenagers’ health and risky behavior.

Although the report has many important findings, we focus here on an important but often overlooked issue, namely how parental mental health problems can impact kids. The question posted to students in the survey was “Have you ever lived with a parent or guardian who had severe depression, anxiety, or another mental illness or was suicidal?” The lifetime prevalence was 36% for females an 22% for males, with an overall rate of 28%.

Thus, over 1 in 4 youth report that their parent/guardian is living with (or has lived with) severe mental health problems or is suicidal…a figure similar to rates of parental substance abuse as found in both this study and other recent research (McCabe, McCabe & Schepis, 2025).

Research has clearly documented that offspring of parents experiencing mental illness are at increased risk for an array of physical and mental health problems themselves. The youth’s risk level is affected by many variables, some beyond their control (e.g., genetics) but others that are modifiable (e.g., exercise, healthy diet, avoiding substances, staying social connected).

However, sadly, these youth are often invisible. The parents may be preoccupied with helping the individual with the illness, and our healthcare system does not routinely assess offspring well-being nor engage them in care. This often leaves parents feeling alone and unsure how to most effectively support their child(ren).

Further, parents often have minimal guidance on what to say to their children about parental mental health problems. Due to the complexity surrounding mental illness and other family demands, sometimes children are told nothing…which can result in kids coming up with inaccurate and often scary explanations (e.g., it’s their fault their parent is ill).

So, how can parents know WHAT to tell their kids, WHEN, and HOW?

Here we offer 7 suggestions, including some resources for youth. Seeing your children struggle with your partner’s behavior can be painful, so we hope these recommendations are empowering for your family.

7 Tips for Talking to Your Kids about Your Partner’s Mental Health Problems

1. Offer information in bite-size chunks, using language your kids can understand.

Children are perceptive. Although they may not fully understand what they see and feel, they usually sense when someone in the family is struggling. As children fear what they don’t understand and often blame themselves, it’s important for kids to know at least some of what is going on (e.g., Mommy is really sad today so is sleeping a lot in her room; I know you’re disappointed she cannot come to your soccer game tonight…so is she!). By naming and openly talking about the situation, you also have the opportunity to discuss and honor how it’s impacting your kids.
As these conversations might be awkward and stressful, you may choose to ask for help from professionals or other resources (see below for examples).

2. Listen more than you talk. Follow your kids’ lead in the conversations. Encourage them to share their feelings and ask questions.

When you acknowledge the elephant in the living room of the mental illness, you open the door for children to share their feelings and questions. Although you may have an agenda for certain issues to discuss in a specific conversation, your child may raise the subject at random times, such as while driving to school or at bedtime. It’s helpful to encourage ongoing dialogue, and to help your kids feel safe to share their thoughts and feelings freely. Let them know you want to hear what’s on their mind and in their heart. The questions kids have and their reactions to mental illness change over time, so the discussions and responses need to shift accordingly.

As a parent, you may not know the answers or what to say, and that’s ok to acknowledge! You may consult with a professional or family member to think through how to respond. On the other hand, some questions just don’t have easy answers, and you can help your kids learn to live with ambiguity and uncertainty.

3. Engage your partner in the conversations with kids as appropriate.

In some situations, it may be more appropriate for you to talk with your children without your coparent present, such as conversations about violence (or threats thereof), active substance misuse, paranoia, or other frank symptoms of psychosis such as hallucinations or delusions. It may be easier to explain and your child may feel more comfortable if your partner with the illness is not involved in these discussions.

However, much of the time, it’s helpful for everyone to be involved as appropriate. It’s empowering to encourage kids to talk about and ask their parents questions about mental illness, even if it may be difficult. Of course, selecting a good time when your partner is stable and open to conversation is important.

4. Be hopeful and reassuring.

There are many good reasons to be hopeful about managing mental illness, and children can be comforted by positive messages.

You might consider ideas such as:

  • We have doctors and counselors who are helping us during this difficult time.
  • Mental illness is treatable. There are many medicines and therapies that can manage your parent’s symptoms and help them to lead a meaningful life. Scientists and doctors are developing new treatments all the time.
  • We have a lot of family members and friends who want to help.
  • You’re not alone. About 1 in 4 families has a loved one living with mental illness.
  • We’re working through this together as a family. Just like we all came together as a team when grandma got cancer, we can all work together and help each other now.

