Kids have lots of questions when someone in their family is sick. When a parent or caregiver has psychosis, it often becomes a secret that nobody talks about. Children may turn to social media or peers and access information that could be incorrect or scary.   

This pamphlet prepares you to talk about psychosis with the child in your life. It lists common questions children have and suggestions for how you can answer them. 

Every family’s “beginning conversation” about psychosis will be different depending on the child’s age and ability to manage the information. You know your child best. 
  

What is psychosis? 

• Psychosis is a loss of contact with reality. People with psychosis have trouble telling the difference between what is real and what is not. This is called a “psychotic episode.” 
• Our bodies contain chemicals, hormones and other elements that need to be in balance to keep us healthy. When things get out of balance, people can develop illnesses such as diabetes. When chemicals in the brain are out of balance, it can affect how the brain works. 
    

How does psychosis feel? 

• A person with psychosis may have several symptoms, but everyone has a different combination of symptoms. 
  • The person will have difficulties with perception: . They may feel and look confused. They may hear voices or see things that aren’t really there, or that other people can’t hear or see. These are called “hallucinations.” 
  • They may not be able to hear what someone else is asking or telling them. 
• The person may have thoughts and beliefs that seem strange to others. These are called “delusions.” For example, they may believe that someone is following them. This is called a “paranoid delusion.” 
• The person may say things that are scary or make up an unbelievable story. They may also say things that don’t seem to make sense. 
• The person may have a hard time talking about or showing their feelings to their children (for example, giving hugs or saying “I love you”). They may even say mean things. This can be scary and painful for children. It is important to acknowledge the child’s feelings. 
    

What causes psychosis? 

• Some people get psychosis and others don’t, and it is unclear why. Scientists are doing research to try to understand more about psychosis. 
• There are many possible causes of psychosis. Some.times the causes are not known. The cause in one per.son can be different from the cause in someone else. 
• Psychosis can develop over time or all at once. 
• Psychotic symptoms may appear after a life crisis, stress or other illness. They can occur in illnesses such as schizophrenia, schizoaffective disorder, bipolar disorder, major depression and posttraumatic stress disorder. Psychotic symptoms can also be caused by another medical condition. 
• For some people, substance use causes psychotic symptoms. 
    

Can psychosis be fixed? 

• Yes, psychosis is treatable. 
• With treatment, the troubling thoughts, feelings and behaviours gradually go away. For some people this happens quickly, and for others it takes longer. 
• Sometimes psychotic symptoms remain or come back, and have to be treated again. 
• Some people have only one psychotic episode in their lifetime. Others have many episodes. It depends on the person and the type of illness. Some people have only a few symptoms and are still able to do everything they usually do. 
• Other people may need to have a period of rest where they focus on getting better. 
     

How can my parent or caregiver get better? 

• A person may have strong symptoms when they first experience psychosis. This can be very confusing and frightening for the person and their family. 
• Doctors, nurses and other health care workers provide treatment that has helped other people with psychosis. 
• Treatment often includes medicine and talk therapy. When explaining this to your child, focus on the treat.ments their parent or caregiver is getting:
  • Medication helps the chemicals in the brain get back into balance. Then, the person with psychosis will start to feel like themselves again.
  • Talk therapy focuses on the person’s feelings. A therapist helps them learn about their illness and find healthy ways to cope.
  • Therapy may also help the parent or caregiver live with psychosis so that they can still do the things that are important to them. 
      

Is there anything I can do to make my parent or caregiver better? 

• Remind the child:
  • Adults are the ones responsible for making the parent or caregiver feel better. 
  • Doctors and therapists treat the person to help them recover. Other adults like family members and friends can provide emotional support. 
  • The child can show they care in age-appropriate ways, such as a card or photo, or talking on the phone. 
• You can help the child come up with ideas or take them to speak with the care team. 
    

Will it happen to me? Will I get psychosis too? 

• Reassure the child:
  • Psychosis is a mental illness—it’s not something you can “catch” from someone else, like a cold.
  • Psychosis is rare, but no one can know for sure if they will experience it at some point in their life. 
  • It’s natural to worry about this. Psychosis is like other illnesses—if a family member has the illness, another family member may also get it. 
  • Even if a family member has had psychosis, there is a much bigger chance that the child won’t develop it. 

What if my parent or caregiver has to go to the hospital? 

