cartoon of person with upset brain relating to a caregiver

Helping Them Cope

Note: This post is adapted from information I learned in the NAMI Family-to-Family program. We highly recommend attending this program to learn more about mental illness.

Having a mental illness and dealing with the world takes enormous courage and determination. As we have previously written, many people develop defensive coping strategies.

These negative behaviors are actually typical for any person with a life-changing or life-threatening illness. (They include irritability, denial, abusive language and resistance to treatment.) For people with mental illnesses, the behaviors are even more counter-productive. This can be very upsetting to you.

So what’s the best way to react? Here are some suggestions from NAMI:

  • Respect and protect your loved one’s devastated self-esteem. Don’t criticize them. Keep nagging and negative remarks to a minimum.
  • Punishment, argument and pressure make things worse.
  • Ignore as much negative behavior as you can. Praise positive behavior as much as you can. People with mental illness are more likely to improve when they can see behaviors earn them approval and recognition.
  • Accept the symptoms of the illness. You don’t punish a child with a stomach virus for vomiting. Know what the symptoms of the illness are, and try to separate that from the person’s behavior. You cannot argue someone out of a depression or delusions.
  • Accept that your loved one may not be able to fulfill a normal role in the family. Reduce your demand for emotional support and “carrying your weight.”
  • Make these allowances, yet treat the person as a regular member of the family.
  • Encourage independent behavior. Allow them to do what they can, which can vary from time to time. But, again, don’t push.
  • Live in the present. You have a right to grieve, and you may need professional help to do so. But don’t live in the past or focus on “what could have been.” One of the best things you can do for your loved one is to accept that they have an illness that makes life harder, but not impossible. This is how it is.
  • Be patient. When our loved ones take steps toward more independence, it’s very scary for them.
  • Be kind to yourself and the rest of the family. This is hard. Don’t criticize yourself or others when you make a mistake. Give everyone in the family some grace.

how the mentally ill cope

What It’s Like to Have a Mental Illness

Note: Information in the following article came from namigc.org)

It’s difficult to understand what someone with a mental illness experiences, but you can get a better idea by trying this empathy exercise.

Have you ever:

  • Gone for 24 hours without sleep? 48 hours?  Longer?  How did you feel about being awake this long?  How did you look?
  • Dozed off for a second, awakened with a start and didn’t know where you were?  How did you feel? What would it be like to feel that way for a day, a week, several weeks?
  • Lost your sunglasses or car keys and no matter what you did, you couldn’t find them?   Did you feel like screaming?
  • Been driving down the road when suddenly your directions got mixed up?  Say, you confused or reversed north and south. How did you feel?
  • Had a funny little tune going through your mind for a couple of hours or a whole day and, no matter what you did, you couldn’t get rid of it.  How would you feel if that same tune went through your mind for three days, a week or a month?

Now let’s put three or more of these items together.  Say you’d hadn’t slept for three days, you heard the same music going on and on in your head, and you couldn‘t find your keys.  How would you feel?  How would you look?

All these things are experiences from the inner world of people struggling with serious brain disorders.  By thinking deeply about these symptoms, we can feel more empathy and understanding toward those who experience them.

The fact is, even in remission and even when properly medicated, chronic mental illness leaves its sufferers in a devastating limbo.  Many people with mental illness are effectively cut off from the predictable, rewarding, self-fulfilling live involvements that make existence meaningful.  They suffer deeply from their inability to be competent and successful in their daily lives.

This life-constriction threatens our loved ones’ psychological integrity.  It sets up a process where the people with mental illnesses feel they must protect their “core self” at all cost.

Many behaviors that result – refusing medication, rejecting family support and community programs, and disrupting family life, for example – don’t make sense to us. These behaviors are directly related to their struggle to maintain some dignity and self-respect in the face of stigma, failure and shame. It would be kind of us to appreciate that many of our relatives’ behaviors are driven by the need to protect their own fragile senses of self-esteem. 

