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The prevalence of mental health problems in children has continued to increase over the past 30 years (Coughlin & Sethares, 2017). It is estimated that approximately 13.6% of children and adolescents experience a diagnosable mental illness in a 12-month period (Lawrence et al., 2015). Studies have shown higher prevalence rates of mental illness in children and adolescents who live in developing countries compared to their peers from developed countries (Kieling et al., 2011). China is the most populous developing country, with 197 million schoolchildren (ages 6 to 18 years) as of 2011 (Xiaoli et al., 2014). In China, approximately 30 million children and adolescents age <17 years, most of whom are a family's only child, are troubled with various emotional or behavioral problems (Falbo & Hooper, 2015).

Frequent hospital stays and episodes of mental illness are traumatic events not only for children but also their parents (Crowe et al., 2011). Parents may feel distressed, helpless, and anxious as the primary caregivers (Brown, 2018; Clarke & Winsor, 2010; Crouch et al., 2019). Compared to children with physical disabilities, the severity of behavior problems exhibited by children with mental illness is worse, resulting in more challenges for parents and all aspects of family life (Johansson et al., 2019). For example, one study reported that children with behavioral problems require constant surveillance, control, and exertion from caregivers (Oruche et al., 2012). In addition, caregivers need to provide effective support to ensure that their children receive better treatment and care, while trying to maintain a harmonious family relationship (Ferrey et al., 2016; Oruche et al., 2012).

Apart from coping with the physical and emotional challenges of providing care, parents may experience support difficulties, including unmet service needs (Dellve et al., 2006; Taylor & Seltzer, 2011) and low levels of perceived family and social support (Pelentsov et al., 2015). Stigma and stereotypes of mental illness are obstacles for caregivers in gaining broad support (Kaushik et al., 2016). In addition, parents feel guilty and blame themselves for their child's illness, thinking it is a sign of poor parenting or genetic weakness when realizing the damage of illness to their loved one (Crowe et al., 2011; Ward &...

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