Ever wonder what life is like for siblings of kids with serious mental health needs? I spend an inordinate amount of time thinking about this, because I’m running a research study to support siblings of youth admitted for psychiatric hospitalization. It’s called the Sibling Support Demonstration Project, and it’s underway at Cambridge Hospital (MA), where close to 300 siblings and parents have participated.
Mental health disabilities are tricky. For one thing, they tend to be invisible. This means that outside observers usually have an incomplete understanding of situations involving a child’s inappropriate behavior. With a visible disability, such as a child in a wheelchair, it’s immediately clear to outside observers that the child has a mobility impairment and relies on a wheelchair for transportation.
Many of the siblings in my research project are struggling not only with the challenging and often unsafe behaviors that have landed their brother/sister in a psychiatric ward, but they are struggling with the insidious stigma of mental illness – which they often internalize, as if the stigma of our external culture isn’t punitive enough – as well as the trauma of the psychiatric hospitalization itself.
Here are some examples of what these siblings are dealing with:
- Unpredictable behavior and rapidly shifting moods of the brother/sister, and the fact that the brother/sister is often held to a different set of expectations and rules of discipline which may feel like a double standard.
– Physical and verbal aggression from the brother/sister, which can lead to generalized anxiety, sleep problems, impaired concentration in school and many other issues.
– Embarrassment when the brother/sister is unable to control his/her behavior at home, at school and in the community, which can translate into the siblings’ reluctance to invite friends over, be seen in public together and to participate in extracurricular activities.
– Assuming adult responsibilities before they are developmentally ready to do so. Taking on the role of the “little mother” or “little father” in the family (otherwise known as parentification) can be the siblings’ way of managing stress, as well as an indicator that siblings are missing out on their childhood.
– Keeping too many personal problems to themselves because they see how emotionally taxed their parents or guardians are and don’t want to add to the perceived burden.
– A cycle of protectiveness/avoidance, when siblings sense the vulnerability of the brother/sister which leads to over-protectiveness, and then withdraw when the brother/sister’s behaviors become hurtful.
I often remind the parents of these sibs that a mental health disability impacts every member of the family. It isn’t fair for anyone – not for the affected child, not for the parents and certainly not for the siblings.
So the next time you see a child who you perceive to be “acting strangely,” you might wonder: is there a sibling in this family who needs extra support?
Emily Rubin is Director of Sibling Support at the Eunice Kennedy Shriver Center of UMass Medical School, as well as the President of the Massachusetts Sibling Support Network. For more information about the Sibling Support Demonstration Project, go to page 8 of the most recent Shriver Center newsletter.
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