Mental health resilience in adolescents with a depressed parent

Background

One in ten young people in the UK have a current mental health disorder, and by age 18 up to a quarter are affected. Mental health problems affect children’s health, well-being, education and future life chances. Preventing such problems is important, especially in those at high risk.

Parental depression

In the UK at least 1 million children have a parent with serious depression. Parental depression increases risks of child mental health problems by over three times. Despite this, some children have unexpectedly good mental health outcomes - even when parental depression is severe or recurrent.

The study

Our study included over 300 adolescents with a parent suffering from recurrent depression. Three waves of assessment were undertaken with parents and young people. Mental health problems in young people were common – 39% had a mental health disorder, 70% had high levels of depression symptoms or behaviour problems, and over a quarter reported self harm or suicidal thoughts. One in five young people had sustained good mental health, experiencing none of these problems. We examined what family, social and child factors predicted sustained good mental health. We also tested whether protective factors predicted better than expected mood and behaviour at follow-up.

Key findings

Family, social and child factors together explained resilience in this high risk sample. Specific protective factors included depressed parents’ warmth, co-parent emotional support to young people, good quality social relationships and friendships, young people’s own confidence in their ability to deal with problems (‘self efficacy’), and regular physical exercise. Importantly, multiple protective factors were required for offspring to be free of mental health problems (0-1 protective factors: 4% resilient; 2 protective factors: 10%, 3 protective factors: 13%; 4 protective factors: 38%, 5 protective factors: 48%).

Implications for policy and practice

Not all parents with depression receive treatment, and treatment is not always successful. Identifying protective factors that are associated with resilience in adolescents with a family history of depression is therefore important. Preventive interventions typically focus on specific factors in isolation (e.g. psychological therapies or social interventions). Our study shows that multi-modal interventions are needed. Simple changes to existing interventions could have substantial benefits, e.g. promoting frequent physical exercise, involving both parents in family-based interventions, and engaging with schools to help build good social relationships.

For more information on these findings please contact Dr Stephan Collishaw at collishaws@cardiff.ac.uk