Help Wanted

Needed immediately: a person to work 24 hours a day, 7 days a week, 365 days a year. Work gets tougher on holidays and trips. No salary.  No benefits. You may spend significant amounts of your own money out-of-pocket. No training. Learn by trial and error, although  what works one day might not work the next.  Be prepared for days that break your heart and times when you will be mistreated on the job.

If you are a caregiver for a person with mental illness, this is your job description. The shock and horror of getting this job has a seismic impact on the family.  Having a family member with any kind of serious illness is devastating.  Dealing with a mental illness … so often a brain-based physical illness … has extra components that make it even more grueling.

Factors Influencing the Family’s Response

A training put together by Michelle D. Sherman, Ph.D, for the Department of Veteran Affairs to help families impacted by post-traumatic stress disorder, clinical depression and other illnesses common to veterans noted that some families have an easier time responding to this situation than others.

The factors that impact the situation in any health crisis include:

• The family’s support system.
• Previous experience with or knowledge of the illness.
• The family’s coping pattern in times of great stress.
• Access to health care and the quality of that care.
• Financial status.
• Type of onset of the illness (sudden vs. gradual, public vs. private).
• Nature of the symptoms.
• Other demands on the family.
• The loved one’s compliance or refusal to participate in care.
• Prognosis of the illness.

Other factors are specific to mental illness:

• Reactions by others are unpredictable and even hurtful.
• Family members feel guilt that they somehow caused the illness, could have prevented the illness or did not detect it early enough. It’s typical to feel guilty about your reaction to previous behavior caused by the illness that you felt were intentional actions.
• The prognosis and course of treatment are less concrete than with other physical illnesses.
• The loved one can have embarrassing behaviors that could even result in arrest.
• The loved one (as well as some family members) can refuse to accept the diagnosis.  This can result in failure to comply with treatment, lying about that, anger toward the family and total lack of appreciation for the family’s efforts.

As a result, families feel isolated. When they turn to their social and religious support, some get no help. Many fear telling others about the illness and do not ask for help.  Tension within the family can get very tough, especially when one or more family members refuse to believe that the loved one has a mental illness.

Families do tend to go through stages as they deal with the situation.  Next time, we will look at the patterns involved in this.