Caring for a Mentally Ill Person

Caring for a mentally ill child or spouse can be a difficult task, and the situation can affect your entire family. Don't place blame. Here's how to succeed.

Many people take care of someone with a mental illness. During any given year, only about 40 percent of the mentally ill receive professional treatment in the United States, while millions of Americans live with a serious condition. Many partners, siblings, parents, and friends step in to help.

You may have noticed the symptoms slowly. Even people who suffer psychotic episodes will often perceive the world normally and show no signs of illness visible to outsiders. Often sufferers keep their troubles secret — to protect their reputation or for fear of rejection from those they love.

As a caregiver, you may be keeping that secret too, to avoid conflict. You don’t want your loved one to isolate and resist help. Let other family members or a trusted friend know and ask for help. Without a confidante, you can easily become overwhelmed.  

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Dispel any myths about mental illness Your loved one isn’t doomed to live in a mental hospital or on the street. Your relatives may become afraid of irrational violence. Let them know that the mentally ill aren’t especially violent; more often they will appear frightened, confused, or in despair.

As a parent, don’t blame yourself for your child’s problems or assign it to the child’s other parent, attributing the illness to bad parenting or bad genes. Mental illness usually arises from a complex mixture of genes, history, and conditions that no one can pin down exactly.

Schizophrenia, for example, occurs among roughly 10 percent of people who have a first-degree relative with the disorder, such as a parent or sibling. Someone with an identical twin with schizophrenia has a 50 percent chance of developing the problem. Exposure to viruses or malnutrition in the womb and smoking marijuana in adolescence increases the risk.

Diagnosing schizophrenia in teens can be tough because the first signs are common — bad grades, sleep problems, and irritability. They might seem depressed, speak in a flat voice, and become lethargic.

Hallucinations, delusions, and confused thinking warrant immediate medical attention. Be proactive: People who receive good care during their first psychotic episode go on to have fewer hospital stays.

Often people with schizophrenia don’t realize they’re ill and may talk about their symptoms in confusing ways. Do your best to protect your loved one from feelings of shame: Eliminate any stigma in your own mind.

The basic communication rules are the same as you’d follow with anyone with whom you wanted a trusting relationship: Be clear, direct, share important feelings, and focus on the big picture.

The National Alliance on Mental Illness recommends that people with mental illness work with caregivers to create a Wellness Recovery Action Plan that lists daily actions to promote wellness and steps to take in an emergency.

Make a list of:

• Phone numbers for doctors, psychiatrists and therapists, helpful friends and family, and a local crisis line
• The addresses of a walk-in crisis center
• Diagnoses and medications
• The history of psychosis or suicide attempts or drug use, and triggers
• Things that have helped in the past

Make copies and keep the list in several places, such as a drawer in your kitchen, your glove compartment, your smartphone, your bedside table, or your wallet. Adults with an illness that causes psychosis should prepare a psychiatric advance directive while they are competent, authorizing a caregiver to make decisions on their behalf while stating their preferences.

A court may appoint you as a conservator if your loved one attempts suicide repeatedly and refuses treatment for an underlying illness.

In a crisis, you can call 911 and speak to a dispatcher, explaining that your loved one is having a psychiatric episode. Trained police officers can calm a person who is upset and convince him to go voluntarily to a hospital or, in some states, take him involuntarily. The police will also do a welfare check if you can’t reach your loved one and want to know that he is safe.

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Resources

• Mental Health America offers online screening tools and advocacy.
• National Alliance on Mental Illness has an information helpline [1-800-950-NAMI (6264)] and structured in-person support groups for family members.
• National Mental Health Information Center is a government-maintained database of mental health services, including suicide prevention and substance abuse programs.