When Parents Clash on Mental Health Decisions

Parenting involves a lot of sensitive and emotional issues, particularly if it concerns their mental health. For most parents, the acceptance that a child needs help whether counseling, therapy, or medicines is already difficult and at times painful. But when parents are not on the same page, it is more stressful, pitting children in the middle and making parents guilty, frustrated, and terrified. Conflict between parents is normal and does not necessarily mean that one or both parents are failing. Rather, disagreements are usually a sign of the deep love and concern each parent feels, as well as various beliefs, experiences, and comfort levels about confronting mental health issues.

Mental health is important because it affects a child's life today and in the future. Some parents think that seeking help from a therapist, counselor, or psychiatrist is in the right direction to help their child recover. Other parents may be scared, unsure, or resistant to the idea. One parent may be afraid of stigma, side effects of medicine, or labeling a child too early in life, while another parent may be afraid of problems that may ensue if they do not take action at once. These differences may be due to cultural origins, past therapy experiences, religious beliefs, or even mental health beliefs that differ per generation. When beliefs clash, arguments may turn into fights, and both parents may end up disregarded and defensive.

It is helpful to realize that both parents typically have the same goal: for their child to succeed. What they cannot agree on is how to make that happen. Recognizing this common goal can be helpful when there is conflict. Rather than viewing it as one right and one wrong parent, it can be more helpful to view it as a collaboration to discover the best way to support the child. This shift in mindset does not eliminate conflict, but it makes communication and talking easier.

At other times, conflicts remain because people know or believe differently. One parent may have done a tremendous amount of research into available treatments, and the other parent has not. The more research-driven parent may feel frustrated or impatient, while the other parent feels pressured or overwhelmed. Both parents must be able to give their opinions freely. Sometimes, just hearing—really hearing—without interrupting or judging can reduce defensiveness and allow compromise. Asking questions like, Can you tell me more about your concerns? or what do you need to feel comfortable with this decision? Shows that you want to understand rather than convince.

It is also a good idea to have reliable experts involved in the conversation. A consultation with a pediatrician, school counselor, or mental health practitioner can provide parents with reliable information and clear up misunderstandings. An expert can provide information about treatment options, discuss advantages and disadvantages, and provide answers in an objective, fact-based manner. This converts the conversation into a knowledge-based cooperative process. When parents are exposed to the same information simultaneously, it reduces the likelihood of miscommunication and provides a more solid foundation for decision-making.

Other times, regardless of how hard we work, it feels like we can't come to an agreement. One parent may firmly feel that therapy is the answer, and another parent may feel strongly otherwise. In those situations, moving slowly and incrementally can be beneficial. For example, if one parent will not attend therapy, perhaps the family can start with a single session to discuss things through rather than committing to regular sessions. Or if medication is the issue, beginning with therapy alone may feel less intimidating. Moving slowly can help build trust and make both parents feel more comfortable in the long run.

In attempting to come to a compromise, you must hear what the child is thinking and feeling. Children are very sensitive and can sense tension between the parents even if they are not cognizant of the disagreement. This makes them feel anxious, guilty, or confused if they believe they are the source of the issue. You must reassure them that they are not to blame and that the two parents love them. Depending on their level of maturity and age, it may be appropriate to involve them in discussions regarding the care of them. Providing them with some level of input in the process can empower them and reduce the sense that decisions are being made without their involvement.

Parents who are facing such challenges also need time to think about their own feelings. Mental health care conflicts can trigger strong feelings, most often based on their own experiences. A parent who has fought depression or anxiety will want desperately to treat their child, while another parent who had a negative experience with mental health within their family may feel fear or shame. Parents are able to differentiate their own past from the current situation by acknowledging these personal feelings. Parental individual counseling at times can give them more clarity and authority over their own feelings so that they can address the issue better.

A second level of complexity arises when parents are divorced or separated. Conflicts regarding mental health treatment become more divisive in such cases, particularly if legal custody agreements are in place. Treatment decisions in such situations may require both parents' agreement, and persistent conflicts result in delay. Mediation, family therapy, or obtaining an independent third party may at times enable moving the discussion forward. Although such cases are certainly challenging, the overall principle is no different: the child's welfare over personal interests. Lastly, parents should be kind to themselves during this process. Not seeing eye-to-eye on mental health treatment is not an indication that the family is dysfunctional or that parents have failed. It is an indication that they care a great deal and are struggling with hard decisions that do not always have simple solutions. It can be the struggle to find the path to consensus, and frustration and confusion can occur. But with each step toward understanding and communication and collaboration, the child is assisted in significant ways. No parent has all the answers, and no approach is perfect. The most essential is the desire to be there, to continue listening, and to place the child first in every decision. Mental illness is not an issue that is solved once but something we must continue to remember for a lifetime, and discussing these issues with compassion and patience helps children learn to listen and be resilient and compassionate in a manner they will carry with them for many years.