Families and carers play a significant role in the lives of people who are experiencing mental health conditions. It's important to believe people can and do lead productive fulfilling lives despite experiencing mental health issues. Carers and friends who have a genuine belief in the person's potential can be key in providing hope, connection and commitment, and be their most important source of strength and support in their recovery. Recovery is best described as a way of living a satisfying, hopeful and contributing life even with the limitations caused by illness. I've been privileged in working with families and carers for a number of years. Hearing that someone you love has been diagnosed with a mental illness can be devastating. How can we maintain a positive attitude and increase resilience within ourselves and the person we support? Here's some tips for you as carers. Find and maintain hope. Take an "I believe in you" approach. Support the person to make realistic and achievable goals in their recovery and celebrate each milestone. Foster relationships and stay connected with family and friends. Enjoy pleasurable activities. And don't be afraid to ask for support if times get tough. How can I best support a family member or a friend who has a mental illness? Everyone goes through hard experiences at times and we all need family and friends to support us. This is one of the most important factors that determines the quality of life. When illness is experienced people require changeable levels of support from a caregiver. A carer is someone who has a close and ongoing relationship with the person who experiences mental health issues and provides support in addition to their usual relationships. For example, a husband may become a carer when his wife is unwell. When she recovers, he reverts back to lover, friend, and life partner to his wife. Here are some tips. Remember each person's identity and their strengths. Don't be defined by the labels of illness: Carer or consumer. For example, Johnny is an artist, attends university, likes to fish, is the second youngest in a family of five, and happens to have schizophrenia. Jane is a wife, a mom, teacher, plays netball, loves to cook, sings in a band, and also steps in as a carer when Johnny is unwell. Carers often put themselves last and it's not uncommon for the stress of the role to increase the risk of developing a physical or mental illness. Remember, who is asked to put that oxygen mask on first on a plane when you have a young child on your knee? It's you. Only when you care for self, can you effectively care for others. Introduce some strategies to care for yourself each and every day. This will increase your coping skills and, by modeling this to the person you support, will highlight their need to take care of themselves too. Support your loved one to seek professional help. This may include visiting a local doctor or some sessions with a psychologist, counselor, or psychiatrist. Where possible provide extra information on your observations on how the symptoms may be impacting upon their ability to function in their usual way. Get informed. Ask for written and verbal information of symptoms, treatment options, early warning signs, and recovery strategies. And look at reputable sites such as Beyondblue, Sane Australia, and Black Dog Institute. Seek age appropriate information if children are within the family. What is meant by reducing stresses and increasing protective factors? When stress is part of our lives we put ourselves at risk of developing a physical or mental illness, and may become contagious with our stress. Stresses include overwork or lack of work, poor sleep, relationship difficulties, financial problems, poor diet, or substance misuse. We may not always be able to completely rid ourselves from stress, but actively reducing stress will have optimum benefits. Protective factors are those positive influences we implement to create our health and well-being. Here are some tips. Be a role model and reduce your own stresses. Be contagious with your calm to give it to others. Take a breath to buy yourself time to respond rather than react. A breath is a break. Practice mindfulness or other relaxation techniques. And model healthy lifestyle. Work as a team to increase protective factors. Exercise. Stay connected. Find a hobby and plan healthy meals. How do I step back and allow the person to take responsibility for self? Understandably, many families and carers are frightened and want to protect the person from experiencing another crisis in their lives. However, when fear and worry takes over, the reaction is more like a knee jerk "fix it" which unintentionally undercuts a person's ability to help themselves. Mental illness often occurs in episodes and for many people, symptoms come and go. So, the level of care a person requires will vary from time to time. During periods of wellness a person may be symptom free and have only mild symptoms. They may be doing well at work or school, and have positive family and social relationships, and will not require additional supports. However, at times this might change and they may relapse and experience moderate to severe symptoms which impact heavily on their ability to function. They may require a range of support options including emotional support, practical support, and assistance from their treatment team, or, in most severe cases, hospitalization. With the best of intentions, carers may do too much and inadvertently steal the person's capacity to function independently. Whenever possible carers should encourage the person with a mental health condition to take responsibility for their recovery by taking the driver's seat. Such as choosing their own activities, treatment options, and discussing these with professionals. A person with diabetes would be coached to take responsibility for their recovery by monitoring their blood sugars, regulating their diet, and exercise. Here are some tips. Acute mental illness invites families and carers to take charge. This may be essential in the short term but can become unhelpful to the person in the long term. If you're scared to step back, practice those baby steps and handing back responsibility. This also shows you believe the person can do it. Help the person to develop a wellness plan or a recovery plan. This document can be developed in collaboration with the consumer, carers and clinicians. The plan could outline strategies the individual can use to help him or her stay well, the triggers or early warning signs to seek help, and the preferred interventions if she or he starts to become unwell. Make multiple copies of that plan for all involved. Constantly remind the person of their qualities and strengths. How do we break down the stigma? Society can discriminate against people with mental illnesses, but sometimes we can also feel ashamed of ourselves. This is known as self stigma. Here's some tips. Mental illness is no one's fault. Let go of the guilt, the blame, and shame. Acceptance of a major diagnosis takes courage and time and you all may benefit from support or counselling. Acceptance of the diagnosis creates opportunity to normalize the illness. Just as a physical illness affects the body, a mental illness affects the mind. What do I do when the person I support becomes highly distressed? For the past five years I've worked with a psychiatrist, Dr. Emory Bigatton, to develop and deliver an intervention for families and carers called "Staying connected when emotions run high". We introduce frameworks and strategies to assist a carer when a person they support experiences relationship difficulties, demonstrates changing emotions, overwhelming feelings, and/or displays impulsive and destructive behaviors. This intervention showcases a film with two fictional characters demonstrating the four carer dances which simplifies relationships as a dance. In three of the carer dances: Too Too Bossy, Too too Busy, and Too Too Kind carer is contagious with her stress and pours fuel on the fire. In the fourth dance, she uses a good enough carer approach using the five key relationship strategies to pour water on the fire. Here are some tips. Care for self to care for others. Be contagious with your calm. Draw your line in the sand. Boundary setting. And listen without fixing. Develop a safety plan in time of calm, like a fire drill, to promote safety when distress or risk escalates. Sometimes when a person has lost touch with reality, is severely distressed, or is under the influence of drugs or alcohol, they may be at risk of hurting themselves or others. If you believe that anyone's safety is at risk, please call emergency services as an act of love. Caring for someone with a mental illness can at times be challenging. However, with armed with knowledge and appropriate supports, the relationship has potential to grow and strengthen in new ways. Here are some tips. Recognizing the behaviors are often associated with the symptoms. Learning to separate the person from the illness, can be a helpful way to keep the relationship strong. Accept the diagnosis. Recognize all the warning signs and identify best treatment options. Keep connected and seek relevant, professional, and social supports. Keep hope alive. And if your hope meter gets low, help is available for you and the person you support.
