'My childhood life falling apart': A retrospective study of young carers managing parental mental illness in Taiwan.

The population of young carers of parents with mental illness is more likely to be hidden in the community due to the family's concerns related to stigma. Many young carers struggle with caring difficulties with a lack of social support. The aim of this study was to gain insight into the difficulties of young carers managing parental mental illness in Taiwan from retrospective perspectives. Semi-structured interviews were conducted with 19 participants who used to be young carers of parents with mental illness. Interviews were analysed using thematic analysis. Three themes emerged. First, participants experienced grief over the loss of their parent's normality and the disruption of the parent--child relationship. Having to deal with issues alone, they described their childhood lives as falling apart. Second, families tended to conceal mental illness by refusing to seek outside support, resulting in young carers struggling in vulnerable situations. Third, participants used coping strategies to find a balance between maintaining parental mental illness and reducing the impact on their well-being. Most participants used solitary strategies to cope with their emotional distress. Some participants used destructive ways to suppress their pain and sorrow when there seemed no way to improve their family situation. The findings reflect on the vulnerabilities of young carers of parents with mental illness. Services and practitioners should work together to recognise young carers' identities and provide suitable resources to young carers to help them deal with life crises and meet their developmental needs. Key Practitioner Messages Recommendations for practitioners in working with young carers are provided as follows: • It is hoped that practitioners have a better understanding of the adversities that young carers of parents with mental illness have experienced. Their needs and vulnerabilities are often invisible and ignorant due to family secrecy related to mental illness. These young carers inevitably may experience a great sense of loneliness while growing up. It is important that practitioners provide young carers with interventions such as discussion sessions and counselling programmes to allow them to share their family life. It is a big relief for children to understand that they can talk about their concerns or secure support with professionals they can trust. Peer support can also help young carers to discuss about their family issues with those who have the same background. Such interventions can help to develop resilience in dealing with issues. • To meet the needs of young carers, mental health and social service practitioners should work together to promote family-focused programmes that value the needs of the whole family by inviting parents and their children to meetings and to reflect their individual requirements in the intervention programmes. • Schools are considered a vital place in which children spend much time of their childhood. Participants in this study coped with life challenges alone and some of them took destructive ways to cope with their enormous pains without social awareness. It is important that school staff should be trained to recognise that a child may assume a carer role if the child's family members are ill together with having school problems such as missing school and/or having academic underachievement. These can be indicators that the child may be caring for an ill parent at home and school staff should provide proper information or intervention services for the potential young carer in need. • Psychoeducation into mental illness is also needed to support young carers with age-appropriate information, including descriptions of mental illness, coping skills and emergency contacts, which may alleviate some of their caring burden. Access to online resources such as online interventions is recommended to provide young carers with the required knowledge, support services and coping strategies to help them reduce life risk especially when they are alone with the ill parent. • Advocacy aims to reduce the risk of families where a parent has a mental illness and enhance family functioning to better cope with adversity by addressing their own needs and ensuring families have equal access to services. Finally, it is important for agencies, professionals, service providers and policy-makers to be aware of young carers as a hidden population within communities and develop integrated services to meet young carers' developmental needs. [ABSTRACT FROM AUTHOR]