Published Oct 13 2021

Acting early to break the cycle of family mental illness

Both the 2021 Victorian Royal Commission into Victoria’s Mental Health System and the 2020 federal Productivity Commission Inquiry Report highlight the impact of a parent’s mental illness on their children, and the need to break the cycle of mental illness in families.

Monash University’s leadership role in addressing the issue over the past 10 years resulted in the establishment of a research group comprising more than 50 researchers from 12 countries, the Prato International Research Collaborative for Change in Parent and Child Mental Health.

Their work was recently highlighted in the Journal of Child Psychology and Psychiatry, outlining the key principles and recommendations for working with families living with parental mental illness.

Group member Professor Torleif Ruud, from Norway, has previously published research that shows 36% of clients attending adult services have children under 18. These prevalence rates are consistent across many Western countries.

“Mental health services are typically reactive, where their focus is either on managing crises or treating an individual’s mental health challenges,” says Monash Faculty of Education’s Professor Andrea Reupert, the report’s lead author. “While both are obviously important, if this is their only focus, critical opportunities for prevention and early intervention are missed.”

Services missing an opportunity

Monash Rural Health’s Professor Darryl Maybery, a co-author, says mental health services that treat the parent miss a critical opportunity to stop the cycle of mental illness in the community.

“In later life, children whose parents have a mental illness are up to three times more likely to develop their own illness, but nothing is done until they present with their own social or mental health problems.”


Read more: With youth anxiety and depression at record levels, mental health hubs could be the answer


The group’s research has resulted in recommendations for practice, organisational, and systems change.

They found that while genetics play an important role in the transmission of mental illness from parents to children, environmental and socioeconomic factors – including parenting competence, the level of parents’ illness disability, and other family and social supports and stressors – will also influence whether, and how, a parent’s illness impacts their children.

A “family” lens can be provided by incorporating parenting into mental illness treatment plans, and identifying parenting status for those entering mental health services.

Mental health and wellbeing facilities need to be family-friendly, and time, training and resources should be provided to clinicians when working with families. All services – across health, education and welfare – play a part in addressing the needs of these families.

Family members need to be engaged

Other core recommendations include that family members, especially children, are engaged in ongoing conversations and decision-making opportunities when the parent is being treated for an illness; their own needs should be identified and addressed.

There’s an ongoing need to develop legislation, collaborative models of practice, training in family models of care, and the need to benchmark and audit services to ensure children and parents are provided with appropriate care, the researchers say.

“Current practice relies on models that only see individuals, particularly in mental health services,” says Professor Maybery. “This must change. Along with treating a parent’s mental health, professionals must be proactive and provide targeted prevention and early intervention initiatives to children and parents living with parental mental illness.”

About the Authors

  • Andrea reupert

    Professor and Head of School, School of Educational Psychology and Counselling, Faculty of Education

    Andrea is a Professor at Monash University, Clayton and Director of Psychological Programs at the Krongold Clinic. She is the Editor in Chief of the journal Advances in Mental Health, Associate Editor for Australian Psychologist, and has served as guest editor for the Medical Journal of Australia and Child & Youth Services Review for special issues related to families where a parent has a mental illness.

  • Darryl maybery

    Professor, Department of Rural and Indigenous Health, Monash Rural Health

    Darryl is the Director of Research and Professor of Rural Mental Health in Monash University’s School of Rural Health. For 15 years, he was a mental health clinician and psychologist in the areas of drug and alcohol counselling, prison psychology and employee assistance. His research projects include rural, urban and international collaborations with a focal research area in relation to vulnerable families, particularly those affected by parental mental illness, including carers and family.

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