Psychological Traumas Associated with Any Serious Chronic Illness

Whenever a person has a serious chronic illness …. COPD, emphysema, chronic heart disease, or a mental illness … two things happen to their sense of self.

First, they lose their protective belief that they are exempt from harm. Much of our sense of safety and our willingness to take risks in life rests on a belief that serious harm or real trouble will never happen to us. This has been called “evolutionary delusion” because it’s responsible for a large chunk of human progress. Young people especially have this sense.

Second, they lose their sense of a predictable, dependable future. This results in the use of defensive coping strategies.  These are self-management techniques that are basically maladaptive.  They don’t help people get what they really want, but they do provide temporary psychological refuge when confidence and self-image are taking a nose-dive. Let’s look at some defensive coping strategies.

Defensive Coping Strategies

  • Self-absorption
  • Irritability
  • Haughtiness
  • Controlling behavior /Manipulation
  • Anger
  • Rejections of friends and family
  • Blaming others
  • Defensiveness
  • Drug and alcohol abuse
  • Doing nothing
  • Resisting change
  • Refusing help
  • Denial
  • Apathy
  • Bargaining
  • Withdrawal
  • Suspicion
  • Dependency
  • Envy
  • Running away
  • Refusing medication
  • Quitting a job
  • Abusive criticism of others
  • Sleeping excessively

From time to time in daily life, all of us will use one or more of these behaviors.  If we are criticized at work … snubbed by someone we thought was a friend … having a fight at home … we may use one of these behaviors if we feel momentarily crushed.  We complain or attack.  We “need a drink.” We get fed up and call in sick.

For us, these are temporary responses when we feel temporarily defeated.  We normally pull out of them quickly.  We turn to our social and personal life structure, finding comfort and reassurance.

Defensive Coping Strategies in Mental Illness

The situation for people with serious mental illness is drastically different.  Their social and personal life structure is vastly diminished. They are facing poverty, stigma, disability, joblessness, and social rejection. They are trapped on a runaway train going the wrong way.

The negative coping strategies become a familiar and reliable way to protect themselves from becoming even more diminished.

It’s impossible to conceive what mental illness is really like without recognizing the fundamental problem of psychological demoralization.

It takes enormous courage and determination to pull up out of these defensive postures of reacting to mental illness.  But it can happen.  Next time we’ll talk about how we can help.

Christmas tree and lights

The Mental Illness Holiday Survival Guide

The holidays can be some of the worst days of the year when your family is dealing with mental illness.  Not only is it TOO DARN DARK AND COLD, but it’s also a time when expectations of being Merry and Bright can seem especially hard for your family.

Why the holidays can be hard

Having a mental illness makes you extra vulnerable to the demands, pressures and expectations of the holidays. We deal with:

  • The demands of the culture, like parties, shopping, baking, cleaning and entertaining.
  • The changes of schedule, which can be really challenging for a person who has a mental illness.  Getting out of normal routine can lead to forgetting meds and getting self-care out of balance.
  • Family functions and crowds that trigger anxiety.
  • Financial stresses because your loved one is not being able to participate.
  • A pronounced sense of the passing of time. Gathering with cousins, friends and family reminds your loved one of all the “normal” parts of life that seem out of reach to him.
  • The noise, which can make the noise in their heads worse.

The stress can make your loved one have more symptoms. In fact, a NAMI study found that 64% of people with mental illness report that their symptoms are worse during the holidays. And that can make you even more anxious.

Make your loved one a priority in planning

Yes, you can make the holidays a little less stressful for your loved one with mental illness. Their health comes first. And you may be surprised to see that this helps your mental health as well.

Any family member who is inconsiderate or otherwise difficult to your loved one should be kept away. I banned a brother-in-law for horrible comments during a holiday dinner. We didn’t make a big deal of it; we just never invited him again. He’s now dead, and I’m still glad I did it.

