The well-being of children at familial risk of severe mental illness: an overlooked yet crucial prevention and early intervention opportunity

Children of people with severe mental illness are a largely neglected, yet identifiable, population at biopsychosocial risk for reduced well-being and poor mental health. Outside of safety concerns, the well-being needs of these high-risk children are not proactively considered, nor are care pathways organized to systematically address early intervention needs. Mental health policy and treatment guidelines should address the critical interplay between parental severe mental illness and child development and prioritize the development of a coordinated, evidence-based approach to prevention. This Perspective provides a brief overview of what is known about psychopathological antecedents and modifiable risk factors, as well as highlighting developmentally informed prevention targets and potential barriers such as stigma. This integrated evidence could guide the way forward for policy development and prevention with the shared objective of supporting the well-being of children at familial risk, and could highlight research priorities that aim to stop the inter-generational transmission of severe mental illness. This Perspective presents the heightened risk of psychopathology and negative outcomes among the offspring of people with severe mental illness and calls for proactive support.