Page 211 - Encyclopedia of Nursing Research

178 n FAMILy CArEGIVING ANd THE SErIOuSLy MENTALLy ILL

be (1) laws, policies, and regulations affect-
F Family caregiving and the ing care; (2) attitudes of health care provid-
ers including psychiatrists and nurses; and
seriously mentally ill (3) consumer misinformation and stigma.
From the 1960s through the 1990s, care-
giving studies identified several negative
Serious mental disorders are common issues such as burden and related stressor
in the united States and internationally. (Maurin & Boyd, 1990). Caregivers were iden-
Approximately one in four adults suffers tified as needing much social support. Brady
from a diagnosable mental disorder whereas and McCain (2005) summarized the family
approximately 1 in 17 people suffer from a perspective regarding living with chronic
serious mental illness according to the 2004 schizophrenia through a literature review
u.S. Census (2009; http://www.nimh.nih. covering 1990 to 2005. She found that fami-
gov/health/topics/statistics/index.shtml). lies experience stigma, lack of social support,
Effective care of the mentally ill and their lack of knowledge about the disease, and
families requires early community interven- burden. Families expressed a need for a pos-
tion using a variety of integrated approaches itive relationship with health care providers,
including mental health and social service which includes respect and nonjudgmental
teams. Effective mental health treatment approaches. These studies also reported that
must encompass the sick individuals and families continue to experience difficulties
their families and take into account the com- with the mental health system and financial
plex relationship between mental illness, issues.
unemployment, homelessness, drug addic- Since the 1990s, these burdensome issues
tion, and involvement in the criminal justice continue to exist and many positive aspects
system. have also been described (Lohrer, Lukens, &
The importance of alliance building Thorning, 2007). It has now been concluded
between family caregivers, the mentally that health care professionals must develop
ill member, and the health care team was the theoretical flexibility to accommodate the
described by Kempe (1994). Families are diverse situations that family caregivers face
continuing to ask health professionals to in caring for their ill member. Encouraging
communicate with them in a reciprocal way family caregivers to listen to the experiences
(rose, Mallinson, & Gerson, 2006). As men- of others in caregiving roles and then learn to
tal health care continues to become more think creatively about themselves and their
community based, the family is required experiences has been a strategy that is help-
to assume more responsibility and care of ful (doornbos, 2002).
their mentally ill member, yet families are The sibling perspective is growing as
not getting the direction and support that more families must continue to care for their
is needed. Family caregiving for the men- mentally ill member once parents can no
tally ill involves the family steadfastly assist- longer manage the responsibilities (Hatfield
ing the mentally ill family member with & Lefley, 2005). Siblings need assistance from
basic physical and emotional needs as well health professionals to interact appropri-
as maintaining a positive relationship and ately, assess behaviors, and address areas of
environment that nurtures a sense of self and reciprocity with their ill sibling. Health care
belonging and allows the mentally ill person professionals can assist siblings and other
to strive toward educational and vocational close caregivers by destigmatizing the expe-
goals (Smith, Greenberg, & Seltzer, 2007). rience by planning outreach resources for
The roadblocks facing families attempting to all family members (Lukens, Thorning, &
care for their ill family member continues to Lohrer, 2004).