Set expectations

Let your loved on know the plans ahead of time. Make the holiday as consistent as you can.

For you, accept that your holidays are different now.  If you can get rid of your unrealistic expectations and be honest with your loved one and all the other family members, it will go better. Just remember: You can’t force anyone to be happy.

Know your loved one’s limits … and your own

Is being around family a trigger? Are crowds? You need to be aware of this.

Acknowledge your feelings.  If someone close to you is suffering from a mental illness, it’s normal to feel sadness and grief. If it’s a child, a sibling or a parent, Christmas can hold a lot of memories.

Avoid feeling guilty.  Around the holidays, many people want to be many things to loved ones. We don’t want to hurt anyone’s feelings. So we put pressure on ourselves.  Pleasing everyone is unrealistic. 

At the same time, let participation be your loved one’s decision.

Keep your routine

Try as much as possible to maintain routines like:

  • Sleeping
  • Regular meals and good nutrition
  • Exercising
  • Taking medication
  • Keeping appointments with mental health professionals
  • Attending support groups

Think about the warning signs of relapse.  If you start to see them, encourage them to retreat to a normal routine.

Provide dignity

Help your loved one to keep her dignity. Provide a gift fund or another way to allow her to give gifts, so she won’t feel left out if she has no money.

If crowds or frenzy are a problem, encourage them to shop online. Or offer to help pick up the things they need.

Consider volunteering. The satisfaction of giving to others can help you put your own problems in perspective.

Scan every situation that’s coming up to make sure that your loved one won’t get unwelcomed attention.

Keep the celebration small and safe

Hey, it’s a good excuse to keep the unofficially crazy family members away.  You want a small gathering of your own family.  Period. Otherwise it’s too stressful for your loved one.

Identify what they really want to do.

Don’t overschedule. Pick and choose.  If your loved one will be uncomfortable in a situation, it’s ok not to go.

Encourage your loved one to keep connected and not be isolated.  Spending time with a friend or family member … even just one … can help.

Keep it short. Keep it informal.

If you have to do the Big Family Thing, let your loved one stay home. Big groups can be too much for your loved one, especially when you have to Put On a Happy Face. If you have a large family and lots of traditions, you can encourage your loved one to pick her favorites and let go of the rest.

Setting specific times for family traditions, like baking special food, decorating the house, wrapping gifts or attending community celebrations, gives the person something to look forward to.

If any of your extended family members really want to see your loved one, they know your phone number and where you live. Something private is better.  And try not to be bitter if no one asks. (There’s a reason God chose you to be this person’s lifeline. Not everyone can deal with this.)

When people ask

The best answer I’ve found to the question … How is he? … is “About the same.” That’s tough enough for you to answer.  So please don’t put your loved one in a situation where he or she has to answer the question.

During this time, we may find ourselves at extended family gatherings or at parties with people who do not understand the illness. Some people may be uncomfortable and not know what to say to you. Others may say hurtful things or offer cliché advice out of ignorance. It is helpful to prepare by knowing who may be at a gathering.

When the event is at your house

If you are having an event at your house, discuss it in advance with your loved one so he or she knows what to expect. Accept his limits.  Accept her choices. Acknowledge his feelings. 

If the person wants to be more visible during the holiday, brainstorm some things in advance.  What will he say when asked how he is? What will she do during the gathering? Is there a quiet place to retreat if needed?

Work out a plan. The loved one can walk a dog, or go outside.

If someone offers to help you with any holiday preparation, ACCEPT. 

Finally, don’t drink alcohol, especially if you are around family.

When you go to other people’s houses

Don’t overschedule.  Ensure that the person will be able to do their regular nightly routine.

Tell the person whose home you are visiting what you may need in advance. 

Go in multiple vehicles or take other modes of transportation so you can leave when you need to go.

Please don’t put yourself in a position … helping cook at someone else’s home, for example … where you can’t leave with little notice. If you are stuck, have someone … a sibling or spouse … available to get the person home if needed. 

