Page 212 - Encyclopedia of Nursing Research

FAMILy CArEGIVING ANd THE SErIOuSLy MENTALLy ILL n 179

Chronic mental illness can affect the by acting on the informed intention to care
family in many ways, including changes in meaningful and personal ways. A genuine
in familiar roles, changes in the subsystem and focused presence opens the health pro- F
within the family, possible isolation of fam- fessional to hearing and responding appro-
ily members, increased need for problem- priately to the needs of the mentally ill and
solving skills, and adjustments with adapt- the family caregiver. An appropriate caring
ability to family role changes. Caregivers model for the mental health professional
experience more distress as the number of should include specific values, actions, and
tasks increase and the ill member is able to behaviors that meet the needs of the mental
do less in meeting their own needs (Sheehy, health consumer.
2010). The social support required is really Family caregivers have clearly identi-
a large affirming social network of support fied what they desire in terms of care. They
that includes professionals participating in expect open communication with health pro-
the care of the mentally ill person. fessionals, a strong alliance with the health
Over the past 30 years, community-based team, continuing information regarding the
and deinstitutionalized mental health care disease and resources available, which can
have been the most influential movement. come from groups or individuals, and suffi-
A push model (yip, 2006) was developed to cient reimbursement for mental illness from
summarize the problems associated with insurance providers.
caregiving of the seriously mentally ill. The More research on family caregivers of the
model describes members pushing to move mentally ill is still needed. researchers need
the responsibility for mental health care to to provide a new direction that removes bar-
others. Community and institutional care riers to quality care. Long-standing barriers
becomes overloaded and pushes the family to include mistaken public policy, insufficient
assume more responsibility. There is a result health insurance coverage, financial issues,
of families feeling unreasonable demands the attitudes and practices of health care
or burden. Care is poorly coordinated as the providers, and the attitudes and preferences
institutional and community care systems of health care consumers. One necessary
become overloaded. resulting issues include research is to determine ways to convince the
an increase in psychotic violence, public stig- political system and health insurance provid-
matization, and poorly coordinated services. ers to reimburse for mental health services in
The barriers to care are not deliberately a sufficient way.
blocked but are subtle and inadvertent. Most Families and their mentally ill member
long-term mentally ill are eligible for social must cope with stress, powerlessness, physi-
security disability. The amount provided, cal health issues, financial problems, and the
however, does not adequately meet their enormous burden borne by nonprofession-
needs. They are forced to rely on family or als attempting to provide care for the men-
community agencies to underwrite their tally ill. Meeting these needs is accomplished
monthly physical needs for housing, food, through research and the development of
and clothing. This access problem is exacer- health care models that any mental health
bated when they are so dysfunctional they professional could implement within the car-
are not able to actively seek needed services ing context.
and quality care. The politically active, National Alliance
In attempting to address more than the for the Mentally Ill, continues to be instru-
physical needs of the mentally ill and fam- mental in moving legislation, research,
ily caregiver, mental health professionals managed care, and family-focused care
need to also focus on relationship-based care into public debate to help families with a
(Koloroutis, 2004). Nursing is accomplished mentally ill member get the needed care.