Who are these tips for?
These tips are food for thought whether you’re the carer/parent, or maybe a friend or colleague or Mental Health First Aider first aider supporting a carer/parent. Some are even relevant if you’re supporting an adult with mental health issues too. They come with the seal of approval from several teenagers and Time to Change Young leaders, which is always a bonus!
The teenager dynamic
Supporting a teenager with a mental health issue comes with particular challenges, how do you get the balance right in terms of setting boundaries, allowing freedom and knowing when to intervene? Not surprisingly it can be a minefield and there are no easy answers. Challenge yourself, is the behaviour on the scale of ‘normal’ teenager stuff? A useful book to help you come to terms with the changes is ‘Teenagers!’ by Rob Parsons. Having your values and authority challenged is part of the package when you have teenagers, mental health issues add to the complexity. For any extreme behaviours such as addiction and uncontrolled anger, see what you think of the “f*ck parenthood” chapter in the book Fuck Feelings (by Micheal l.Bennett and his daughter Sarah). It’s “One shrink’s practical advice for managing all life’s impossible problems” and at the heart of it lies acceptance, and that all important reminder to recognise what’s in our control and what isn’t.
It’s a journey
Any carer/parent will go on their own journey coming to terms with the mental health issues that their son or daughter is experiencing. This might be a parent’s first experience of the mental health world and what support is, and isn’t, available. Navigating getting your teenager help is hard enough for the carer, and then getting their head around something like self-harm really challenges their own primal reactions to protect against danger. Self-harm, in itself, is not classified as a mental health condition, but an expression and a way of coping with deep distress and emotions. It is often associated with other mental health issues such as depression, anxiety and eating disorders. While it may seem counter-intuitive it is very often the individuals way of coping and staying alive. Check out the factsheets at the specialist website Harmless
Being non-judgemental is put to the test!
In a professional role we might be able to rationalise the need for a non-judgemental attitude, but self-harm which might include self-medication with alcohol/drugs and other ways of coping can be particularly hard to tolerate as a form of expression. Our natural reaction is to actively prevent these dangers, but many mental health issues are about feeling in control. Imagine finding a blade in your teenager’s bedroom. It’s really important, though challenging, for a carer and anyone involved in a mental health first aid situation to take a step back from the situation before acting. A helpful way for a carer to address this might be to say something like “I notice you had xxx in your room, are you safe? Do you need some more support?”
When assessing any situation, include a quick assessment of your own reaction and try not to jump to conclusions, you’ll see danger everywhere. Rob Parson’s has a great example of a parent taking a pill he suspected to be an illegal drug to the chemist’s for analysis. It turned out to be a mint! However, if on assessment of the best available information, you’re still concerned, go with your gut and take action.
Setting boundaries and still allowing freedom in the face of danger
As parents the natural reaction is to give advice, fix things, and sometimes lay down the law as we can see the potential consequences of a course of action a mile off! It would also be natural to be on high alert and not want to let them out of your sight after experiencing the ultimate danger of, say, an overdose attempt. Arm yourself with expert advice, for example the charity Papyrus has information and support aimed at preventing young suicide.
As scary as it is, a teenager will still need freedoms. Setting boundaries is absolutely necessary, it’s just they may need to stretch beyond the pre-teenager/pre-mental health issue ‘comfort zone’. You might weigh up decisions like “Are they safe going to a gig in London at age 14” VERSUS “Are they safe in their room if they’ve been told they’re not allowed to go?” Rewarding trust is a helpful direction to move towards.
Support is still all about listening
Our most powerful tool is to find informal opportunities to engage and then just listen if they do choose to talk. Mealtime might seem like one of those rare opportunities, but what if they have an eating disorder, that will just add to the pressure! Casually making conversation in the car could work better, after all, hopefully they’re grateful they haven’t had to catch a train and walk home in the rain.
If you’re a carer and feel your reaction to a particular event/conversation wasn’t as helpful as it could have been, notice that you feel this way and move on. Sometimes there are no simple right or wrong responses or answers, people are doing the best they can in usually complex and messy situations.
Seek your own support
As well as considering going to a formal carer group (many local mental health charities run them), talking to non-judgemental friend who listens to the eclectic stories with compassion, can be a great help. Someone who shares your sense of humour can make all the difference, comedy and tragedy are often close companions.
A carer frequently puts their own needs last, there may be feelings of guilt to wrestle with, but who does that help? Remember the emergency advice on a plane – you’re meant to fit the oxygen mask to yourself before assisting someone else. What helps you, the carer, relax and feel good?
By re-focusing on your own needs it can reduce the anxiety and frustration that can emerge when the carer is trying to control a situation outside of their control.You may need to acknowledge the immensity of the emotional energy required in a carer situation, and give yourself special permission to say no to some social events and choose to only hang around those people you have the energy for. But equally don’t isolate yourself.
Everyone one is different
A carer and their partner may process and handle the mental-health situation very differently. One partner may live and breathe it every living moment and define how they are feeling in terms of how they think the family member with mental health issues is doing, with each drama played out in painful detail. The other partner may compartmentalise the behaviour and feel less inclination to talk about it. Some acceptance that everyone is different could be useful. This applies to any carer relationship.
The next chapter
What happens when they leave home and maybe go to university? If they need support due to mental health issues, but haven’t told you, it’s unlikely that the university will contact due to confidentiality issues, even if the situation is severe. Frightening isn’t it?! Have a discussion with your son or daughter before they go, and talk through options, having listened to the informative radio podcast Should parents know what is happening at university? . I like the flexible approach of York university which acknowledges students’ vulnerability, particularly in their transition first year. They reviewed all their policies after a spate of suicides to create an ‘opt in’ system. This gives student the option to provide a named adult at the beginning of each year that can be contacted/given information, in the event of serious concerns. The student doesn’t have to choose a parent, they can opt out at any time and ultimately the decision is theirs.
Are you the friend or colleague the carer is turning to?
To be truly supportive, be the one who really listens. Many of us naturally treat listening like crossing the road, we’re just waiting for gaps to jump in and share our experiences. Think WAIT – Why Am I Talking? It’s a really helpful way to check if what you’re saying is necessary, or if a silence or clarification or open question would be more appropriate, to allow them to continue sharing.
Recovery and hope
It may well be a rollercoaster ride but recovery is possible, and likely. For some it’s a life-long journey managing symptoms, for others there may be no further episodes of mental illness, or it could be a mixture with periods of respite and some reoccurrence of issues. The only certainty is that it’s a deeply personal journey. Learning to overcome challenges with the patience and support of those around them and recognising their own resources will help develop the young person’s life skills. We must do all we can to allow hope to flourish, but nobody is claiming it will be easy!
Like to learn more about surviving teenagers?
Have a read of my article Surviving teenagers? It’s a great opportunity to build leadership skills! It’s a chance to remind yourself you’re learning some great life and leadership lessons along the bumpy road, with or without mental health issues.