All your great preparation may result in your loved one refusing to participate at the last minute. And that’s OK. 

Have yourself a merry little Christmas

When you make out your own Christmas wish list, ask for things that will reduce stress, whether it’s a massage, a day trip, a cleaning service or a gym membership. 

Eat right. Avoid the alcohol. Sleep. And write out a list of things that you are grateful for this year.

Live in the now.

I also create my own holiday rituals that are 100% under my control. I celebrate Advent, with a creche, a reading plan and activities that mean a lot for me.

Advent is a time of waiting. We are all waiting for the days when our loved ones will be well, whether here on Earth or in Heaven. You can lift this thought up as you celebrate.

ipad with medical record

Keep Your Own Record

Even today, it’s hard for medical institutions and doctors to piece together a medical record. So it can be helpful to create your own medical treatment record for your loved one with mental illness. That way you have something ready when you need to provide information.

The excellent book “When Someone You Love Has a Mental Illness” by Rebecca Woolis suggests that your record contain information about:

  • Your loved one’s level of functioning before becoming ill.
    • Highest level of school attained
    • Work history
    • Level of basic life skills (cooking, cleaning, money management, experience with independent living)
    • Social skills and relationships with peers
    • Significant achievements
  • Their symptoms.
    • What they are
    • When they began
    • Worst episodes with dates
    • Most effective treatment so far
  • Treatment history.
    • Dates of psychiatric hospitalizations
    • Diagnosis
    • Types of medication used and their effectiveness (with dates if possible)
    • Types of therapy used and their effectiveness (with dates if possible)
  • Your loved one’s level of functioning between hospitalizations and treatments.
  • The names, addresses, phone numbers and emails of all members of the treatment team (psychiatrist, therapist, social worker or case manager).
  • Medical insurance information.

When you are dealing with mental health professionals, you want to appear credible. You make the best impression when you are courteous and respectful of their time. Try to understand that these professionals are under constraints such as:

  • Not being able to be effective with those who refuse treatment.
  • A heavy caseload.
  • Lack of adequate funding.
  • HIPPA and other confidentiality regulations.

Even if the illness is decades long, try to go back through your documentation to create a medical record. It will probably be more helpful than the record that the treatment team has.

parents and child at therapist

How to Check on a Child’s Mental Health

An urgent public health crisis. Yes, we’ve had quite a few of those lately. But that is exactly what the U.S. Surgeon General’s office called the state of children’s mental health, starting in 2021.

It’s easy to understand why. The national statistics about mental health in children were getting worse before the pandemic. The Center for Disease Control and Prevention announced this year that more than one-third (37%) of high school students reported poor mental health in the pandemic and 44% reported that they felt persistently sad or hopeless during 2021.

And it’s not just the teenagers. ADHD, anxiety, behavioral issues and depression are the most commonly diagnosed mental disorders in children.

1 in 6 children aged 2-8 years has a mental, behavioral, or developmental disorder

Bar Chart: Mental disorders by age in years - Depression: 3-5 years: 0.1%26#37;, 6-11 years: 1.7%26#37;, 12-17 years: 6.1%26#37; Anxiety: 3-5 years: 1.3%26#37;, 6-11 years: 6.6%26#37;, 12-17 years: 10.5%26#37; Depression: 3-5 years: 3.4%26#37;, 6-11 years: 9.1%26#37;, 12-17 years: 7.5%26#37;

Nationwide Children’s Hospital in Columbus started the On Our Sleeves campaign to encourage families to talk with children about mental health issues. One aspect of this campaign is Operation: Conversation, an excellent way to start the school year.

