A Study of The Management of Mental Illnesses in a Family

According to the American Psychiatric Foundation (2018): “Mental illnesses are health conditions involving changes in thinking, emotion or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities” (American Psychiatric Foundation, p. 1, 2018). There are several different types of mental disorders that can strike individuals during any stage of life. Some of these include: Autism, Schizophrenia, bipolar disorder, and Borderline Personality disorder. Although, these are only a few of the many types of mental disorders that exist.

The number one mental illness faced within the United States would be anxiety related disorders (American Psychiatric Foundation, p. 1, 2018). In the text, Miller-Day claims that nearly 57 million adults are currently dealing with at least one mental illness within the United States. However, researchers have admitted that this figure is somewhat unknown due to the great amount of stigma associated with such illnesses (Miller-Day, 2011). Stigma plays a leading role, in these sometimes-invisible disorders. Treatment and Management can become very difficult for families living with mental disorders, primarily, because most are lifelong and untreatable.

When families are dealing with a loved one diagnosed with a mental disorder, there are generally three treatment plans offered to them. These include: hospitalization, medication, And psychotherapy. Although, most often these disorders are never completely rid from individuals, these treatments have been the most significant in alleviating symptoms. Many mental disorders are also fatal, such as depression. Many lives are claimed by suicide, which leaves families devastated. Not to mention, that these cases are occurring more than ever. Whitaker claims that since the introduction of Prozac in the year 1987, about 400 a people a day are being diagnosed with mental illness (Whitaker,2005). Whether people are seriously suffering more, or desire to obtain medication is still unknown. Nonetheless, this huge epidemic should not be taken lightly, and interventions and treatment plans much be considered with a high degree of concern.

Family communication and behavior play leading roles in the outcomes of such individuals. Families that play an active role in the lives of their loved ones tend to have more favorable results in such cases. Barrowclough, et. al. studied such ideas in comorbid Schizophrenia patients, with emphasis on family interventions role in the treatment of dual disorders. The two examined were substance abuse, as well as Schizophrenia. Intensive treatment programs were utilized that placed emphasis on concepts of consistent care with motivational interviewing, cognitive behavior therapy and family interventions. Thirty-six participants were studied in this experiment, 18 received the treatments above, while 18 received routine care alone. Those in the first group, who were part of family based interventions had significant improvements in general functioning opposed to those who had routine care. In this 12-month study, nearly 94% of the 18 whom received family intervention as part of treatment had both symptom improvements of Schizophrenia, and abstinence of drug and alcohol consumption entirely (Barrowclough, et. al., 2001).

Pitschel-Walz, et. al. also studied Schizophrenic drug addicted individuals as well. Family based interventions vs. patient interventions proved to successfully decrease substance abuse. Relapse in these individuals is generally at 60%, however, with family involvement in intervention, it reduced to 40% (Pitschel-Walz, et. al.,2001). As we can conclude, family interventions in dealing with Schizophrenia and drug addiction can yield significant results. Families can communicate nonverbally, such as in these examples, and be directly improving the situations of their loved ones facing mental illness and addiction. These behaviors indicate support throughout the life-long struggle of mental disorders.

Pitschel-Walz, et. al., studied family involved treatment vs. individual based treatment, as did Rea, et. al. in an experiment on Bipolar disorder. Bipolar is a mental disorder that causes sudden and aggressive mood changes in individuals. These range from manic highs to depressive lows. This experiment focuses on psychosocial treatments as an appendage to pharmacological preservation. According to Rea, et. al. (2003): “The findings indicate that an outpatient family-based treatment can lead to a reduced risk of relapse and rehospitalization, as compared with a comparably paced individual therapy program. Group differences were particularly apparent in the year following participation in the treatment program when 28% of those who had received family-based intervention relapsed, as opposed to 60% of those in individually based treatment. Results for rehospitalization during the posttreatment follow-up period were even more striking: Twelve percent of patients in family-based treatment were rehospitalized, compared with 60% in individually based treatment” (Rea et. al., p. 489, 2003). As we can see, in this example, just as the other reviewed, family involvement is crucial to the outcomes of mental health patients.

Autism is another mental disorder affecting communication and learning for many Americans. Family-centered approaches also yield improvements in realms of social communication, emotional regulation, and transactional support in autism sufferers. Such approaches are dependent on not only educating autistic individuals, however, education of their parents as well. When both the autistic individual and their corresponding family member work towards achieving these goals, more effort is put forth by the autistic individual (Prizant, et. al. ,2003). Utilization of family members in rehabilitation and care of mental illness patients has a direct link to beneficial health outcomes (Saunders,2003). However, involvement can be less than easy as showcased in Saunders study. As the author suggests, families are constantly adjusting and adapting to mental illness. Most mental illnesses, affect all aspects of family functioning, family relationships, and increases in emotional and physical illness within the family as well. Such changes can also wear down finances, marital relationships, and daily household activities as Saunders suggests.

