How Families Can Help in Self-Management of a Mental Disorder

Nicole Chovil, PhD

Reprinted from "Self-Management" issue of Visions Journal, 2003, 1 (18), pp. 7-8

Families of people with serious mental disorders can be an invaluable source of support in management of mental disorders. Many people with serious mental illness either live with their families (including parents, spouses, siblings and children) or have regular ongoing contact with their family.1,2

Family members are often the first to recognize behavioural changes that accompany a mental disorder and can aid a person in getting connected with mental health services. Families of individuals diagnosed with a mental illness also often serve as informal case managers, providing and coordinating care for their relatives. Family members often see the signs of relapse and can encourage their relative to seek help early.

In order to effectively self-manage a mental disorder, consumers may need training in skills to deal with their illness, including taking medications as prescribed, dealing with community and hospital services, learning new ways to cope with symptoms such as auditory hallucinations, anxiety, etc. Skill learning may also be needed in relation to maintaining a healthy lifestyle, including good eating habits, exercise, maintaining an apartment, work, and social life. Other skills that may need to be developed include the ability to deal with emotions and the impact of the illness on their lives. Families can assist by learning what is involved in self-management as well as by learning what they can do to help the person.

The following areas have been identified as ways in which families can assist in management of mental disorders:

1. Learning about mental illness and services available. Families and their ill relative can benefit from education that helps them to understand the often-confusing nature of mental illness. Education should include learning about:

  • behaviours/symptoms that create problems for the individual (and which may be frightening and bizarre to other family members)

  • why a person may not see that there is anything wrong with them

  • why the person may refuse to seek help (e.g., go to a doctor or mental health centre)

  • self-management skills that a person can use to manage their illness

  • why certain medications are used and their side-effects

  • an understanding of the reasons and implications of not taking medications as prescribed or following through with recommended treatment

  • how to determine what services are needed by their relative, what is available in their community, and how they can assist their relative in accessing these services

2. Engaging person in a treatment plan

  • learning how to communicate with a person in ways that will encourage them to seek help

  • alternative steps families can take (legal procedures under the BC Mental Health Act) when a person does not agree to seek help

3. Identifying warning signs or symptoms of relapse

  • learning how to give feedback to their relative about symptoms/signs that indicate a possible relapse

  • identifying and minimizing situations that may place too much stress on the person and increase chances of relapse

4. Managing medication

  • helping their relative to develop a medication routine

  • information on ways to facilitate taking of medication on a regular basis

  • learning about ways to deal with side-effects

  • assisting the person in working with their doctor around side-effects

5. Working with their relative to develop a crisis plan for relapse

  • it is recommended that this emergency plan — also known as advance directives or Ulysses Agreements — include steps to follow when the person feels the onset of illness or episode: these might include increase in medication, contacting the family doctor (or psychiatrist) or taking time off work. The emphasis should be on developing an action plan that enables the situation to be handled as safely as possible

  • the plan should also include information about current treatment, the names and contact details of health professionals and the local psychiatric facility, and a series of steps to follow. It should also note the individuals who comprise the person’s support network and the role that each should play in the event of a crisis

  • the plan should also identify who will take care of financial and other aspects of the person’s life should they need to be hospitalized or be unable to care for themselves

6.Helping to foster a lifestyle conducive to recovery and maintenance of good mental health

  • providing social support to relative

  • encouraging independence

  • encouraging engagement in exercise, social activities, work, school, etc.

Mental illness is much like many other illnesses: with proper medical care, management and strong support, people can recover. Families can play a valuable role in supporting persons with mental illness.

 
About the author

Nicole is Director of Programs and Support Services for the British Columbia Schizophrenia Society. She is also Project Manager for the Canadian Family Education Program, a new education program being developed by the Schizophrenia Society ofCanada. Nicole is happy to report that her brother, Ian, is successfully managing his schizophrenia

Footnotes:
  1. Clark, R.E. (1996). “Family support for persons with dual disorders.” In R.E. Drake & K.T. Mueser (Eds.), Dual diagnosis of major mental illness and substance abuse: Volume 2 – Recent research and clinical implications. (pp. 65-78). San Francisco: Jossey-Bass.
  2. Goldman, H.H. (1984). “The chronically mentally ill: Who are they? Where are they?” In M. Mirabi (Ed.), The chronically mentally ill: Research and services. (pp. 33-44). Spectrum Publications.
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