Asking the right questions

By asking important questions and listening carefully, parents, grandparents and others can detect the signs of positive mental health as early signs of emotional problems. Some of the conversation starters include:

  • Did you talk to anyone new today?
  • Did anything happen at school today that you weren’t expecting?
  • What’s your favorite song right now. How does it make you feel?
  • What animal do you think is most like you?
  • What made you proud today?
  • How did you cope with hard emotions today?
  • What is a problem you solved today? How did you do it?
  • What do you do when you want to cheer up?
  • When you feel worried, sad or any, what is going through your mind.

The free, expert-developed resources for starting these conversations, talking with kids about mental health and giving advice are found here.

Although the number of problems are going up, most parents do find indicators of positive mental health, such as:

  • Affection
  • Resilience
  • Positivity
  • Curiosity
  • Persistence
  • Self-control

If you hear something that worries you, you are not alone. (Information about early signs of mental illness in children is found here.) Don’t ignore it. Seek help. If you work with reputable people, you can help your child learn techniques for dealing with difficult thoughts. You also may find a brain chemistry issue so early that it can be treated, allowing your child to experience a happier life.

Columbus-Area Respite for Caregivers

Columbus-area caregivers now have a free program that helps both the caregiver and a loved one with mental illness. ADAMH, Concord Counseling Services and NAMI have teamed to provide this respite program for caregivers to all Franklin County, Ohio, residents.

Please Google “mental health respite programs” to find similar programs in your area.

A respite program allows a trained professional to spend time with your loved one so you can do other things. You’ll get a three-hour block per week to yourself so you can enjoy self-care and tend to other responsibilities. Even better your loved ones with mental illness get to enjoy activities they pick and interact with other people safely, with a trained mental health professional nearby.

This video explains the Concord respite program that’s free to all residents of Franklin County, Ohio.

The mental health specialist spends up to three hours a week or 12 hours per month between 7 a.m. and 9 p.m. with your loved one. They can do activities at home or out in the community. Flex funds are available to help pay for the activities. There’s no waiting list at this time.

For more information about the Concord respite program, call 614-501-6264 or click here.

Take Action Today

Today is Mental Health Action Day, and we’ve had a bad couple of years.

If you are worried about anyone, getting answers to these questions may show the person needs some extra support:

  • Have things that used to feel easy started feeling difficult?
  • Does the idea of doing daily tasks like making your bed now feel really, really hard?
  • Have you lost interest in activities and hobbies you used to enjoy?
  • Do you feel irritated, possibly to the point of lashing out at people you care about?

If the answers are yes, visiting a counselor for an assessment is needed.

Life doesn’t have to be so hard. You can find more answers in this blog.

sad caregiver at Christmas

Holiday Tips When Someone You Love Has a Mental Illness

The holidays can be some of the worst days of the year when your family is dealing with mental illness.  Not only is it TOO DARN DARK AND COLD, but it’s also a time when expectations of being Merry and Bright can seem especially hard for your family. The stress can make your loved one have more symptoms, and that can make you even more anxious.

Here are 14 tips to handling the holidays. Some ideas were suggested by an excellent book:  “When Someone You Love Has a Mental Illness: A Handbook for Family, Friends, and Caregivers” by Rebecca Woolis.  Others are things I’ve learned, often the hard way, over time.

