Relationships and Family

Building relationships throughout life is not only fundamental to learning how to communicate and socially interact, but is also essential for fulfillment and happiness.

In today's society individuals often have to face a variety of personal and social problems which can mean that certain relationships are given a low priority. Though this often can't be helped it does mean that communication begins to break down and subsequently issues and conflicts may arise.

The breakdown of key relationships can have long lasting repercussions and negatives effects on both our physical and mental health, and this section of the site endeavours to bring together relevant information and statistics which we hope will further your understanding of how relationships can impact mental health.

Marriage

According to figures from the Office for National Statistics (2008) recent decades have seen a long term decline in the number of marriages, with the marriage rate (calculated as the number of marriages per head of the population) falling to its lowest since records began in 1862.

In 2008 a total of 232,990 couples were married, representing a drop of around 1 per cent in the 12 months since 2007¹. In addition to this, the same figures also show that men and women have been opting to marry slightly later in life. The past decade has seen the mean age at marriage increase by almost five and a half years for men and just over four and a half years for women. The fact that men and women are choosing to marry later, coupled with an increasing trend towards cohabitation may indicate that couples now prefer to be more financially stable before embarking on a married life together.

In terms of the effect of marriage on our health, research has consistently found that being married carries a significant health benefit and that the breakdown of a family structure can negatively impact both physical and mental health in adults and children².

The State of the Nation Report (2006) highlighted that on average, married individuals have better physical health and longevity than the never married. In addition, the mortality rate is significantly lower for those who are married, an effect which is noticeably more prevalent in men among whom the mortality rate is 250 per cent higher in unmarried men than in married men, compared to 50 per cent higher in unmarried women.

Further to this, the death rates from coronary heart disease, stroke, cancer, pneumonia and cirrhosis and higher among those who are divorced and widowed.

Divorce

The breakdown of a marriage will almost certainly be distressing and difficult for everyone involved, even if the separation is a mutual agreement³. On top of the often complicated legal process couples also have to contend with the personal and emotional aspects, both of which are huge upheavals. Often those separating will face losing touch with their children, moving home/area, financial difficulties and a drop in living standards. These factors are stressful in their own right, and when combined with the emotional aspects could trigger the onset of depression or another mental health condition.

In a study conducted by the Office for National Statistics it was found that individuals aged between 60 and 74 who were divorced and separated had the highest prevalence of mental disorders, which affected around 19 per cent of women and 17 per cent of men⁴. Being single was associated with a low prevalence in both sexes and being married was associated with a low prevalence in men (7 per cent) but a higher prevalence (12 per cent) among women. In addition to this, of all men, those who are divorced are the most likely to commit suicide⁵.

In terms of how family breakdown impacts children, it is generally negative. At the very least children will be anxious about their family relationships and the disruption to their own lives. Unfortunately, experiencing divorce as a child may also result in a reduced capability of maintaining relationships in the future.

2008 marked the fifth consecutive year that the number of divorces had fallen, decreasing by 5.1 per cent to 11.2 divorcing people per 1,000 married population, compared with 11.8 in 2007. The 2008 rate is the lowest since 1979 when there were also 11.2 divorces per 1,000 married people⁶.

In addition to this, 2008 also marked the forth consecutive year that divorce rates were highest among men and women in their late twenties. In this year, there were 22.8 divorces per 1,000 married men aged 25 to 29 and 26.0 divorces per 1,000 married women in the same age group. This compared to 16.5 divorces per 1,000 married men aged 45 to 49 and 14.5 divorces per 1,000 married women in the same age group.

Step-families

According to statistics, step-families are the fasting growing type of family in the UK, making up 10 per cent of all families with dependent children. In 2001 there were 631,000 step-families with dependent children in England and Wales, of which 346,000 were married and 285,000 were cohabiting².

It has been estimated that there are now more reconstructed families than nuclear families and men are becoming increasingly likely to be living with other men's children whilst their own grow up else where². Due to the fact that the majority of children stay with their mother following a divorce or separation, most stepfamilies have a stepfather as opposed to a stepmother.

Becoming part of a step family can prove difficult for everyone involved and it is not uncommon for step siblings to be jealous and competitive, or for step parents to have difficulty bonding with their new family or vice versa⁷. Some step-children may be deliberately hostile towards a step-parent as they may feel it is the only outlet for their feelings, and those who do not express their feelings openly may become withdrawn.

In a 2005 report, Parentline Plus revealed that there were high levels of depression and anxiety in the 14,500 calls that they received from step-families in that year². According to the report, role ambiguity and role strain are issues for many step parents who found that these aspects negatively influenced their marital relationships and caused feelings of stress and inadequacy.

