Parental mental illness is an ACE (Adverse Childhood Experience).
The ACE study defines parental mental illness as “Was a household member depressed or mentally ill or did a household member attempt suicide?” The point is that a child growing up in the house had to be aware of the parent’s mental illness; a diagnosis that was shared between a parent and a psychiatrist and managed so effectively that the child never knew about it is not an ACE; and this is the goal of keeping a parent’s mental illness from becoming an ACE.
The term “mental illness” is enormously broad and can range from illnesses like schizophrenia that completely change someone’s perception of reality, to mood disorders like depression that can cause episodes of crippling emotional dysregulation to eating disorders to neurodegenerative conditions like Alzheimer’s.
Mental illnesses can be caused by a wide variety of things including trauma, environment, and genetic factors. Mental illness as an ACE is caused when a parent’s mental illness is not properly treated and the symptoms of it affect their child’s life.
The vast variety of mental illnesses can cause a huge variety of impairments. Mood disorders, such as depression, anxiety disorders and bipolar disorder can cause parents to have too little energy, or too much, to properly connect with their child and meet their emotional needs.
Postpartum depression is a specific type of depression that is linked to maternal stress, details of the pregnancy and delivery, and some other factors. It is strongly linked to poor maternal bonding and a higher risk of abuse and neglect, and it carries so much shame and stigma with it that mothers may be reluctant to seek help for it.
All mental illnesses can make holding down a job and running a household difficult. Many people who suffer from mental illness learn to “self medicate” with street drugs or alcohol, and this can pose the risk of addiction and arrest.
Schizophrenia, and other diseases with related symptoms, can cause delusions and hallucinations and tends to cause paranoia. It can cause very irregular and sometimes violent behavior because the sufferer cannot properly comprehend the world around them.
Mental illnesses vary in severity and in treatability, and because of that it is unwise to say that any particular diagnosis makes someone unfit to parent. If a parent is able to emotionally engage with their children, make sound judgements about their care, run a household and work with professionals in order to manage the mental illness in question, they are not generating an ACE. If a parent has drastically struggled with these things in the past building a support network and possibly supervision becomes important.
Maternal home visiting programs prevent parental mental illness from becoming an ACE. Maternal home visitors can connect their families with local resources, provide the emotional support they need to sustain treatment, and can help unravel some of the thinking errors that involve children that parents tend to develop (such as “I’ve already ruined my baby’s life”, “the baby is doing that because he hates me, like everyone else does” or “the baby will be better off without me”). Of course, there need to be appropriate mental health resources in a community for this to work; that means everyone in every community having access to appropriate, high-quality mental health care.
Prenatal care providers can also play a role in connecting a pregnant woman with quality mental health care, and many healthcare providers are incorporating screening for postpartum depression into their standard practices.