Communication efforts about such issues can strain all members of the family. As stress increases, harmful words are projected accidently in many cases. Mental illness can be one of the hardest chronic health issues facing individuals and families alike. However, with encouraging input of each family member on such issues, better outcomes are possible in these difficult circumstances (Saunders,2003). As we have viewed, thus far, family involvement in treatment has been significant to outcomes of these individuals. But what happens, when family is on the other side of a plastic screen? Due to violence and addiction, many facing mental disorders are imprisoned for various reasons. Despite these facts, family involvement can still be performed through the walls of the prison. Lamb, et. al. claims that family communication in these instances also yield less psychotic episodes and feelings of depression (Lamb, et. al.,1988).

Often times, with mental disorders, families either take on the roles of caregivers or outsource these needs to local hospitals. Taking on the role of a caregiver to a family member with chronic mental health can be extremely difficult as discussed briefly above. However, as Veltman, et. al. proclaims, there are several rewarding benefits of doing so as well. Having such a personal relationship with relatives facing mental illness not only benefits the affected but also the caregiver. Having a positive attitude while taking care of the individual yields proactive outlooks for those affected. This relies on the fact that the individual with chronic mental illness can pick up on these vibes. All to often, caregivers claim they are burdened significantly by having to stop their lives to take on these roles, very few respond positively to these changes. Although, mental illness affects emotions and thinking capacities, individuals can tell when their caretakers are sincere or burdened. This discourages those affected, and inevitably makes them feel as if they are a burden. Positivity and involvement of these family members lives communicates to them the idea that they are not a burden, and they are loved and supported, even when the going gets tough (Veltman et. al. ,2002).

Just as positivity can communicate love and support when dealing with family members dealing with chronic mental disorders, negativity can communicate the opposite. All to often, family caregivers report their jobs as being a huge burden on their lives. They take no pride or satisfaction when dealing with their loved ones. Burdens come in many forms, whether it be financially related, task related, or the demand for constant monitoring of these individuals (Ohaeri ,2003). Nonetheless, those who claim these individuals to be a burden, are basically communicating the idea that they are stressed and unsympathetic. As Miller-Day suggests, stigma comes in three forms of mental illnesses. These include self, structural, and public (Miller-Day,2011).

Stigma, also makes family disclosure hindered as well. Both characteristics of mental illness, and social characteristics of the family were proven to be directly related to the amount of family stigma received. According to Phelan, et. al. (1998): “Family members were more likely to conceal the mental illness if they did not live with their ill relative, if the relative was female, and if the relative had less severe positive symptoms. Family members with more education and whose relative had experienced an episode of illness within the past 6 months reported greater avoidance by others” (Phelan, et. al., p. 115, 1998). Disclosure is a significant aspect of family communication in mental illness, and by avoiding this talk, the family cannot move forward.

Although, family involvement is significant in mental disorder outcomes, some situations make it very difficult to do so. Mental illness is generally a chronic disorder, and time does not stop in the midst of it. Many family members face the issue of aging, which leaves them incapable of being a caregiver. This often leads to hospitalization of the mentally ill individually. Although, this is certainly difficult to communicate, the mentally ill deserve to know that these instances are of no fault of their own. When communicating about such issues, it should first be addressed that the parents do love and care about the mentally ill. And if conditions could be different, they would avoid this consequence. These issues area becoming a huge social concern, and burdens become more when a family member is getting to the age of not being able to caregiver any longer (Lefley, 1987).

There is much advice I would offer to a family managing mental illness. I would begin this conversation with explaining the severity of this chronic illness. Family involvement at all ends has proven to be significicant to positive outcomes. What I mean by this, is that family members should be present for diagnosis, and the entire journey through. Negative outcomes are associated with individual based interventions, whereas positive outcomes reside in family based interventions. In such cases, where family either showed behavior (caregiving and active participation in treatment) or communication (vocalization and encouraging words), the affected felt less depressed and had fewer psychotic episodes in numerous cases.

Families must understand that when a member is diagnosed with a mental disorder, all parties are affected in one way or the other. Often times, it deals with daily tasks, finances, or relationships. Nonetheless, families should take each day one at a time. I would encourage these families to be open and honest with their member facing the mental disorder. Part of this means having full-disclosure with all relatives and friends. Hiding a mental illness reveals that there is something wrong with having it. This sort of stigma only communicates embarrassment, and no party should feel this way. I would also inform the family that they are not alone, and that nearly 57 million adults in the United States face mental illness as well. Although, many people hide such cases due to associated stigma, it is very normal to have one.

Adjusting to these conditions will not be easy, nor will it be favorable. Some cases reveal that mental illness is somewhat of an invisible disease, however, to the one suffering it is very visible. Families must be patient, understanding, and loving when dealing with an individual with a mental disorder. Unlike most physical disorders, mental ones can’t always be fixed, have the pain pinpointed, or even be rational in some cases. Therefore, families should treat these cases the same as physical based issues. Family involvement, and open-communication are dire in this journey of mental illness.