Approximately 25 per cent of young people living in step-families run away before they reach the age of 16². A step-child's desire to distance themselves from their step-family is sadly quite common, and is confirmed by various figures which suggest that children living in stepfamilies are three times more likely to run away from home than children living with both their natural parents.

Single parent families

Various cultural shifts which have occurred during the past few decades now mean that single parent families are more common than they have been in the past. The proportion of lone parent households has increased from 7 per cent in 1971 to 10 per cent in 2001². It is thought that the actual rise is far more significant than the data suggests, as figures currently exclude those who form a new couple and those with children over the age of 16.

Further to this, research has found that an estimated 70 per cent of young offenders come from lone parent families and all levels of anti-social behaviour are higher in children separated from their families².

Adoption

In 2009 there were 4,655 children entered into the Adopted Children Register, a decrease of 5.7 per cent compared to 2008⁸. Around 60 per cent of the children adopted in 2009 were aged between one and four, compared with 39 per cent in 1999, a percentage which has been steadily increasing over the past decade. In contrast, the number of children adopted in 2009 who were aged under one was only 2 per cent, compared with 4 per cent in 1999. Less than a quarter (24 per cent) of children adopted in 2009 were aged between 5 and 9, representing a decrease of 10 percent since 1999 when children in this age band made up 34 per cent of the total number of adopted children. The proportion of children aged 10 and over being adopted also saw a decrease in 2009, dropping to 15 per cent from 17 per cent in 2008.

Adoptions were at their highest in 1968, during which they peaked at 25,000 before dramatically falling in the mid 1970s. Since then they have remained consistent at around 5 thousand per year.

December 2005 marked the full introduction of the Adoption and Children Act 2002, which replaced the Adoption Act 1976 and modernised the legal framework for adoption in England and Wales⁹. The new Act allows an adoption order to be made in favour of single people, married couples and for the first time civil partners, same-sex couples and unmarried couples.

Unresolved anxieties about identity may underlie mental health problems in some adopted children, especially if their adoptive parents are reluctant to talk about the situation. It is generally accepted that all adopted children should be told about their adoption as soon as they are able to understand. Many adopted people have a yearning to meet their birth parents and, since the Children's Act 1975, which gave them access to their original birth certificates, many have been able to do so.

Mental Health

Recent research has indicated that a family breakdown increases the risk of poor mental health². As discussed above, both divorce and separation are extremely stressful life events, the effects of which are distressing and long lasting and lead to an increased likelihood of poor mental health and suicide.

A key factor in divorce and separation is the feeling of grief for the loss of a partner, which could be a precursor to the development of mental health conditions². The past decade has seen huge rises in diagnosable mental disorders, with an estimated one in four adults being affected by at least one kind. Further to this, the number of anti-depressants being prescribed has increased by an enormous 700 per cent in the last ten years and it is thought that 33 per cent of visits to GP surgeries are to discuss symptoms of depression.

As the number of adults with mental health disorders continues to rise, so does the number of adults caring for dependent children. The Office for National Statistics report (2000) which put forward the one in four figure for the number of adults suffering from a diagnosable mental health condition broke that figure down further and found the following[10] :

• Postnatal depression affects 10 per cent of all new mothers.
• Phobias affect 1.9 per cent.
• Personality disorders affect 5 per cent.
• Bi-polar disorder affects 1 per cent.
• Obsessive compulsive disorder affects 3 per cent.
• Schizophrenia affects 1 per cent.
• Depression and mixed anxiety affect 9.2 per cent.

Often, parents who are faced with managing a mental illness and the demands of a family will struggle to stay in control². Poor mental health may mean they begin to interpret and experience life in a different way, and this in itself can lead to the disruption and breakdown of a family. Research and statistics show that children from family environments such as this are more likely to run away than those whose parents remain together. Each year around 100,000 children run away from home, of which 80% make reference to problems at home and 12% refer to a threat of emotional abuse and neglect, physical abuse, sexual abuse and domestic violence.

Mental Health in children

Unsurprisingly the emotional effects of separating and divorcing parents are far reaching and reverberating for children. When parents separate a child will experience huge life changes, from getting used to reduced contact with one parent right through to feelings of abandonment, anger and guilt.

Studies have found that children living with single parents face double the risk of developing a mental disorder than those who are living with married or cohabiting couples. In addition, children with step-parents fared better when there were no other step-children and children from two children households had lower rates of mental health problems than those in four or five children households².