5. Be honest about your kids’ increased risk of developing mental health problems, but focus on building resilience and what they can control.

Older children and teenagers may ask difficult questions about their own risk for developing a mental illness, wondering “Am I going to be like that someday?” Such questions are understandable and reflect considerable fear among the kids, and parents may struggle to know how to respond.

This issue goes beyond the scope of this article, but a more detailed exploration of navigating these conversations can be found in Chapter 16 of our book for teens, “I’m not alone.” In general, acknowledging there is some genetic component to mental illness and they may be at higher risk is important. At the same time, parents can help children focus on what they have control over, such as their activity levels, diet, use of alcohol/drugs, and social connections. Parents can help their children by teaching them how to understand and cope effectively with feelings, recognize early signs of more serious problems, and seek out treatment early.

6. Avoid parentifying your child, but do let them know how they can help.

Sometimes children in families with parents managing mental illness become caregivers, taking on extra responsibilities. They may help more with household chores, take care of younger siblings, assist parents with keeping doctor appointments or managing medications, or try to “cheer up” their distressed parent. The reality is that sometimes these behaviors are helpful, especially during times of crisis, but it’s best to avoid children bearing these additional responsibilities in daily routines.

However, at the same time, children often want to know how to support their parent; they may want to be encouraging, but don’t know how. Thus, it can be helpful to talk with kids about how they can be supportive yet not take on the responsibility for their parent’s wellbeing. For example, you might say: Although you can’t cure your parent, there are ways you can help and support him/her. Your mom/dad loves it when you (fill in the blank with small things your child can do, such as offer hugs, pick up their room, send loving text message)

7. Monitor your kids’ social media use, and seek out resources for them

Depending on your child’s age and developmental level, they have likely already searched online for information about mental illness. Although there is a lot of excellent content online, unfortunately many inaccurate messages also circulate. Therefore, it helps to be aware of what your kids view and help them find reputable sources, such as the National Alliance on Mental Illness (NAMI), the American Psychological Association, and the American Psychiatric Association.

A variety of books are now available addressing issues of parental mental illness, including memoirs and fictional books for young children. There are also a few nonfiction books that offer skills and support. Many parents find it helpful to read the books before (or along with) their children to gain insight and facilitate dialogue. Some resources we recommend include:

  • Clarke, L. (2006). Wishing wellness: A workbook for children of parents with mental illness. Magination Press.
  • Boucher, V., & Fitzpatrick, O. (n.d.) KARE: The magazine for young caregivers. AMI Quebec. https://olivergfitzpatrick.wordpress.com/portfolio/kare-the-magazine-for-young-caregivers/
  • Sherman, M.D., & Sherman, D.M. (2024). I’m not alone: A teen’s guide to living with a parent who has a mental illness or has experienced trauma (2nd ed).  Seeds of Hope Books.
  • Villatte, A., Piché, G., Habib, R. (2020). When your parent has a mental illness: tips and testimonies from young people. Université du Québec en Outaouais: LaProche Laboratory. https://lapproche.uqo.ca/wp-content/uploads/2022/01/When_your_parent_has_mental_issue_VA_web.pdf

Michelle D. Sherman, PhD, LP, ABPP, is a board-certified clinical psychologist in Minnesota who has dedicated her career to supporting families of adults living with a mental illness or trauma history. She is a Fellow of the American Psychological Association’s Society for Couple and Family Psychology and was named its Family Psychologist of the Year in 2022. She is the Editor-in-Chief of the journal, Couple and Family Psychology: Research and Practice. She worked for 17 years in the VA system and as a professor at the University of Minnesota and University of Oklahoma medical schools. In her personal life, she writes books (with her mother as co-author) for family members who love someone living with a mental illness or PTSD (www.SeedsofHopeBooks.com).

She is the author of “Loving Someone with a Mental Illness or History of Trauma: Skills, Hope, and Strength for Your Journey” (2025, Johns Hopkins University Press) and “I’m Not Alone: A Teen’s Guide to Living with a Parent Who Has a Mental Illness or History of Trauma” (2nd ed., 2024, Seeds of Hope Books).

 


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