Supporting Family & Friends

Family and friends need information and help, too.

Jump to a topic:

Managing a Crisis
What to Expect
Caring for the Caregiver
Know Your Rights
More Information for Family & Friends

Managing a Crisis

FAMILY GUIDELINES

1. GO SLOW. Recovery takes time. Rest is important. Things will get better in their own time.

2. KEEP IT COOL. Enthusiasm is normal, but keep it toned down. Disagreements are normal, but keep these toned down, too.

3. KEEP IT WARM. Family bonds are meaningful and important. Stay connected. Use kind words; nurturing, respectful, supportive and loving but not detached.

4. GIVE EACH OTHER SPACE. Time out is important for everyone. It’s okay to reach out. It’s okay to say “no.” Allow your relative to withdraw when they need to, and learn to recognize the behaviors that signal this need.

5. SET LIMITS. Everyone needs to know what the rules are. A few good rules keep things clear.

6. IGNORE WHAT YOU CAN’T CHANGE. Let some things slide but don’t ignore violence.

7. KEEP IT SIMPLE. Say what you have to say clearly, calmly, and positively.

8. FOLLOW THE TREATMENT PLAN. This is an action plan for treating the illness. If medication, family psychoeducation and/or other interventions are part of the treatment plan, then follow this plan to aid recovery.

9. CARRY ON BUSINESS AS USUAL. Re-establish family routines as quickly as possible. Stay in touch with family and friends.

10. TAKE CARE OF YOURSELF. Families need to take care of themselves, too. It’s difficult to care for someone else if you are not taking good care of yourself. It is important to ‘recharge’ one’s own battery.

11. AVOID STREET DRUGS AND ALCOHOL. They make symptoms worse, can cause relapse, and prevent recovery.

12. PICK UP ON EARLY WARNING SIGNS. Note changes. Develop a list of early warning signs that may indicate your relative is relapsing. Discuss with your family member and their provider in order to head off a relapse.

13. SOLVE PROBLEMS STEP-BY-STEP. Follow a sequential process to resolving concerns.

14. LOWER EXPECTATIONS, TEMPORARILY. Use a personal yardstick to compare this month to last month instead of last year or next year.

Source: Family Institute for Education, Practice & Research. (2010). Family Guidelines.

What to Expect

Families affected by mental illness commonly experience an array of emotions, setbacks, and milestones. Family and friends may compare their feelings to some, if not all, of the stages of mourning (denial, anger, bargaining, depression, and acceptance). Since most mental illnesses are chronic in nature, you will need to develop your own set of coping skills. These skills will help you navigate through some very tumultuous periods. However, just when it seems things may never improve, resiliency of family allows us to see the light at the end of the tunnel.

Soon after disease onset, family and friends may feel as though the rug has been pulled out from beneath them. At times, the expectations we may have for a loved one may need reevaluating in order to deal with the reality of what lies ahead. Since there are various types and severities of mental illness, no two families are affected in the same way. Many seek solace in support groups, such as NAMI, or the support of close friends and extended family. Due to the potential for stigma, family may recoil and keep their experience to themselves. This defense mechanism allows us to protect our loved one’s privacy and dignity. Stigma may even be felt within a family, making it hard to agree on treatment and plans for the future. Since relapse and recovery can be cyclical in nature, many family members will settle into the role of caregiver. Family will also learn that, due to mental health laws and insurance limitations, they may have problems getting medical help for their loved one. The early years can be very taxing on a family. Over time, most families learn to recognize and understand symptoms, helping their loved one develop coping skills. The important thing to remember is that without family, individuals with mental illness may never reach their full potential. When those with severe mental illness do not receive necessary support from family and friends, they may find themselves homeless, in jail, or a threat to themselves or others.

As a friend, you may find it difficult to see your friend deal with the various symptoms of a mental illness. In more severe cases, you may find that until your friend recovers or stabilizes, he or she will not be able to focus on the friendship you once shared. Additionally, that friendship may change due to the ongoing nature of many mental illnesses. You must not give up! Like family, friendship can improve recovery and mood considerably. As with any other illness, we must stick by our friends in order to give them hope and inspiration. They may need you now more than ever. After all, that’s what friends are for.

Your experience with the mental illness of family or friend can seem emotionally draining at times. Your adjustment period will vary but, in time, you will experience moments of joy and peace. After seeing what it takes to recover from a mental illness, you will understand the true meaning of bravery and courage. Any stereotypes or myths you may have believed will change. You will be become a much more empathetic, patient person who does not take much for granted. Above all things, it is very important that you do not give up on your loved one…for you play a huge role in his or her recovery.

Caring for the Caregiver

Caregiver Stress Test

The following test can be used as a guide to help you identify and/or measure feelings, pressures, and stress as you fulfill your caregiver responsibilities. If your response to one or more of these statements is “usually” or “often”, it may be a signal to begin looking for help so you can take better care of yourself.

Seldom-Sometimes-Often-Usually-Always

I feel tired and I don’t get enough rest.

I wish I had more time for myself.

I feel like I’m neglecting other members of the family.

I feel guilty because I can never do as much as I think I need to do.

I don’t go out anymore.

I argue or disagree with the person I’m caring for.

I argue or disagree with other family members.

I cry.

I worry about money.

I am concerned that I don’t have the knowledge and skills to give quality care.

I don’t feel well.

Adapted from Caregiver Stress Test at www.acsu.buffalo.edu/~drstall/hndbk3.html

Know Your Rights

It is important for both the person with mental illness and the supporters of that person to know and understand legal and ethical rights and responsibilities of the person with mental illness, as well as the family and caregivers of the person with mental illness. All residents of New York State including those diagnosed with mental illness are entitled to humane and quality treatment. Additionally, mental health professionals must respect the privacy of individuals under treatment, keeping confidential all information as long as the information is deemed non-threatening to the client or others.

Rights are different, depending on the age of the person with mental illness, intensity and duration of symptoms including potential for harm to self or others. Also, rights vary depending on legal documents in effect regarding guardianship and power of attorney.

For example, a child under legal age has the right to privacy, even from parents. This means that mental health professionals cannot share confidential client information without the written or expressed permission of the client, even a child, unless that child is at risk of harm to self or others. This can be especially frustrating for parents who want to help their child if the mental health professionals have not received permission of the client to share the content of counseling or therapy sessions.

Likewise, an adult with mental illness may not want certain information shared with their spouse, parents, or children and therefore, do not give the mental health providers permission to disclose information. While there are exceptions to this right of privacy, families should be prepared to accept and respect the limitations placed on mental health professionals regarding sharing of private information.

Legal rights also vary depending on whether the client is receiving care as an inpatient in a hospital or not. The New York State’s Office of Mental Health has helpful websites that provides links to inpatient rights and rights applicable to individuals diagnosed with serious mental illness .

More Information for Family and Friends

The National Alliance on Mental Illness has more information for family and friends. Also, the local NAMI Saratoga, New York is very helpful.

MH Info