Paola now calls herself an ‘adult child’ of a parent with a mental illness and works as a co-convener at Children of Mentally Ill Consumers/Parents (COMIC). COMIC lobbies and advocates for the rights of children and their ill parents. Paola is also a project officer with the national initiative COPMI, Children of Parents with a Mental Illness, which produces information resources for those working with children.

As a young child who struggled to gain visibility and resilience, Paola now talks openly about her experience in the belief that increased awareness and education will help other child carers. She strongly believes such information would have helped her understand her mother’s condition and therefore would have made a difference to her childhood. Paola says it was very confusing as a child growing up in a household where things were “not quite right”.

“It took many years before I understood what mum was suffering from. She became ill when I was six, but it wasn’t until my very late teens that I began my journey of trying to understand her illness. One huge turning point for me was watching the movie One Flew Over The Cuckoo’s Nest. It was the first time I saw the effects of medication and shock treatment and could relate it to my mum’s condition.”

It’s common for children of parents with a mental illness to feel guilty, overburdened or isolated. Others try to come to terms with feeling ashamed because of the stigma towards mental illness. For many children like Paola, having a mentally ill parent can feel like having an absent parent. Due to her mother’s illness, Paola learnt all her domestic skills through her father.

“He taught me how to use the washing machine and how to prepare a particular Italian dish. I also adopted my friend’s mother as my second mum and if it wasn’t for her I would not have learnt a lot of things.”

Paola’s only other support was her small handful of Italian aunties and uncles who lived in Australia. The great bulk of her family lived in Italy. This feeling of isolation is very common amongst immigrants, but add to that the family shame felt towards Paola’s mother’s illness.

“There were comments like: ‘your mother should be locked away’. But in the Italian community as a child you look up to your relatives because they are your elders and you don’t question them. I actually spoke up only 4–5 years ago and I am now 47. It took me a very long time to confront them about things they said to us which were very hurtful. My relatives have since apologised and I have forgiven them. We have a much better relationship now, whereas before I used to avoid them in case they said something hurtful.”

Without that ongoing support Paola struggled to understand her mother’s illness and the workings of the mental health system. She says while she was often used as her mother’s interpreter during medical appointments, the mental health profession failed to provide her with basic information about her mother’s illness.

“We have a systemic issue that puts up a lot of barriers around privacy and confidentiality. I laugh at that because I have been used as my mother’s interpreter and have always known what has been happening to her. But, what I didn’t know was what schizophrenia was. No one ever explained that to me. I had to really investigate it during my late 20s.”

While some families are also trying to manage on their own, Paola says this raises some serious concerns, especially amongst parents living with a mental illness who also have dependent children. Paola says her concerns were confirmed after she called the general admissions department at three hospitals in South Australia where she checked if staff asked patients if they had dependent children.

”I even asked the psychiatric ward: ‘do you ask if the person is a carer and the answer was no.’ It confirmed to me that this was standard. By not acknowledging this, how can staff determine if that family needs help? From a parenting point of view that sort of stuff is what COMIC advocates for. We don’t want to come from a child protection point of view, but more from a family support point of view.”

Paola urges family to have a care or crisis plan in place. “Think about a single parent. If a care plan or crisis plan hasn’t been implemented (and usually on first episodes that doesn’t occur) kids maybe left to fend for themselves. If a parent doesn’t have some kind of care plan in place what happens to those kids whilst the parent is in hospital? They have the potential of being left unsupervised.”

To combat this problem COMIC has produced the Supporting Our Family Kit, which provides families with an effective care plan to avoid these situations.

Paola also advocates for the sector to be more child and family oriented. COMIC would like to see hospitals and mental health services create a family environment where children feel comfortable and safe. “There have been many adult centres that say this is not a place for children. At COMIC we laugh at that because these children live with mental illness on a daily basis, so what are you trying to protect them from? It would be nice to have a spot that is child friendly. For example if you see a cartoon you know that that space is trying to engage with children and young people. But if it’s very stark and clinical, there’s no engagement whatsoever.

“I have actually taken my own son into a psych ward where he was approached by someone who was unwell. He was a bit frightened, but I explained to him that that person was really unwell and they were in hospital to get better. That kind of reassurance is detrimental. I’m a child of a parent with a mental illness. There is also a grandchild of a grandmother with a mental illness.”

While young people now have more access to mental health information through programs like COMIC, COPMI, Mindmatters, Headspace and Reach Out, Paola would like to see more education about mental health in our schools. She says her son was bullied at school about his grandmother’s illness and she immediately suggested to his school to invite the Mental Health Education Group in South Australia to address the entire school.

“Mental health education hurts nobody. If we don’t teach our children about mental health by role modelling and educating them how are we going to be able to say to them that it’s okay to seek help. We need to shake off the stigma from the past. I had to tell my son that those students were saying those things about his Nona because they didn’t understand. I explained to him that by teaching them he would not only be helping them but himself and his Nona.”

While Paola acknowledges how challenging it is being a parent, she describes it as even a greater challenge being a parent with a mental illness.

“Those parents need support and by offering support and extending that to their partner and children you are actually helping an entire family’s mental health. Statistics for family breakdowns are very high for those affected by mental illness and that could potentially be avoided if there was better support.

“I have been exposed to the mental health system now for over thirty years. I have had to teach myself a lot. My journey has been a long one and I like to believe that we are moving towards an era of change. I can see a mental health system that is family oriented. I can see children with a parent with a mental illness acknowledged, educated, supported and encouraged. We are becoming less afraid of mental illness, less afraid to ask questions, less afraid to ask for help, and we are finally being encouraged to do so. We are on a road towards rehabilitation and recovery because this is something we all want.”