Working with the Family

Necessity to Assess Treatment Choices and Family Resources

About a fourth of the people who have a mental illness will have a single episode. About three fourths will continue to have various degrees of symptoms over time. This seems to be true no matter where or how they are treated. Since treatment and care is costly, it is necessary to plan for the future. Families who have lived with mental illness for a long time often describe how, at the time of the first episode, they sometimes commit themselves to very expensive treatment in expectation of a cure that never materialized. Eventually they found themselves providing for long term care with severely drained resources.

Before making commitments to any treatment, families should consider:

1. How much insurance coverage does the ill person have, should the illness be long-term? What is the best plan to assure benefits are available for the required time?

2. If other financial resources are available to the family, how much should, in all fairness, be reserved for the needs of all the members of the family for education, health care, and retirement options? These are hard choices, but they must be made or there are regrets later.

3. If a family is considering a particular type of treatment, they should fully explore to what extent research can demonstrate a positive outcome. They should not be swayed by the enthusiasm of those who provide the treatment.

4. Families should know that the costliest care is not always the best. Money will not cure mental illness. Private care is not necessarily better than public. There are real limits to the effectiveness of any treatment. Many people will continue to need medication. Others may need medication and ongoing assistance with social and vocational skills. Beyond that there is no magic that can erase all the effects of mental illness.

   References

   Bernheim K. F. and Lehman, A. F. (1983) Working with Families of the Mentally Ill, Harper & Row, New York, NY

   Cannon, J. (1990) "Pastoral Care for Families of the Mentally Ill," The Journal of Pastoral Care, 44 (3), 213-221

   Friedman, E. H. (1986) Generation to Generation: Family Process in Church and Synagogue, Guilford Press, New York, NY

   Germain, C.B. (1991) Human Behavior in the Social Environment, Columbia University Press, New York, NY

   Hatfield, Agnes B. (1991) Coping With Mental Illness in the Family: A Family Guide NAMI Book No. 6, National Alliance for the Mentally Ill, Arlington, VA.

   
   

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