Mental illness: how family and friends can help
Mental illness affects around 20 per cent of Australians every year, but it is treatable. This pamphlet answers commonly-asked questions about the effects of mental illness on the families of people affected, and how they can be supported to help the person and themselves.
The term ‘family’ is used to describe any relative or friend who cares about the person with a diagnosis.
How are families affected?
Many forms of mental illness first appear when the person is in their late teens or early 20s. Whether it’s depression, an anxiety disorder, or a less common condition such as bipolar disorder or schizophrenia, the first episode is likely to occur when the person is still living with their family. Even if they have moved out of home or are older, the mental illness may not only be distressing for them, it may affect others too.
Mental illness often has a ‘ripple effect’ on families, creating tension, uncertainty, troubled emotions and big changes in how people live their lives. Different family members are likely to be affected in different ways. These effects on the family are sometimes not acknowledged by health professionals.
Families may also take on the role of day-to-day care. This often happens with little training or support, or acknowledgment of their own needs and mental health. When families are accepted as partners in care and do receive training and support, there is strong evidence that this leads to better outcomes for everyone involved.
Sometimes families are not listened to by health professionals. ‘Patient confidentiality’ may be given inappropriately as a reason for this. Yet families are often the main support for people affected by mental illness, and have a right to be treated as ‘partners in care’. They need information about the illness and treatment provided, and about training and support to help themselves as well as the person who is ill.
Where do we start?
Developing a practical, positive attitude is always a good place to start. This means:
- Coming to terms with the fact that someone you care for has a mental illness, and that this is likely to have a serious emotional impact on you as well as them. There may be anger at this happening in your family, confusion, or a sense of loss and grief at how the person has been changed by their illness. It’s important to acknowledge and talk about these feelings.
- Developing a sense of balance between:
- acknowledging the effects of the illness on the person and hopes for recovery;
- wanting to do things to help the person and encouraging them to be independent;
- showing you care and not being over-involved;
- giving the person your time and having time for yourself and other family members too; and
- encouraging the person to do things and not being unrealistic and demanding.
- Preparing yourself by learning as much as you can about the illness and its treatment, and considering what you can reasonably do to support the person. Discuss this with other family members and the treating health professionals. If there is a type of care you cannot provide, then discuss with the health professional what arrangements can be made to provide it in some other way.
What skills do we need?
Having a mental illness isn’t easy. Caring for someone affected often isn’t easy either, and sometimes first instincts are not helpful. The SANE Guide for Families contains lots of information and tips that others have found useful.
Talk things over with the person affected and other family members. Talk about how you feel and encourage others to do the same. Try to ensure everyone has the same understanding and position.
Find out about any training for family carers of people with a mental illness you can attend, and consider joining a support group to meet others in your position.
Encourage the person with a mental illness to be involved as much as possible in looking after themselves, and to get out socially and do things in their local community as much as is practical.
Consider the person as a whole — remember that they have the same range of personal, emotional and sexual needs as anyone else. Is their physical health being looked after by a general practitioner? Are alcohol or drugs a problem which needs attention?
If there are suicidal thoughts, self-harm or aggression towards others, take these seriously and discuss with a health professional. Prepare a plan together for what to do if someone becomes unwell again. Always have crisis numbers handy.
Plan ahead for when you are unable to provide care. Talk about this with the person and health professionals, and consider what legal and financial steps may be needed to ensure care continues.
What do we do in a crisis?
When someone becomes extremely unwell, it can be distressing and confusing for others, as well as the person concerned. Remember these principles for what to do.
- Communicate clearly in an honest, understanding manner. Do not crowd, rush or unnecessarily touch the person.
- Provide a calm, safe environment. Move to quieter, more open surroundings. If necessary, remove items with which the person might harm themselves or others. Seek help from a doctor, Psychiatric Emergency Team or the police.
- Try to behave in a quietly confident manner. Be firm but friendly and unthreatening. Reassure that help is on its way.
How can we look after ourselves?
When caring for someone else, it’s important to remember to look after yourself and other family members too.
- Allow for regular ‘time out’. Make sure to make time to regularly do things you enjoy and to socialise. Ask about respite care to give everyone a break.
- Talk about how you feel. Don’t ‘bottle up’ feelings if you are sometimes frustrated or need support. Let the treating health professionals and others know how you feel, and ask for support if you need it.
- Be sensible about what you reasonably can — and cannot — do. Try to prioritise and organise what you need to do, by making a weekly list for example. Ensure that this is realistic and fair, and that it includes time for yourself and others as well as the person you are caring for.
- Don’t try to do too much. Pace yourself and look out for signs that you are becoming stressed. Have a plan for what to do if this happens.
Where can we find support?
- Ask a health professional or call the SANE Helpline for details of support groups and other services for family carers in your local area. There may also be groups for young people whose families are affected.
- Centrelink provide details of benefits and services for family carers as well as for people with a mental illness.
- Carers Australia provide details of local Carers Associations and their services, including respite.
- Commonwealth Carelink provide details of government services for people with a disability and their carers.
How do I get more information?
Call the SANE Helpline for information and advice. Phone 1800 18 SANE (7263) or email firstname.lastname@example.org.