It is important to keep in mind that the perspective described in this article is not founded on any formal research, but is based entirely on my experience helping clients from various ethnocultural backgrounds living in the Kamloops area deal with parental mental illness and its effects on offspring.
Reprinted from "Parenting" issue of Visions Journal, 2004, 2 (2), p. 44
Kamloops has several ethno-specific groups living in the area and each one is at a different stage of settlement and acculturation. Each individual handles this stress in his or her unique way, and when a mental illness is part of the equation, it often becomes a painful process for the families.
Mental illness is difficult enough for the mainstream population, but additional factors – like language difficulties, social change, role reversals, racism, cultural disintegration, financial strain, religious beliefs and stigma– can cause significant distress for an immigrant parent or other family member who deals with a mental illness.
Along with the known naturalistic causes of disease, many Eastern cultures believe that mental illness is also due to some supernatural powers, which are beyond human control. Illness is sometimes also seen as a character weakness, which goes along with the belief that mental health can be achieved through self-discipline and willpower. For the individual with the illness, these ideas often interfere with following a medication treatment plan and may worsen the condition.
Mental illness in a parent or a child is often kept a secret from the children and the community, as there is a significant shame attached to it. Clients and their families often try strategies such as traditional health methods and general isolation of the individual before they consider going to a physician with psychosomatic complaints. Referral to a mental health professional is usually the last resort and is through the family doctor, the employer, the correctional system or a community agency working with ethnocultural groups. There is often a great fear of the word mental in the term ‘mental health services,’ so clients would prefer to meet elsewhere for the first time, rather than be seen accessing a mental health office. Developing trust with this group and acting as a cultural mediator is a crucial part of the helping process.
For most individuals, including parents with mental illness, a big key to the treatment of their illness is acceptance of the diagnosis. This is also true of the family that surrounds the person with mental illness. From the perspective of both clients and families, the most oppressive component of family burden is stigma. It leads to marginalization and ostracism of the person and affects their jobs, insurance and housing arrangements. It severely decreases the chances that they will seek help.
The stigma also has adverse effects on the client’s self-esteem, damages family relationships and increases the feelings of isolation and shame. The changes that are forced on the family eventually affect the offspring, who may internalize the stigma that has surrounded their ‘crazy’ parent; the situation may be worsened by the tendency for known social supports to withdraw from the family. The devastating impact of the illness is experienced intensely by all members of the family through grief and loss, as well as shock, disbelief, anger, despair, anxiety and guilt. They may feel that parent or partner they had known and respected is lost to them.
This situation often contributes to conflict between the ill parent and the adolescent children. Clients, especially males who have grown up in traditional patriarchal societies, are further burdened by their children’s ‘lack of respect and communication gap.’ They are unable to consider the developmental needs of the youth or to see the relationship between their illness and their children’s behaviours. As with the mainstream culture, offspring often take on the caregiving responsibilities, get ‘parentified’ in the process, and then miss out on meeting their own personal needs. The resentment tends to build up and can lead to explosive interactions and painful experiences for everybody. One mother tearfully related an instance when her 16-year-old told her to “grow up and be mature, Mom! Think of your children for once!” This was after the mother had to be endeav hospitalized for the fifth time and the teenager had to take care of the younger siblings.
Not having enough knowledge about mental illnesses, and perceiving that there is a choice for the parent causes a lot of additional difficulties. A number of other issues can affect the healthy development of offspring, such as feeling responsible for the illness and walking on eggshells, the unpredictability of the parent’s moods, and the constant secrecy surrounding the illness.
While these experiences are not significantly different from how other cultures experience parental mental illness, the mental health professional must also consider the influence of the cultural component and how that can make an already difficult situation even more challenging.
Cultural factors may play an important role in causing psychiatric disorders, via their roles as stressor, resource/support system, definition and standard of normality/abnormality, and the concepts of self and personhood.
About the Author
H, Picku Multani is a Cross Cultural Counselling Services Clincian with Interior Health - Thompson Cariboo Shuswap Health Services Area, Mental Health Services, Kamloops.
Anthony J. Mansella and Ann Marie Yamanda - Multicultural Mental Health, 2000, p.13