In Germany, 1.5 to 2.75 million children live with addicted parents and 3.8 million live with parents with other mental illnesses. The social consequences for these children can be very far-reaching. For example, they lack emotional support from their parents. They often take on their tasks, especially if they have younger siblings.
They also find it more difficult to be successful at school and to integrate among their peers. They are particularly at risk of being neglected and physically and mentally abused. Compared to children of mentally healthy parents, their risk of developing a mental or addiction disorder themselves is increased. At the same time, feelings of guilt, social isolation and stigmatization of addiction and other mental illnesses prevent the affected parents from seeking help for the family.
Such underage children have so far (almost) not been taken into account in our clinical care system. The therapeutic offerings in psychiatric-psychosomatic and addiction medicine clinics in Germany focus (almost) exclusively on the treatment of sick mothers or fathers.
Family-centered treatment options are lacking
A multi-professional group of experts appointed by the Bundestag also criticized this in its final report (BAG KipE) presented in 2019 and called for a greater expansion of family-centered treatment offers in the psychiatric-psychotherapeutic, psychosomatic and addiction support system. She saw this as “the most efficient starting point at the places where parents are treated, especially in the clinics and their outpatient clinics”.
However, in standard care, no financial resources or staff positions have been earmarked for this – for example in social services or nursing services. Clinics that offer family-centered treatment can only do so because they receive financial support from foundations or private individuals.
Stable financing is urgently needed
An example of such a family-centered prevention approach in Baden-Württemberg is the project “Stark im Sturm – Help for children of parents with mental illnesses and addictions”. It is funded by a foundation and is practiced at five large psychiatric-psychosomatic and addiction medicine clinics.
However, such funding is often limited in time. If they disappear, the supply can no longer be maintained. The psychiatric-psychosomatic and addiction medicine clinics urgently need stable financing in the health system.
Anne Koopmann is a senior physician in psychiatry at the Central Institute for Mental Health (ZI) in Mannheim and an adjunct professor at the University of Heidelberg
Yvonne Grimmer is a specialist in child and adolescent psychiatry at the ZI and professor of social medicine and health promotion at Darmstadt University of Applied Sciences
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