What is the first step we must take in order to fully understand the impact of parental mental ill health on children, and to consider the potential consequences for children who, by choice or election (see Aldridge and Becker, 1993a), undertake caring responsibilities for their parents? The first step must be to contextualise adult mental ill health. In this chapter, we do this by reviewing some of the early medical investigations that have helped shape current understanding about symptomatic behaviours and outcomes. At the same time, it is also important to look more broadly at what social research tells us about the impacts of mental ill health on children. The first part of this chapter reviews this medical and social research. The second part reviews data on the incidence of young caring, and in particular on the prevalence of children caring for parents with mental illness.

Representations of mental illness

Medical research to date has contributed to our current understanding about mental ill health and its impacts on individuals and the family. It has also, to some extent, informed the political and public perception of mental illness both in an institutional and community setting. Furthermore, it has helped inform the social and political framework that has shaped the lives of people living with mental health problems.

The body of medical research and its subsequent literature is useful in a number of ways: in clinical and pharmacological settings; in terms of improving our understanding about diagnostic methods, the nature of particular illnesses and prognoses; generating clinical evidence that may lead to new and effective treatments. However, the usefulness of this body of research in informing us about outcomes for individuals and families that are not exclusively clinical but, rather, are psychological, psychosocial and even political is more problematic. And yet, this medical work has undoubtedly been both expositional and influential in all of these areas.

In addition to this medical evidence, we must also recognise the influence of the media in shaping public perception of people with mental health problems living in communities today. Certainly some print and broadcast media have tended to link adult mental illness, particularly those with psychotic illnesses, with danger to the public (see Philo and Secker, 1999; Murray, 2000).