Family Perspective
It is estimated that between one-third and one-quarter of adults with serious mental illnesses reside with their family, most often a parent. These parents, many of whom are elderly, financially strained, and female, comprise one of the largest caregiving groups in the nation. Families often perform a host of critical roles in support of their relatives and have less time to spend on themselves.
Evidence suggests that family interventions prevent relapse, reduce costs, and improve family outcomes so families are extremely supportive of efforts to expand family education and supports. For a variety of reasons, most families do not currently receive these interventions. In a recent study of family caregivers conducted at the Nathan Kline Institute, it was found that even amongst members of National Alliance for the Mentally Ill (NAMI) groups, families often lack the most basic information about diagnosis, treatments, mental health resources, and care management strategies.
NAMI of New York State provides support to families and friends of individuals diagnosed with mental illness through more than 50 affiliates. They educate the public about mental illness through literature, speaking engagements, videos, workshops and conferences. In addition, through ongoing communication with mental health professionals and public officials, they seek to improve and expand mental health services.
Recipient Perspective
It is important to educate families and persons diagnosed with a mental illness about the nature and course of psychiatric diagnosis and to help them understand that people can and do recover from a mental illness. Family education programs should present a well-rounded and balanced curriculum on the nature of mental illness – all of its possible causes – including abuse and trauma, and all of the possible courses of action to work toward recovery. A family education program should not solely focus on a medical model, rather it should focus on providing families with all the information they need for themselves to better support their loved ones.
Cultural Perspective
Utilizing the family as a resource requires recognition of the roles and expectations of family members and those in the support network. The cultural context in which the relationships are developed is a determining factor for family and support network involvement in treatment and recovery.
An expanded definition of “family” is helpful to understand recipient’s family context, community norms and relationships. In many communities family membership is fluid, expanding and changing over time and needs to be defined by the individuals receiving the services. An openness to natural networks and acknowledgement of the cultural considerations provide effective tools for outreach and engagement.
Family work needs to include a deep appreciation and understanding of the family’s views about health, illness, wellness, privacy and help seeking. The values around these issues have a strong cultural base. Some cultures and communities have a heightened sense of stigma and focused education and support may be required. Strategies for effective service delivery will vary culture-to-culture and family-to-family. Use of formal and informal community leaders to broker service access and support families within their networks will strengthen the recovery efforts.