• If the parent or caregiver needs to go to the hospital or the child is worried this may happen, explain that the hospital will make sure their parent or caregiver gets the help they need. They will also have a comfortable room where they can rest. 
• You can answer other questions about treatment. For example, the child may want to know if they can visit their parent or caregiver. If they cannot, help them find other ways to connect. 
• Tell the child that it is okay to have questions about what is happening. 
    

What if my parent or caregiver is too sick to look after me? 

• Develop a plan so the child knows what will happen if their parent or caregiver has to go to the hospital. Review it together and ask the child what they think. 
• Make arrangements with a “safe person.” This should be someone the child feels comfortable talking to and who can support them. 
• Explain what is happening and that sometimes people with psychosis need a period of time to focus on getting better. 
• Help the child stay in contact with their parent or caregiver in a way that is healthy for both of them (e.g., visits, letters, cards, phone calls). 
• Remind the child that their parent or caregiver is get.ting help. As that person begins to feel better, they will be able to spend time together again. This period of change can be very hard, and the child may miss and worry about their parent or caregiver. If the child has to leave home and stay with someone they don’t know, this may also feel scary. 
• Try to keep the child in their school and involved in activities they enjoy. If they seem ashamed or guilty about having fun while their parent or caregiver is in the hospital, invite them to talk about these feelings. 
    

What do I tell other kids? 

• You can practise conversations that the child can have with other kids at school. Try out stock phrases and explanations: . “My mom is sick and needs to be in the hospital so she can get better.” . “When my dad gets sick, it affects what he says and how he acts.” 
  • Let the child know that a lot of people find it hard to talk about psychosis, and that this may include their friends. As people learn more about mental illness, they begin to feel more comfortable discussing it. 
  • Acknowledge that not being able to talk about what they are going through with their parent or caregiver may make the child feel lonely and sad. 
• Tell the child that they can share with their close friends, but they may find it easier if an adult is there. 
• Suggest talking to an adult they trust like a family mem.ber, therapist, teacher or doctor if they are unable to talk to their friends. Depending on the child’s culture or com.munity, there may also be a religious leader or elder who can give support. 
• Remind the child that they do not have to share any details they do not want to. If they feel uncomfortable, they can stop a conversation. Suggest saying, “Thanks for asking, but I don’t want to talk about this anymore.” 
• Tell the child that since some people do not under.stand mental illness, they may make jokes or mean comments. If this happens, the child should leave these conversations and get a teacher or another trusted adult involved. Remind the child that they and their parent or caregiver deserve to be treated with respect. 
    

What can I do if I’m really worried about my parent or caregiver? 

• Offer to make an action plan with the child. This can help them feel better and help them decide what to do when they are scared. 
• Action plans can include:
  • the name and number of an adult they can call
  • phone numbers of their parent or caregiver’s doctor or an emergency line they can call if they are worried  about something medical
  • a safe place they can go or activity they can do
  • specific steps to take in an emergency. 
• Children need an adult they can talk to if their parent or caregiver isn’t available. This could be another family member, a teacher, a friend’s parent or the family doctor. 
• The parent or caregiver may have said or done things that upset the child. These things were related to the illness, not to anything the child did wrong. It can help for them to talk to someone about what this was like. 
• If the child is worried and has no one to talk to, they can call Kids Help Phone at 1 800 668-6868 for support. 
• In an emergency, the child can call 9-1-1. If they or their parent or caregiver are at risk of self-harm, they can call the 9-8-8 national suicide crisis helpline. 
  
  

Resources 

• Speak to your family doctor. 
• Call the Centre for Addiction and Mental Health at 416 535-8501 (select 2). 
• Visit the CAMH Family Resource Centre. 
• Connect with the RBC Patient and Family Learning Space.  
• Thriving Minds is a hub is for youth, parents, caregivers and health-care providers; powered by the CAMH SickKids and The Garry Hurvitz Centre for Community Mental Health (GH-CCMH) at SickKids.
• Schizophrenia Society of Canada - schizophrenia.ca
• Hope + Me (Mood Disorders Association of Ontario) 
  • Toll-free: 1 888 486-8236
  • Toronto: 416 486-8046 
  • info@hopeandme.ca
  • hopeandme.org 
• Institute for Advancements in Mental Health
  • (formerly Schizophrenia Society of Ontario) 
  • Toll-free: 1 800 449-6367
  • Toronto: 416 449-6830 
  • www.iamentalhealth.ca