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Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

Plotting the Course Ahead

Mental health and the Ulysses Agreement

Mark Littlefield, MA, and Natasha L. Smith, BA

Reprinted from the "Families and Crisis" issue of Visions Journal, 2017, 12 (4), p. 28

In ancient mythology, the gods told the hero Ulysses that if he wished to make it home safely with his men, he had to sail his ship between two islands inhabited by the Sirens, beautiful mythical creatures—half-woman, half-bird—whose song rendered sailors incapable of good thoughts or actions.

Ulysses knew that if he and his mean heard the Sirens’ song, their ship was likely to crash upon the shore, and everyone on board would be lost.

Ulysses devised a plan. He had the crew put wax in their ears so that they would not follow his directions at a time when he knew he might make poor decisions. He also ordered his men to tie him to the mast so that he could not jump into the sea—even if he were tempted by the Sirens’ song. Finally, he ordered them to not change course under any circumstances, to keep their focus on home. With this plan, Ulysses and his men were able to sail past the Sirens and return safely to the shores of Greece.

This tale of heroism is the inspiration behind the name of the Ulysses Agreement, a collaborative, non-legal document that outlines a plan to follow when a family member experiences a mental health crisis and is not able to take part in family life as usual. This co-authored article, from the perspectives of a clinician and of a parent, focuses particularly on how a Ulysses Agreement (UA) can benefit a family when it is the parent who has a mental health concern. But in fact, UAs can be helpful tools regardless of who is facing mental health challenges. Each UA can be tailored to suit a family’s unique needs.

From the perspective of a clinical partner

Over the past eight years, I have had the honour to work with families in which a parent has a mental health concern. These parents often report that their number-one fear is losing their children to Child Protection Services.

Many parents tell me they experience judgement, ignorance and even bullying from extended family members and professionals about their capacity to parent. They also hear that they are incapable of parenting, a burden to their children and, in some cases, a threat to their children’s safety.

In my experience, however, all parents parent in similar ways—whether they have a mental health concern or not. Like all parents, parents with mental health concerns love their kids, want the best for them, will do anything for them—and on occasion wish they’d been able to sleep a little longer, just for the peace and quiet. Like all parents, they manage the good times and the bad.

In my work, I have found that one of the best ways to address the fact that a parent has a mental health concern, and may require certain types of support at various times, is to create a plan that details how friends, family and professionals can work together to enable parents to focus on their recovery while letting their children know that they and their parent will be cared for. Both these things are fundamentally important—otherwise, kids worry. The Ulysses Agreement is such a plan—a document that outlines a course of action that the parent has developed in partnership with his or her supportive community.

In addition to providing everyone with clear guidelines about how to work together, the UA helps manage parents’ fears. Essentially, it tells the world, “I may happen to have a mental health concern but that does not interfere with my role as a parent. Here is my plan to care for my kids when I may not be able to do so myself.”

When a UA addresses the needs of a family in which a parent has a mental health concern, it provides the following:

  • A description of the daily wellness activities the parent undertakes to stay healthy and happy

  • A brief explanation of the mental health concern and what symptoms can look like

  • A description of early warning signs—when to enact the UA

  • A description of early support activities

  • A list of medications that work and others that don’t

  • A description of what care plans are in place for the children and the parent should a hospitalization be required

  • The children’s daily care routines (from a child’s perspective, predictability means safety)

  • Guidelines for talking to the children about what is happening to their parent

  • How contact between the parent and the children will be maintained

The UA should be revisited regularly and updated to reflect the unique and changing needs of the family over time. The UA should also be flexible enough that it can be adjusted to meet unforeseen circumstances, while still staying true to the parent’s original intentions.

For a UA to work the way it is intended to work, the individual with the mental health concern must see the UA as a wellness plan rather than as a punishment for having a mental illness. When the UA works, children report, “I like knowing who to talk to if mom starts becoming unwell. I also like knowing what will happen to me and my mom if she goes to hospital again.” Parents report, “I like knowing that my kids will have their needs met, I know what they will be told and that we will stay connected. I also like that I can focus on my recovery so I can get back to parenting quicker.” Family members report, “I appreciated knowing what I can do to help, as well as what not to do.”

From the perspective of a parental partner

Having struggled most of my life with mental health concerns and addictions, my journey has been the uneven ebb and flow of bipolar and borderline personality disorder, which usually ends in crisis and a trip to the psychiatric hospital for a “stay-cation.” As the mother of a 12-year-old boy who struggles with his own mental health concerns, I now find myself with the strength and desire to provide more stability in our lives as a family.

The United Nations Convention of the Rights of the Child (UNCRC) states that children have the right to their own opinion, that their opinions matter, and that their views must be heard and considered when care decisions are made.1 I believe that the intentions of the UA and the UNCRC are related. Children should feel they are part of the process when plans are made to address mental health concerns in the family. As a parent working on my own state of recovery and wellness, I believe the UA allows for my child to be comfortable sharing how my mental health concerns are affecting him; this in turn helps us work towards managing those concerns—what great parenting is all about!

Despite the seeming formality of the UA’s structure, developing a UA and sharing it—or something like it—with your own support network (family, friends and so on) can actually bring some comfort. And even though the UA is not legally binding, it gives everyone in the network the chance to communicate in a healthy, productive way, during times of wellness and recovery and during times of challenge. This removes the stresses of the unknown, as well as any links to feelings of obligation and confusion (which may be present when a family is dealing with Child Protection Services, for example, and feeling forced to do what they’re told so that their children will not be removed from the family’s care).

For example, once when I came home from a lengthy stay in hospital, I was told that if I did not comply and take the medications I’d been prescribed—medications that made me very tired, and which consequently make parenting very difficult—then my son would be taken away from me. Developing a Ulysses Agreement together allowed my child and me to learn and acknowledge to ourselves and each other our strengths and our supports. It has also helped us identify new strengths and supports.

Now, with the UA agreement in my tool box, I know I can show my medical practitioners and others that I have a plan and a support network, and we can all begin the task of removing the shame and stigma around mental illness, addictions and more.

 
About the authors

Mark works with the British Columbia Schizophrenia Society and the Ministry of Children and Family Development (MCFD) – Child and Youth Mental Health (CYMH) to help families and professionals build effective care plans for both parents and children dealing with mental health concerns

Natasha is a panromantic asexual, not only a proud single parent to a rare Phoenix bird but also a proud woman of Musqueam descent. She lives with bipolar 2 and borderline personality disorder. Her bachelor’s degree is in political science and anthropology

Footnote:
  1. The United Nations. (1989). Convention on the rights of the child. Treaty Series, 1577, 3.

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