Is It Right to Blame Parents for Actions of Their Adult Children With Mental Illness?
There was a shooting in our town. Three people are dead, including the killer who died by suicide. The broadcast news and social media were full of information about the two women victims. They were generous and high-achieving women. A loss for our community. Most of the social media has been full of warm thoughts and prayers for the families.
But there was one post that blamed the killer's parents for not doing enough. Assuring readers, until parents of the mentally ill take action, there would be more mass killings. That post bothered me.
The facts are individuals with serious mental illness are 12 times more likely to be a victim of a crime including financial and sexual exploitation. They are also at a higher risk for suicide, self-neglect and premature death from medical conditions.
Furthermore as Andrew Solomon says in the introduction to Sue Klebold's book, A Mother's Reckoning: Living in the Aftermath of Tragedy, " Most parents think they know their children better than they do;children who don't want to be known can keep their inner lives very private."
What is Mental Illness?
Mental illness, like so many physical illnesses, vary in the degree of severity from mild to moderate to severe. In 2016, there were an estimated 10.4 million adults age 18 or older in the United States with serious mental illness. A severe mental illness is described as a mental, behavioral or emotional disorder resulting in serious functional impairment -substantially interferes with one or more major life activities. Major life activities include self-care, self-direction, learning, mobility, receptive or expressive language, or capacity for independent living.
HIstory of Service in Community for Those with Serious Mental Illness
In my lifetime, there has been a paradigm shift from warehousing persons with mental illness in large state-run institutions to placement in the community. Advancements in medication and litigation ended the segregation into large institutions and began the funding of services in the community. However, the communities were not prepared and in the 1950s, federal funds were allocated to the development of community mental health centers. Then, in the 70s there was another shift in funds toward the development of community services for those with serious mental illness. There continue to be efforts to enhance services in the community. Yet, today, many states still face major challenges in marshaling the resources for community-based services for the working-age adult with serious mental illness.
8 Million Caregivers
The most important safety net for those with mental illness and other disabilities is relationships with others. Thus, the valuable role provided by more than 8 million caregivers in the community. They care for adults with mental illness despite the difficulties finding community providers and navigating a limited and unequal health care system. A 2017 National Alliance for Mental Ill (NAMI) report, it was revealed that patients with mental illness have difficulties finding a mental health therapist who would accept their insurance. The Milliman report released the same date, noted that psychiatrists are routinely paid less than primary doctors and medical specialists for same types of services--even those services under the same billing code. There is also the 1996 Health Insurance Portability and Accountability Act (HIPPA) which protects adults' medical records and other health information. Thus, if services can be found, caregivers may not be allowed access to information unless the adult with mental illness gives consent or the family member has guardianship rights.
Futhermore, it is difficult to be part of the treatment when you are blamed for the behaviors of your child or for the mental illness itself. Yet, historically parents have been blamed for the behaviors of their childten with mental illness, even for the illness. Mothers have been labeled schizophrenogenic, refrigerator mothers, and more. That is not to say that parent-child relationships are not important, they are critical. But, it is known that environmental and genetic factors are at play here as well. Environmental factors can run the gamut of:
falling victim to a crime, or
All these negative environmental factors can produce stress which if there is a genetic component increases the risk of mental illness.
Early Warning Signs of Mental Illness
On the flip side, early identification and early effective treatment can help individuals learn how to identify and manage stress triggers that heighten their mental instability. The key is the early intervention which is difficult unless you know the early signs of mental illness.
Unfortunately, there are no easy tests to diagnose a mental illness. You need to be able to sort out a physical illness or mental illness or response to the environment. It is especially important to rule out a physical or environmental cause for behaviors before you began a treatment for mental health that is inappropriate. An accurate diagnosis is the first step.
According to the NAMI website, each illness has its own symptoms, but some commons signs of mental illness include:
excessive worrying or fears
feeling excessively sad
confused thinking or problems concentrating or learning
avoiding friends or social activities
changes in sleep habits or feeling tired and low energy
extreme mood changes
changes in eating habits
difficulty perceiving reality (delusions or hallucinations)
abuse of alcohol or drugs
multiple physical ailments without obvious cause
thinking about suicide
inability to carry out daily activities or handle problems and stress
change in school performance
Guilt and Blame
Simon Davis points out in his article in a BC's Mental Health and Substance Use Journal that "feeling of guilt about whether or not mental illness is someone's "fault" are very common. They are also deeply uncomfortable. In fact, they are so uncomfortable that people often find it hard to talk about them. These are feeling that cause families much suffering. People need to be aware of this vulnerability and the damaging effect of judgemental comments."
It is more than guilt the families may feel. Sue Klebold writes about her son who died in the murder-suicide at Columbine High School in her book, "For me, the incomprehensibility of the way Dylan died magnified these feelings of instability at the foundation of my identity by throwing everything I believed to be true about the life I'd lived, about my family, and about myself into question." Seventeen years after the Columbine High School attack, Kelbold state in her book, "A day does not pass that I do not feel a sense of overwhelming guilt - both for the myriad ways I failed Dylan and for the destruction he left in his wake."
A Mother's Reckoning: Living in the Aftermath of Tragedy
A telling and insightful book from the mother of Dylan, one of the murder-suicide victims of Columbine High School. Raw and educational, it will leave you wanting to hug your children one more time and tell them you love them and tear their room apart at the same time.
With so many factors that may be stressors--some beyond parents' control and some not; with so many warning signs misread or missed by parents and those in the community; with so many families struggling to work through the system and get help for their loved ones with mental illness placing the blame solely on the parent is the least helpful thing we can do.
Placing blame on individual parents allows policy-makers to avoid the work they need to do to bring about change. Placing blame solely on parents allows us as a community to avoid the conversations and the work we need to do to end the stigma of mental illness.
A valuable resource to families and individuals with mental illness is the National Alliance for Mentally Ill (NAMI). They have a website (nami.org) and a toll-free helpline that is open Monday through Friday 10:00 a.m. to 6:00 p.m. (1-800-950-950-6264 or email firstname.lastname@example.org or text 741741). As always if you have a crisis or emergency call 911.
Miller, Joel. Gun Violence and Mental Illness: Myths and Evidence-Based Facts. American Mental Health Counselor Association. 10-3-2017.
Davis, Simon. Visions BC's Mental Health and Substance Use Journal 2013. 8 (3) pp. 12-13.
Primm. A B.,College Students of Color. Overcoming Mental Health Challenges July 16, 2018. Retrieved 11/6/18 from https://www.nami.org/Blogs/NAMI-Blog/July-201/College-Students-of-Color-Overcoming-Mental-Healt
Schmidt, Charles W. Environmental Connections: A Deeper Look into Mental Illness. Environmental Health Perspective. August 2007
NAMI. Know the Warning Signs. 2/2/15
Klebold, Sue. A Mother's Reckoning: Living in the Aftermath of Tragedy. Broadway Books.2017.