  1. Accept this ain’t gonna be pretty.  If you can get rid of your unrealistic expectations and be honest with your loved one and all the other family members, it will go better.
  2. Help your loved one to keep her dignity. Provide a gift fund or another way to allow her to give gifts, so she won’t feel left out if she has no money. Scan every situation that’s coming up to make sure that your loved one won’t get unwelcomed attention.
  3. Hey, it’s a good excuse to keep the unofficially crazy family members away.  You want a small gathering of your own family. Period. Otherwise it’s too stressful for your loved one.
  4. Keep it short. Keep it informal.  If you have to do the Big Family Thing, let your loved one stay home. Big groups are too much for your loved one, especially when you have to Put On a Happy Face. And do your own celebration. 
  5. If any extended family members really want to see your loved one, they know your phone number and where you live. Something private is better.  And try not to be bitter if no one asks. (There’s a reason God chose you to be this person’s lifeline. Not everyone can deal with this.)
  6. The best answer I’ve found to the question … How is he? … is “About the same.” That’s tough enough for you to answer.  So please don’t put your loved one in a situation where he or she has to answer the question.
  7. If you are having an event at your house, discuss it in advance with your loved one so he or she knows what to expect. Accept his limits.  Accept her choices. Acknowledge his feelings. 
  8. If the person wants to be more visible during the holiday, brainstorm some things in advance.  What will he say when asked how he is? What will she do during the gathering? Is there a quiet place to retreat if needed?
  9. Tell the person whose home you are visiting what you may need in advance.  Please don’t put yourself in a position … helping cook at someone else’s home, for example … where you can’t leave with little notice. If you are stuck, have someone … a sibling or spouse … available to get the person home if needed. 
  10. All your great preparation may result in your loved one refusing to participate at the last minute. And that’s OK. 
  11. If someone offers to help you with any holiday preparation, ACCEPT. 
  12. When you make out your own Christmas wish list, see if you can ask for things that will reduce stress, whether it’s a massage, a day trip, a cleaning service or a gym membership. 
  13. Eat right. Avoid the alcohol. Sleep. And write out a list of things that you are grateful for this year.
  14. A nice thank you card to people who have been helpful to your loved one personally or professionally is always good.
job interview sticky note

Jobs for People With Mental Illness

Note: The sources for this post are NAMI.org, southeast.org, ood.ohio.gov, “When Someone You Love Has a Mental Illness” by Rebecca Woolis and my own experience working for a program that linked jobs to people with mental illness.

Families of people with mental illness frequently pin much hope on their loved ones getting jobs. It can even become almost a fixation. “If he would just get a job …” There’s often hope that a job will lead to more stability, but it usually has to be the other way.

Unfortunately, many people with mental illness are too ill to function in the workplace. They lose job after job, not because they are difficult, but because they are too ill.

However, once a person is on a treatment plan, symptoms can reduce. Increased stability makes it more possible for the person to have a positive work experience. Others can never deal with the stress of a full-time job, which can make symptoms worse. But they may be able to work part-time or on a volunteer basis, instead.

What the Law Says

As we said previously, the lack of sufficient funding for people with mental illness has a big impact on their families. There’s not enough money to hire enough case managers, social workers and vocational counselors. So families often have to get involved to ensure the system works for their loved one.

The first step to getting involved is understanding what the Americans with Disabilities Act (ADA) says. And what it does not say.

Most government regulations define an individual with a disability as a person who has a physical or mental impairment that substantially limits one or more life activities: walking, talking, hearing, seeing, learning, performing manual tasks, caring for oneself, thinking, concentrating and interacting with others. This applies to most people with severe and persistent mental illness.

Title 1 of the ADA covers private employers with 15+ employees, state and local governments, services funded by the government, labor unions and employment agencies. It prohibits them from discriminating against qualified individuals who have disabilities in hiring, firing, advancement, etc. The law does not cover employers with less than 15 employees.

The law says employers may not ask prospective employees about the existence, nature or severity of a disability. What they can do is ask about the prospective employee’s abilities to do the job. (Remember: The law protects qualified people with disabilities.) And none of this applies if the person has an active substance abuse problem.

The ADA requires that employers provide reasonable accommodation to the known mental limitations of an individual with a mental disability unless it would impose an undue hardship on the employer’s business. Undue hardships are due to significant difficulty or expense to the employer based on size, financial resources, etc. 

Reasonable accommodations include job restructuring, part time or modified work schedules, reassignment to a vacant job position, and modification of training materials.

The ADA also impacts colleges and universities. It can require them to restructure exams and materials. Many universities and colleges have offices for disabled students that help them get reasonable accommodations.

Returning to Work Gradually

One pathway to returning to working is to move through a system that gradually requires more responsibility and work skills. This can mean starting as a volunteer in an organization with tasks and required hours.