Other factors which may result in relationship or family issues:

Post natal depression

Postnatal depression is a condition which usually see's a parent develop an indifference to their baby, often rendering them unable to care for their child.

As it stands the condition is far more prevalent among women than it is in men, with a number of studies indicating that between 10 and 15 per cent or one in seven to ten mothers will experience postnatal depression¹¹. Symptoms are similar to those of general depression and will usually involve the parent becoming emotionally withdrawn and overwhelmed with feelings of despair and guilt.

Post natal depression often has a knock on effect on family life, as other family members, especially the spouse, may find it difficult to fully understand their partners inability to bond and care for their child. In addition to this, even when post natal depression has been treated, sufferers often feel they have missed valuable bonding time with their baby and may feel that others see them as a bad parent.

Mid-life crisis

At some point after reaching the age of 50, some individuals may begin to experience a strong and complex set of emotions. Reaching the midway point in life can make individuals evaluate what they have and haven't done, often triggering dissatisfaction with what they have achieved¹². Common feelings among those who are experiencing a midlife crisis include unresolved difficulties from the past, dissatisfaction with the present, a fear of growing old and a lack of time to achieve their goals.

Sexual issues

Though sexual difficulties are often symptoms of more serious emotional issues, they can trigger problems in a relationship. A lack of sexual desire, difficulty getting an erection or erectile dysfunction can all result in a loss of 'intimacy' in a relationship which in turn could lead to further problems.

According to figures from the aptly named 40over40 website (an erectile dysfunction organisation), 40 per cent of men over 40 suffer from some degree of erectile dysfunction¹³. In addition to this, erection problems will affect approximately 40 per cent of men by the age of 40, and up to 70 per cent of men by the age 70¹⁴.

Sexual issues are also a factor for women, of whom 30-40 per cent claim low sexual desire at any one time. A lack of sexual desire can be triggered by many causes, from traumas early on in life, right through to a psychiatric illness or work stress¹⁵.

References

¹Office for National Statistics (2008) Marriages in England and Wales, Statistical Bulletin. Available: http://www.statistics.gov.uk/statbase/Product.asp?vlnk=14275

²Grant, H. (2006) The State of the Nation Report – fractured families. Available:http://www.scie-socialcareonline.org.uk/profile.asp?guid=6ECB23F0-7606-4987-A689-DCA762995094

³Anon (n.d)Taking stock – what to expect. Available: http://www.divorce.co.uk/Splittingup/tabid/56/Default.aspx

⁴Evans, O., Prince, M., Singleton, N., Stewart, R. and Meltzer, H (2003) The Mental Health of Older People, The Office for National Statistics. Available: www.statistics.gov.uk/downloads/theme_health/PMA-MentalOlder.pdf

⁵Royal College of Psychiatrists (2006) Men and Depression. Available: www.rcpsych.ac.uk/pdf/Men%20%20Depression%20lft.pdf

⁶Office for National Statistics (2008) Divorces in England and Wales Statistical Bulletin (updated 2010). Available: http://www.statistics.gov.uk/statbase/Product.asp?vlnk=14124

⁷Boursac, A. (1995) How to cope with relationship problems, revised edition, Mind. Available: http://www.mind.org.uk/help/diagnoses_and_conditions/relationship_problems

⁸Office for National Statistics (2010) Adoptions in England and Wales – Statistical Bulletin. Available: http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=15049&Pos=4&ColRank=2&Rank=144

⁹Office for National Statistics (2010) Adoptions. Available: http://www.statistics.gov.uk/CCI/nugget.asp?ID=592

¹⁰Office for National Statistics (2000), Psychiatric morbidity among adults living in private households in Great Britain. Available: http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=9324&Pos=3&ColRank=1&Rank=272

¹¹Chung, T., Lee, D., Leung, T., and Yip, A. (2004) Ethnoepidemiology of postnatal depression, The British Journal of Psychiatry.

¹²Gorman, J. (1996) How to survive a midlife crisis, revised edition, Mind. Available:http://www.mind.org.uk/help/medical_and_alternative_care/how_to_survive_mid-life_crisis

¹³Anon (n.d.) Erectile Dysfunction. Available: http://www.40over40.com/

¹⁴Anon (n.d.) I have problems getting an erection. Available: http://www.relate.org.uk/sex-therapy-service-common-problems/233/index.html

¹⁵Jenkins, R. (2005) World Health Organisation, Introduction to sexual disorders (female). Available: http://www.library.nhs.uk//mentalHealth/ViewResource.aspx?resID=79413