Family is an important and inevitable part of an individual and its uninterrupted presence gives us a psychological support and courage to courageously deal with any kind of trouble.It provides a strong and long lasting shelter to a person and every one looks toward his family for primary care. Although family’s role is necessary in physical illness but in psychiatric illness it has an undeniable and imperative part in treatment exercise and it is indeed one of the mental health promoting practice. So we can say that family plays an integral role in alleviating the significance of mental illness because only medical intervention is ineffective.
The support of family for an individual with mental illness is crucial in Asian Indian culture. The involvement of the family is so imperative, that often it becomes a prerequisite of seeking help for psychiatric illness (Stanhope, 2002 as cited in Cook & Tarnovetskaia, 2008). Studies have concluded that the rate of recovery from schizophrenia is greater and mortality of people with schizophrenia is lower in the developing world than in the developed countries and the key positive factor that bring that change is the involvement of families in the course of treatment (Warner, 2009).
Let’s view this aspect in a sense that what difference it will make if family is not involved in the treatment of psychiatric illnesses in cases where people living alone without any family support during the course of their illness. Maladaptive parental behavior is associated with an increased risk in offspring for anxiety, depression, disruptive personality, and substance use disorders during late adolescence and early adulthood. (Ajit Avasthi,2010)
Childhood exposure to parental verbal aggression is associated, by itself, with moderate to large effects on measures of dissociation, irritability, depression and anger-hostility.According to studies, lack of family and social relationship cause homelessness and badly effect the quality of life (Pinikahana, Happell, Hope &Keks,2009). . This causes too much frustration to the patient and instead of reducing mental illness it enhances much pain and suffering to the patient. Thus it has been found that when family support is absent the severity in the mental disorder keep increasing and any sort of medication often failed to produce good result. Resultantly family support is very vital and has a big impact to a patient suffering from mental illness..
Families have valuable information and knowledge about their relatives. They also have expertise, acquired through sometimes painful experience.They know about approaches that work and those that do not. Consumers, service providers and families benei¬?t greatly when family members are involved as full partners in the care and support of people with mental health and addiction problems. When family support is not provided to an individual suffering from a mental illness, he endures a lot of setbacks and it has a direct impact on him. Mostly he confused about his parents changed behavior and feels embarrassing for being in the affected persons company.
A 50 years old male patient Noor Ali Hussain was in Nizari Senior Citizen, suffering from mental illness for the last ten years. The patient has a history of schizophrenia, bipolar disorder, depression and odd behavior. On clinical day, I interviewed him about his family history. He told me that his family leaves in America and they have left him in senior citizen. Moreover, he explained that his family doesn’t come to meet him, they just call him only on some special occasion. He stated that he feels happy when he talk to family and he want to live with them. However his family doesn’t take him with them to America because he is illiterate and aged.Further stated family told him that we are busy in our work no one is here to take care of you and left me in senior citizen. After carefully assessing this pathetic situation I decided to choose this topic that is family support in mental illness. In my patient multiple disorders were present and in such cases family support is very important in rehabilitation and recovery of mental illness. But, in my patient case, unfortunately the family support ceased to exist.
Care giving literature has illustrated that the prominent role in the provision of support for individuals with mental illness falls on family members, especially on women (Saunders 2003, Zauszniewski et al. 2008, Huang et al. 2009). Evidence linking caring for a member with mental illness to increased levels of burden for the family caregiver is compelling and consistent. Family caregivers have widely identified burden as ‘any individual whose presence and performance aroused either fear or shame must be burdensome and could not be living within a supportive environment’ (Thompson & Doll 1982, p. 380).
Studies have concluded that mostly people consider taking care of a mentally ill person as a burden. The family care giving burden framework best define my patient case because it distinguishes between the objective and subjective burden (Hoening and Hamilton,1996). Objective burden emerge in the form of disruption in everyday life in the household, financial constraint, breakdown in daily activities and social interaction and these are observe by the caregiver. Subjective burden are the caregivers feelings, attitude and emotions that reflects that he carries a burden(Bull, 1990; Hoening & Hamilton,1966; Maurin&Boyd, 1990; Reinhard, 1994). Therefore it is necessary to minimize the sense of burden felt by caregivers. Some strategies and interventions that could be help when families are involved in order to promote mental health are discussed briefly.
Skilled Training and Health Management(ST&HM) intervention was developed with the aim of enhancing independent functioning and health care outcomes for older adults with SMI (primarily schizophrenia-spectrum disorders and bipolar disorder) (Bartels et al., 2004).moreover HM consisted of health care preventive measures to identify and monitor acute and chronic medical problems. Moreover family interventions should focus on expanding training to patient and key relatives about mental illness recovery, skills training, task sharing of household and self-care. A positive change in these areas is likely to improve the quality of life of people with mental illness and their families.
Other effective strategies include discussion, debriefing session and family therapy that are good practices to involve family in care. Family therapy is also useful Psychotherapy that teaches families and their members to resolve the issue effectively and improve their understanding. According to psychiatric mental health nursing book(2006) Psychoeducation family therapy has been more successful in treatment of patient with schizophrenia and it reduces long term hospitalization as well(Dixon, 2001). According to psychiatric mental nursing book(2006),Self-help group are best position to help clients and families find additional support and information.
Family support in mental illness can’t be ignored and it has a lasting role in the recovery of a mentally disorder individual. But sometime family considers burden and feels embarrassed and frustrated. In such crucial time, I think nurse can play a positive role by educating and counseling the family and his close relative about the intensity of the case and teach them strategies and skill to tackle the issue. By concluding, it can be said that family is an important source in promoting mental health but at the same time it is also necessary for the care professional to avoid commenting any mistake which may restrain the family from their beloved one who suffer from mental illness.Lastly, through assessing the identified framework and effective strategies we can play a role in alleviating the burden of mental illness that may bring a positive change in the patient who is diagnosed with mental illness. The prerequisite to promote mental health is to deal the patient holistically and make family involvement in treatment an integral part.