Then, if this works, vocational rehabilitation counselors can help the person find supportive employment, maybe even part-time. In supportive employment, the employer knows that the worker has a mental illness under treatment. This helps the employer to understand if problems arise and to contact the vocational counselor.

Finally, once a person has the workplace skills and dependability needed, they can get a job.

Getting a Job in Ohio

Since I have lived and worked in Ohio, it is the system I know. Other states’ systems may vary.

The Ohio Bureau of Vocational Rehabilitation provides people with disabilities the services and support to get and keep jobs. The bureau’s staff does these things:

  • Evaluation and treatment of an individual’s disability
  • Information and referral services
  • Vocational counseling and training
  • Job search and job placement assistance
  • Educational guidance (tuition resources and other support)
  • Transportation services
  • Occupational tools and equipment
  • Personal attendant services (reader, interpreter, etc.).

The bureau customizes its services for each person using assessments and one-on-one meetings with professional vocational rehabilitation counselors.

After an application is completed and submitted, an interview is scheduled between your loved one and a counselor. You or another friend or family member may accompany your loved one to the interview. A counselor will talk about career goals, work history, educational background, disability and the services necessary to reach an employment goal.

Eligibility for vocational rehabilitation services is based on four factors:

  • The individual has a physical, cognitive, or mental impairment documented by the appropriate qualified professional (doctor, psychologist or other).
  • The documented impairment causes a substantial impediment (barrier) to employment.
  • The person can benefit from vocational rehabilitation services that lead to an employment outcome.
  • The person requires vocational rehabilitation to prepare for, secure, retain or regain employment

The vocational counselor will be honest if they feel that your loved one is not ready for employment. How much you have to help your loved one with the meeting is a part of that, whether it is said or not. If your loved one can’t get up to go to the meeting or can’t answer the questions without your help, he or she is probably not yet ready for a job.

When your loved one is determined eligible for services, an Individualized Plan for Employment (IPE) is created with the counselor. The IPE is an agreement between your loved one and OOD describing services that will be provided according to your loved one’s choices. Your loved one may be responsible for some costs of the vocational rehabilitation plan, especially college tuition.

When your loved one is ready for employment, the counselor and other OOD staff will help them prepare for the job search. The counselor can offer information on accessing public transportation (if available in the community) or arranging for private transportation. The counselor also can help your loved one with job site modifications for accessibility and efficiency.

They also may be able to set up supportive employment, which can transition to a regular job where people are not told about the illness.

OOD also can help your loved one keep the job if they are having trouble working because of their disability. The counselor can work with your loved one and their employer to determine the services necessary.

In Columbus, Southeast Vocational Services, formerly COVA, is another vocational services program.  I served on the board of this organization, which works with everyone from people with PhDs to those with entry level skills.

Its Transitional Employment program or “Project Work” provides temporary employment to people with a history of severe and persistent mental illness and substance abuse disorders. People get up to 1,000 hours of paid employment services within a 12-month period with the goal of moving from transitional employment to permanent employment full or part-time.

Southeast also offers benefits counseling and re-entry support for people leaving prison. Call Southeast at (614) 294-7117 to ask about it.

Filling out applications

It’s best to work with a vocational counselor, social worker or case manager to fill out applications for jobs. Legally, your loved one only needs to elaborate on the diagnosis if it impacts the ability to do the job. Otherwise, they should not volunteer information about their medical history.

They should tell the truth about their employment history. (Again, this is where recent volunteer jobs can come in handy.) The counselor can help with good answers to explain the gaps in the history.

You can practice with your loved one as a coach for the interviews. They may be anxious and fearful, so a practice … even a dress rehearsal … helps. Help your loved one with the appropriate dress. You can fill out the applications together and make copies in case they get lost or damaged. You also can use relatives who have knowledge of the loved one’s level of responsibility for references. If your loved one has had volunteer experience, those individuals also may make great references.

