The experience of mental illness in a family context When someone has a mental illness, the consequences for that person and for the family can be severe. Relationships can be thrown into turmoil. In the initial stages of the illness often no one understands what is happening. Behavior that is symptomatic of psychosis can be misunderstood and treated as bad behavior. Family members experience trauma, grief, confusion and fear.

Often it takes a long time for the realization to set in that a person is not just being problematic, but has an illness, and even when this is known, different family members have different levels of understanding and acceptance. The consequences for families can often be profound and family breakdown can occur. Often too, the person with the illness is fearful and confused. Irritability, confused thinking, delusional thinking and paranoia can all be symptoms of psychosis, and when this is not understood, frustration, aggression and confrontation can escalate the situation. In the longer term, people with a mental illness can suffer enormous social consequences as a result of their illness, including loss of friends, unemployment, loss of social status and social confidence. This increases stress levels and can exacerbate the illness. Predictably, the frustration caused by this is often played out in those closest to the person – families and especially the primary caregiver, most often the mother.

What can friends and family do? If someone in your family has a mental illness, there are things you can do that can help: • Learn as much about the illness as you can. Knowledge is power • Seek help and support whenever possible. Counselling can be helpful as can educational programs • Be as open as you can about it. Secrecy only increases the stigma that people with a mental illness already face • Develop effective strategies for dealing with symptoms of psychosis – eg never argue with delusions, because they are fixed and false beliefs • Separate the person and the illness. Always remember that this person’s behavior may be a symptom of mental illness and not just bad behavior • Be open to learning more effective communication skills • Never forget that mental illness is just that – an illness. It is a physical illness that effects the brain. No one is to blame • Consider developing your communication skills. These are an asset and can assist in deescalating crisis situations.

References

1. World Health Organization. Strengthening Mental Health Promotion. Geneva, World Health Organization (Fact sheet no. 220), 2001.
2. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
3. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627.
4. Murray CJL, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Geneva, Switzerland;World Health Organization, 1996.
5. Chapman DP, Perry GS, Strine TW.The vital link between chronic disease and depressive disorders. Prev Chronic Dis 2005;2(1):A14.
6. Ryff CD, Keyes CLM. The structure of psychological well–being revisited. J Pers Soc Psychol 1995;69:719–727.
7. Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well–being. J Pers Soc Psychol 1989;57:1069–1081.
8. Keyes CLM. Social well–being. Soc Psychol Quart 1998;61:121–140.