One way to help our loved ones with mental illness is to create a low-stress, healing environment. These ideas are based on “Helpful Family Attitudes and Skills” by Dr. Christopher Anderson and “Guidelines for Creating a Low-Stress Home Environment for a Mentally Ill Person” by Dr. Brian D. Eck.
Three Key Principles
Accept the person as ill. This is simple to say but difficult to do. The grief over a dramatic reduction in functioning is never totally resolved. Both the patient and the family cling to old images and false hopes of what the ill person could have been if he had not been afflicted with the illness. To be helpful, families should greet patients where they are, love them as they are, and promote growth that is in line with their current condition. Specifically:
- Mourn the loss, but not in the presence of your relative.
- Never discuss what he was or what he could have been in front of him.
- Avoid comparisons to peers.
Attribute symptoms to the illness. It’s an impossible task, but families must attempt to be objective and calm when the loved one’s brain is causing bad behavior. This includes times when the loved one is screaming that he hates you because you are poisoning him. Our culture is more likely to attribute behavior to an illness when the person has Alzheimer’s or brain cancer. Even when the behavior is completely unacceptable and must be restrained, such as violence, it is likely due to the illness.
Include the person in the family. Families often subtly exclude loved ones with mental illness from the family. Examples include:
- Not discussing the loved one with friends when they discuss their other children.
- Not inviting other people to their home when the loved one is present.
- Not altering family gatherings so the loved one may be included for at least part of the event.
- Not including the loved one in family portraits.
- Not asking the loved one to help you do things.
Creating a Healing Environment
Recognize that the illness is no one’s fault.
Understand the limits of the illness and the extent of the person’s control over his behavior.
Go slow! Recovery and growth take time. Rest is important.
Keep it simple and structured. People with mental illness do better with structure and predictable routines. Home life should have a consistent rhythm with change as seldom and gradual as possible.
Keep it calm. For the most part, try to keep the environment quiet with calm voices and limited stimulation.
Give people space. Private time and space are important for everyone.
Set limits. Have clear and appropriate expectations. Everyone needs to know what the rules are. A few good rules that are consistently enforced will help keep things calm.
Ignore what you cannot change. Let some things slide. Do not ignore violence.
Speak simply Say what you have to say clearly, calmly, and positively. When you address them, your loved ones will most likely respond only to the first couple sentences that you say to them at one time.
Offer praise and encouragement. Try to be sure that you have at least a ratio of four positive interactions to one negative or challenging interaction.
Follow doctor’s orders. Encourage your family members to take their medications as prescribed and only those that are prescribed. If you can, have them sign a release of information so that you and the doctor can discuss your family member’s treatment program.
Carry on your business as usual. Reestablish routines as quickly as possible when they are disrupted.
No street drugs or alcohol. Emphasize that illegal drugs and alcohol make symptoms worse.
Recognize early signs of relapse. Learn what changes you will see in your family member’s symptoms and behaviors, especially those which usually occur just before a relapse. Contact their care team when you see the changes.
Find a way for the person to learn life skills.
Solve problems step by step. Work on one thing at a time and be patient as they learn from the consequences of their behavior. Let them experience the non-dangerous consequences of their choices.
Offer opportunities to meet their needs Offer opportunities to have major personal, social, activity, and competence needs met.