Getting back into the work world can be a great challenge. If benefits are involved, be sure to learn what the impact will be. May God bless you and your loved one in this effort.

the road to recovery

Recovery: How Do We Get There?

Note: This information comes from my own lived experience, notes from various seminars I’ve attended and “Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness” by Matthew A. Stanford.

No matter how difficult the circumstances are, people who have mental illness may recover. In fact, between 60 percent and 80 percent of people with mental illness who get and stay in treatment show recovery.

Mental illness is a chronic condition, meaning we can manage symptoms but not cure the disease. So what does “recovery” mean?

The Substance Abuse and Mental Health Services Administration defines recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential.

What does recovery look like?

For people with mental illness, it means going from Distress to Stability to Function to Purpose. For you, it means moving from Caregiver to Manager to Partner to Family.

The process is hardest on Americans because of our culture

Mainstream American culture values individuality and independence more than any other culture. This can cause U.S. caretakers to think caring for an adult is unusual, while it’s accepted as part of life in other cultures.

Recovery requires a holistic recovery effort that takes months or years, not days or weeks. Here are some of the issues that need to be addressed:

Physical needs

Sleeping well: Up to 80 percent of people with mental illness have chronic sleep problems as opposed to 10 to 18 percent of people without. The most common issues are insomnia and late insomnia. This is important because sleep deprivation can result in suicidal ideation, paranoia and agitation. To sleep well, encourage your loved one to try these tips:

  • Have the same bedtime with same routine every night.
  • Reduce caffeine.
  • Talk to their doctor.
  • Take effective medication.
  • Learn relaxation techniques.

Eating healthier

Doing exercise such as walking or gardening

Emotional and mental needs

Developing healthy thinking patterns: Your loved one’s therapist can work with them until they maintain healthy thinking patterns. Some things they need to learn are:

  • How to suppress negative thinking
  • How to accept a negative situation
  • How to recognize cycles and triggers
  • How to take a preventative approach when a relapse seems likely

Doing activities that heal the brain: Research suggests that active mental activities have a healing effect on the brain. Watching TV or movies are passive activities, which do not help. Active mental activities include:

  • Painting and drawing
  • Reading
  • Photography
  • Music
  • Gardening
  • Word games or puzzles

Living a structured life: Daily and weekly routines also reduce stress and bring a sense of safety.

Spiritual needs

Discovering hope in Jesus: We can help our loved ones understand what they mean to God. People with mental illness often feel that God doesn’t love them or that their faith isn’t strong enough. You may be able to help them to understand their identity in Christ. Even heroes of faith like David (Psalm 13), Job (Job 3), and Jeremiah (Lamentations 3) struggled with times of intense hopelessness. Encourage your loved one to share their feelings, requests and gratitude for what is good in prayer.

Finding purpose: Your loved one has a purpose in God’s plan that is just as important to God as everyone else’s. In fact, their heaviest cross … a mental health situation … can be an opportunity for God to manifest in their lives.

Growing spiritually: Focus on God’s love and your loved one’s identity in Christ rather than working on scriptures that focus on sin. Brief daily encouragements from the Bible are better than in-depth Bible study. Encourage them to check with you or others when they think they are hearing directions from God’s voice. Worship is good, but it should not be too stimulating or overwhelming.

Living in community: My church, Vineyard Columbus, has a One-Minded in Christ support group for people with mental health diagnoses. Check to see if you can find something like this in your community.

Relational needs

Stay connected to a few trusted and supportive people: Supportive friends and family are essential to recovery, but the friends and family also need the support of others. Some of the best ways you can help are:

  • Learn to resolve conflict, to defuse your own tension.
  • Learn to validate emotions.
  • Learn to affirm their faith in Christ.
  • Help them find opportunities to serve.

Recovery is possible. As we hope and pray, let’s take these steps to help our loved ones.