Serious Mental Illness and Family Caregiver

World Wide Mental Illness as a Health Issue 

    Approximately
eleven million adults in the United States live with serious mental illness and
about three million dependent children. suffer from a severe emotional
disturbance (Dean, 2003). The United States currently spends over $70 billion
per year on mental health treatment. 

    Effective care of the mentally ill and
their families requires early community intervention using a variety of
integrated approaches including mental health and social service teams. 

    Effective mental health treatment must encompass sick individuals and their
families and take into account the complex relationship between mental illness
and unemployment, homelessness, drug addiction, and involvement in the criminal
justice system.

Coordination Between Nurses and Care Givers

    The
importance of alliance building between tween family caregivers, the mentally
ill member and the health care team was described by Kempe (1994). Families are
continuing to ask health professionals to communicate with them in a reciprocal
way ( Biegel , Robinson , & Kennedy, 2000). 

    As mental health care continues
to become more community-based, the family is required to assume more
responsibility and care of their mentally ill member, yet families are not
getting the direction and support that is needed (Levine, 1998). 

    Family
caregiving for the mentally ill involves the family steadfastly assisting the
mentally ill family member with basic physical and emotional needs as well as
maintaining a positive relationship and environment that nurtures a sense of
self and belonging and allows the mentally ill person to strive towards
educational and vocational goals. 

    The roadblocks facing families attempting to
care for their ill family member continue to be: 

(a) laws, policies, and
regulations affecting care.

(b) attitudes of health care providers including
psychiatrists and nurses.

(c) consumer misinformation and stigma.

    From
the 1960s through the 1990s care-giving studies identified several negative
issues such as burden and related stressors ( Maurin & Boyd, 1990).
Caregivers were identified as needing much social support. Since 1990, these
burdensome issues continued to exist but many positive aspects also have been
described. 

    It has now been concluded that health care professionals must
develop the theoretical flexibility to accommodate the diverse situations which
family caregivers face in caring for their ill members. 

    Encouraging family
caregivers to listen to experiences of others in caregiving roles and then
learn to think creatively about them- selves and their experiences has been a
strategy that is helpful ( Doornbos , 2002).

Illness Understanding and Family Response 

    Levine
(1998) identified that families want information about mental illness and how
to cope with the situation. It was also found that family caregivers value a
positive relationship with health care providers, which includes respect and
nonjudgmental approaches (Rose, KE, 1998a). 

    In addition, Biegel , Rob Inson ,
and Kennedy (2000) found that families also wanted dialogs within groups and
individualized whole family support. Those studies reported that families
continue to experience difficulties with the mental health. system and
financial issues.

How Mental Illness Effect Family

    Chronic
mental illness can affect the family in many ways, including changes in
familiar roles, changes in subsystems within the family, possible isolation of
family members, increased need for problem-solving skills, and adjustments with
adaptability to family role changes. 

    Caregivers experience more distress as the
number of tasks they must complete increases and the ill member’s depression
increases. The social support required is really a large affirming social
network of support that includes professionals participating in the care of the
mentally ill person ( Margliano et al., 1998),

How Caregiver are Good Guider of Family Members

    More
research that focuses on family caregivers of the mentally ill is needed.
Researchers need to focus on how to remove barriers that impede access to
quality care. 

    Long-standing barriers include: mistaken public policy,
insufficient health insurance coverage, money, the attitudes and practices of
health care providers, and the attitudes and preferences of health care
consumers. 

    One necessary research need is to determine ways to convince the
political system of the need for parity in reimbursement for mental illness
from insurance providers.

Difficulties Faced by Families

    Doornbos
(2002) summarized the many difficulties experienced by families as they provide
care for their mentally ill members. She found that the issues that families
and their mentally ill members must cope with include stress, powerlessness,
physical health issues, financial problems, and the enormous burden borne by
nonprofessionals at- tempting to provide care for the mentally ill. 

    Finding a
better way to meet the many needs described by family members with a mentally
ill member is also an important contribution needed in nursing. Meeting these
needs may best be accomplished through research and development of a health
care model for all mental health professionals.