Before we get into section one, I'm just going to remind you about the Family Guide to Mental Health re-, Recovery, which we'll be revisiting through the lecture, through the video clips that you'll be seeing. This, this website actually has more videos available on it than the ones you'll be seeing in the lecture, so if you'd like to see the rest of them, they're available in the gallery that you see linked here. You can also, you can also get to those videos by going to the front page of the website, and we also have the website linked as one of the resources, bef-, beside lecture 5.0. So we're starting with families and mental health. And we're starting with families and mental health, because I believe that promoting mental health is one of the primary functions of families. On a basic level, families function to promote the health, growth, and development of all of the family members, and it does so by performing functions like the ones you see here. Some like protection, physical nourishment and safety, are geared to securing the survival of family members and others like love, nurturing and spiritual nourishment, are geared toward promoting the happiness and well-being of family members. Let's take a closer look at how families work. In social work, we talk about the family as being a system that interacts with other systems in the social environment. The family system must operate in certain ways in order to carry out the functions that were suggested on the previous slide. Some of the processes that must be in place are connections between the members of the family, as indicated by the arrows I've put here. These connections are important so that people feel connected to each other, learning and information is transmitted between family members and emotional safety is in place. These connections between family members are also why the well-being of individual family members is tied up with the well-being of others. If one part of the family system is unwell, then others can become unwell. At the same time, when members of the family system are well, then this can contribute to wellness for others. The family system must also have boundary system within it, and around it. The boundaries within a family system are to foster a sense of personal integrity and independence, for each individual family member. The boundary that surrounds the family system, is to ensure that members feel a sense of connection within, and are given some protection from what is outside of the family system. But these boundaries are not impenetrable, it's important for there to be points of openness between family members, and also between the family and the external environment. Another thing that we see in family systems, is role differentiation. This just means that different people have different roles and different things to do. Families have tasks that need to be carried out and the family functions effectively when there are people in place to carry out those roles effectively and there's clar, clarity about who has what role in the family system. Some would also say that hierarchy is important in the family system, because there's a need to have some people who carry extra responsibility for insuring the family system is operating smoothly. In many families, this will be the parents, or maybe grandparents in a multi-generational family. But the person who assumes more authoritative roles, and the importance of hierarchy and chains of authority within a family system, is very much determined by culture. And when I say culture, I'm thinking about Ethno-culture, but I'm also thinking about just the culture of the family itself. In psychiatry there have been attempts to actually measure how functional families are by using scales that evaluate how they're dealing with various challenges and responsibilities, that families must address. An example of such a scale is the McMaster Model Of Family Functioning. It's very much based in a Judeo-Christian organization, or sorry orientation to family functioning, and based on questions about family structure, organization and interactions, which help us to characterize families in terms of their health and effectiveness. The McMaster Model is oriented to identifying strengths in families, but it's also able to identify areas of difficulty, challenge, or even severe problems. The sixth categories for evaluation are listed here. Problem solving, is this a family that is able to solve problems, and has a usual set of steps for doing so? Communication, Is there effective communication among family members? Roles, is there clarity, clarity about who does what, and how things get done, and do they get done? Affective resposiveness, is this a family that's able to share and communicate appropriate emotional responses to each other? Affective involvement, are members of the family interested and concerned about each other, invested in each others well-being? And finally, behaviour control, does this family have some kind of internal controls in place that set the boundaries and the latitude for acceptable behavior? Okay I just want to pause for a moment here to emphasize the point that I made earlier about, culture. So, the McMaster Model of Family Functioning, gives you a framework for thinking about families and what they have to accomplish. And, you can see that it defines healthiness in terms of things like being able to communicate directly with people, in terms of, the way that people express affection around each other, this sort of thing, right. But that's very much embedded within a particular cultural context. So if we're thinking more generally about families, it means that the McMaster Model for Family Functioning may not trans-, translate very well to other cultural context, we don't know, it will translate better to some than to others. But in a more general sense, when we're thinking about the health of families, I think on a fundamental level we want to know,is this family functioning in a way that promotes the health and well-being of all of its family members. And if you see a family that is functioning in a way that does not promote that health, does not promote their security and safety, does not promote their well-being, then you start thinking about, well what's going on with this family that's getting in the way of that. So I just wanted to make sure that we were clear that there isn't one model for effective family functioning. So what happens to families when a family is affe-, when a family member is affected by mental illness? Well the health promoting functions of the family remain the same, but there are new challenges introduced. The personal resources that each family member brings to the family system may not be at a sufficient level to promote family health. The entire family system may be depleted, by the impairment of one or more family members and the effects that, that has on everyone else. In addition, for reasons that we will discuss later in the lecture, supports and resources that had been outside the family in the external environment, which helped at the function effectively, may not be as available anymore and this will have an effect on the families' health promoting capacity, too. Families do not necessarily know how to deal with having a member that is mentally ill. Attitudes toward mental illness, specifically stigma, get in the way of us talking openly about mental illness. And some of the consequences of that, are that there is little preparation for individuals to know how to deal with being diagnosed with a mental illness, and also little preparation for families to know how to deal with having one of their members diagnosed. Despite the challenges, families play an important role in promoting mental health in the context of mental illness. This is discussed by a family member in this first segment from The Family Guide To Mental Health Recovery.
