Centre for Addiction
and Mental Health

Concurrent Substance Use and Mental Health Disorders: An Information Guide

Explaining concurrent disorders to children

Concurrent Substance Use and Mental Health Disorders: An Information Guide

On This Page:

How much should I tell the children?
What to tell children
Outside the home
During illness
During recovery

Explaining a mental health or substance use problem to children can be awkward and difficult. To protect their children, parents may say nothing. They may try to continue with family routines as if nothing were wrong. This strategy may work in the short term. Over the long term, though, children can feel confused and worried about how their parent’s behaviour has changed.

Children are sensitive and intuitive. They quickly notice when someone in the family has changed, particularly a parent. If the family doesn’t talk about the problem, children will draw their own, often wrong, conclusions.

Young children, especially those in preschool or early grades, often see the world as revolving around themselves. If something bad happens, they think they caused it. For example, a child may accidentally break something valuable. The next morning, the parent may seem very depressed. The child may then think that breaking the object caused the parent’s depression.

How muchshould I tell the children?

Children need to have things explained. Give them as much information as they can understand.

Toddlers and preschool children

Toddlers and preschool children understand simple, short sentences. They need concrete information and not too much technical language. It is best to explain simply and then try to make the child’s life as normal as possible. After explaining the problem, you can make the child feel better if you move on to do something special that the child enjoys.

School-aged children

School-aged children can handle more information than younger children. However, they may not understand details about medications and therapies.

Teenagers

Teenagers can generally manage most information. Often, they need to talk about their thoughts and feelings. Teenagers worry a lot about what other people, especially their peers, think of themselves and their families. They may ask about genetics. They may also wonder how much they should tell others. They may fear prejudice about mental illness or substance use problems. Sharing information encourages them to talk.

What totell children

It is helpful to tell the children about three main areas:

1. The family member has a problem called “concurrent disorders.” The parent or family member behaves this way because he or she is sick. The illness may have symptoms that cause the person’s mood or behaviour to change in unpredictable ways.

2. The child did not cause the problems. Children need reassurance that they did not make the parent or family member sad, angry or happy. They need to be told that their behaviour did not cause their parent’s emotions or behaviour. Children think in concrete terms. If a parent or family member is sad or angry, children can easily feel they did something to cause this, and then feel guilty.

3. It is not the child’s responsibility to make the ill person well. Children need to know that the adults in the family, and other people, such as doctors, are working to help the person. It is the adults’ job to look after the person with the problem.

Children need the well parent and other trusted adults to shield them from the effects of the person’s symptoms. It is very hard for children to see their parents distressed or in emotional pain. Talking with someone who understands the situation can help sort out the child’s confused feelings.

Outsidethe home

Many children are scared by the changes they see in a family member with concurrent disorders. They miss the time they used to spend with this person. Having activities outside the home helps, because children are exposed to other healthy relationships. As the person recovers, he or she will gradually return to family activities. This can then help mend the relationship between the children and the ill family member.

Parents should talk with the children about what to say to people outside the family. Support from friends is important. However, concurrent disorders can be hard to explain, and some families are concerned that:

other people will not understand
other people may act in a way that is prejudiced toward the person with concurrent disorders.

Each family must choose how open it wants to be.

Duringillness

Children’s everyday activities can be noisy. Some people who have concurrent disorders may not be able to tolerate children’s noise and behaviour. Family members may need to protect an ill parent from situations that may lead him or her to be irritable and abrupt with the children. At times, children may need to play outside the home. Or the parent may need to rest for part of the day in a quiet area of the house.

During recovery

Once recovered, the parent or other family member can explain his or her behaviour to the children. He or she may need to plan some special times with the children. Such times re-establish the relationship. They reassure the children that the family member is again available and interested in them.

In Concurrent Substance Use and Mental Health Disorders: An Information Guide

Authorship

Introduction