Communication with children about parental bipolar disorder: a qualitative interview study.

Background: The impacts of parental bipolar disorder (BD) on families and children highlight the need to understand how best to talk to children about their parents' diagnosis, especially as their developmental capacity for understanding grows. This qualitative study aims to explore the strategies, challenges, and support needs of parents in relation to communicating with their children (5-12 years) about BD, in order to inform the development of further interventions and resources.

Methodology: Purposive and snowball sampling strategies were used to recruit parents with BD, their partners, and stakeholders who support parents with BD. Recruitment occurred via social media, emails, and community outreach between April 2022 and April 2023. Semi-structured interviews were conducted with 11 parents with BD or non-BD partners and 12 charity workers or mental health professionals. The interview guides explored participants' lived experiences and professional insights into communicating about parental BD with children. Data were analysed using reflexive, inductive, thematic analysis.

Result: Participants identified several benefits of sharing parental BD diagnoses with children, including fostering understanding, adaptation, compassion, and strengthening family relationships. However, they also noted challenges such as uncertainty, stigma, and potential distress for children. To make communication effective, participants emphasised the importance of age-appropriate dialogue, addressing children's concerns, providing reassurance, and preparing them for future episodes. They highlighted that transparent, interactive communication, thoughtful timing, and collaboration with family members and professionals are crucial for tailoring the process to each family's unique needs.

Conclusion: Our findings underscore the complexities of communicating a parental BD diagnosis to children, highlighting both the potential benefits and challenges. Participants emphasised the need for developing interventions and policies specifically tailored to address the particular communication needs of families impacted by BD.