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Saturday 7 May 2011

Mental Illnesses - a Family Affair

I'm fully aware that mental health services like to say that an individual with a mental illness is an individual.  Very rarely do they look deeper into the family situation.

In my 44 year association with mental illness (my father was diagnosed with Manic depression [Bipolar] and Paranoid Schizophrenia in 1967) I have views that tend to be overlooked by the experts in favour of just dealing with that sufferer.  My research through other family members shows that maybe I was predisposed to be mentally ill, as are all my siblings and wider whanau.  And my further research once I was diagnosed tends to suggest that the hereditary link is an important component in someones own affliction and how they react to The Experts.

My own family suggests that all mental illnesses are hereditary, a rogue gene or something similar.  My paternal grandmother needed treatment in hospital, my father's younger sister required intervention and hospitalisation, and my father had numerous visits to hospitals for his care.  In 2000 I too required hospitalisation and since have been hospitalised 5 times for my own Bipolar and Schizophrenia (since rediagnosed as Schizo Affective Disorder).

Why this intrigues me?  Since I have been in the system I have talked to people at length on their own backgrounds as far as a mental illness is concerned and though many didn't have a parent with a full blown mental condition, they did have family members that were into doing drugs or alcohol (self medicating) and these people had mood disorders and due to this they themselves found themselves clashing with those parents afflicted.  As teenagers their lives often became unbearable and they either left the nest early due to that conflict, or continued to clash until they then needed medical intervention.  Now we are aware that with a lot of families there is always a predominantly dominant partner and they are the ones that cause the most grief to the susceptible.

This happened with me, although I will give my father some credit knowing he was mentally ill and mostly was alright.  But when we clashed it was world war three.  For reasons of my own sanity and to try and quell the family issues, my mother suggested I join the forces, so in May 1975, under duress, I joined the Navy.  Therein my dealings with mental illness ceased (my father wouldn't talk to me for years for not going to university). Then in the 90's, happily married, very successful at work, and enjoying the great middle class life offered by our wonderful country, the pressures started growing.  All through my life I had been counting the days when I passed milestones my father hadn't passed.  That too brought pressure until in 1998, my father died the day before my sisters wedding and the added pressure burnt a whole in my psyche and I started regressing. For two years I was a walking timebomb, and it I didn't see in myself the warning signs I'd seen in my father, and eventually I bombed.  I was having issues with my oldest daughter and they mirrored the scraps I had with my own father and I missed those warning signs, as you do when you are unwell.

But back to families and conflict.  A lot of people in families have relationship issues and these lead to widespread conflict.  I think when Mental Health services are dealing with individuals, they also need to take into context the family dynamic, afterall when most of these young people are released back to the family they are stepping back into a conflict situation.  The old adage "Opposites attract, Likes repel" is brought to bear in this scenario and often young sufferers are sent back into a situation they don't won't to be in.  And to make matters worse, not many young people with a lived experience of mental illness are able to go out by themselves to live and have only the family/whanau to go back to.  SO!!

Should we also get MH services to widen their brief and check out the family situation to help them cope with their young family member?  A big ask, but something that I suggest needs to be addressed to allow our tangata whaiora to slip smoothly into a family unit that will care for their loved one, not disassociate them!  If a family member that is causing the strife is addressed and their life made better then I see an improvement for the outlook of our tangata whaiora.

3 comments:

  1. That is a very sound piece if advice, to get the family situation checked out, to aid the recovery of patients returning home, especially if they are young.
    Depression runs through my family as well and that has cause me problems over the years.
    Good post.

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  2. Thanks Mamarewog. Yeah like water runs in a river so do issues in families. I guess if families took ownership and did something positive about their issues, instead of hiding behind the stigma of it all, then maybe we could make inroads into better care for any sufferer. Mental illness is not a curse, it's a cold hard reality and one that needs to be warmed up a bit so all are accepted and work towards recovery.

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  3. My partner works in a therapy called Multi Systemic Therapy (MST), which is targeted at youth with mental health and behavioural issues, who have usually had contact with youth justice.

    MST is incredible in action! The therapy tends to be a bit precious about its terminology and processes but it is just common sense! and in a way is what you are talking about. The idea is that the child is operating within a number of systems (family, peer, education, justice etc) and aims to strengthen these systems in order to support the child, starting with the family.

    Obviously the family situation is crucial for children still at home, but wouldn't it be good to see this approach expanded to include adults?

    I think this sort of idea was probably part of the justification behind the disestablishment of long term psychiatric facilities (along with 'better' medications, the human potential movement, and political expediency) - ie, the idea that the patient would be better off at home with support from surrounding systems...that the community would embrace these individuals with open arms....

    Except the surrounding systems had no idea how to treat the mentally unwell, families included. And like you say, many families are already struggling with other members suffering from serious mental illnesses, or at the very least, falling apart with the exhaustion of dealing with ill family members.

    My only first degree relative with mental illness is my teenage son. And my family are incredible at supporting us, as I am on my own at home with him, my partner living in another city. But even with that help and understanding, the gaps in support from other systems are enormous.

    I have seen Community Mental Health here in palmy work amazing things here to support very isolated patients (i can't help but use patient rather than tangata whiora or consumer; when i am ill i am a patient, when i pay cash for bananas i am a consumer.) and as you point out in one of your posts, mental health workers are over-worked and under-funded. the burn-out level is high, and it is difficult to retain specialist staff (I have my 4th psychiatrist in 3 years). When I lived in Chch, I had one psych for 3 years, and he stayed on long after I left the region.

    But outside trained professionals, the community is at best prejudiced against those experiencing mental illness. I had a friend (past tense: she is dead to me now) who was/is convinced, as a nurse, that the psychotic just need a hug and someone to listen to them, that psychological pain is not real, and that the depressed just need to get over themselves, because she was sad once and she got over it.........

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