Talking with children about mental illness

Q: How should I talk with my child about mental illness?

Parents often ignore or neglect this topic for several reasons, according to clinical psychologist John Barton, Ph.D., with Phoenix Children’s Hospital.

Many feel it’s “not gonna happen to my kid,” says Barton, who also serves as director of the clinical psychology center and senior lecturer in the department of psychology at Arizona State University in Tempe. Like most of us, parents rarely expect mental illness to strike in their own family — especially to their children.

They may avoid the subject because of social stigmas associated with mental illness. They may fear exposing their own family skeletons — Uncle Joe’s erratic behavior or a parent’s depression — or they may simply not realize how common mental illness really is.

Disorders like ADD/ADHD, bipolar illness, depression, generalized anxiety and obsessive compulsive disorder affect one in five Americans, including children and teens, according to Cindy Gattorna, director of child and adolescent services for the Arizona chapter of the National Alliance on Mental Illness (NAMI).

Do the math, she says, and you’ll quickly realize just how likely it is your child will encounter fellow students, neighbors, friends and family members with some form of mental illness. Even your own child may one day join this misunderstood minority.

“There’s greater compassion and less fear if you talk about it,” Barton says.

Even parents who are open to discussing mental illness often stumble, feeling they just don’t know what to say. Approach mental illness as you would any other topic, Barton suggests. “Tell them your beliefs and ask them theirs.”

Tie the topic to a well-known celebrity or historical figure like artist Vincent van Gogh, composer Ludwig von Beethoven, football player Ricky Williams or mathematician John Nash. It will help your child understand that mental illness affects real people from all walks of life.

Start at an early age, suggests Gattorna. Describe mental illness as a physical illness — a “broken brain” of sorts. Current research points to a host of biological underpinnings, from genetic factors to variations in neurochemicals in the brain. Liken it to a broken leg or a “broken” heart, something your child may have experienced.

“Don’t be embarrassed,” says Gattorna. Talk about mental illness the same way you’d talk about asthma, diabetes or multiple sclerosis.

Use a model or picture of the brain with kids under age 7, says Gattorna. Older kids are ready for words like “brain cells” and “brain chemicals.” Move from concrete to conceptual as kids mature.

Explain that symptoms can include unusual behaviors — acting extremely angry or sad, sleeping way too much or too little or being overly mean to teachers or classmates. Add that it can affect thinking — sometimes making a person unduly suspicious of others or unable to organize simple tasks.

Gattorna suggests saying something like, “Not all kids choose their behaviors. Sometimes things are happening in their brains that confuse them or prevent them from acting the way we expect them to.”

Tell children it’s not okay to emulate those behaviors. Teach them to tell you when someone else’s odd behaviors make them feel unsafe.

Encourage children to be patient. Remind them that our country was founded on differences and that there is value in every person, including those with obvious or hidden disabilities. Say, “We need to be accepting of others.”

When your children observe extreme behaviors in others, respond with words like, “That person looks very ill,” Gattorna says. Use an empathetic rather than judgmental tone. Avoid words like “crazy,” “nutso” or “mental.” Tell children these words are hurtful and reinforce painful stereotypes. Encourage them to dissuade others who use them.

Remind children to treat kids with mental illness as kindly as they would treat anyone, says Barton. But acknowledge children’s discomfort if extreme behaviors make them recoil. Say, “I see you turning away,” then talk about what your child is feeling and ways to respond.

For more tips and resources, read “Talking To Kids About Mental Illness” by the American Academy of Child and Adolescent Psychiatry.

Finally, enlist your child’s school. Request more and better information about mental illness in school health curricula and teacher training, urges Gattorna. It helps when others are well informed and open minded. Talking with children today will help future generations take mental illness out of the closet and into everyday conversation.