Used with permission from the National Alliance on Mental Illness (NAMI)
When someone has a mental health condition, support from family can make a big difference. However, it may be hard for us as family members to know what approach is best. It’s particularly difficult to balance showing support with caring for our own health and encouraging others to be responsible for their actions.
Remember you’re in the process of learning
Helping a family member is difficult, even if you do everything ‘right’. No book, therapist or website can tell you how to prepare for the situations that may arise.
It may help to think of this experience as a learning process. Every person with a mental health condition experiences it slightly differently. One person may fear losing a job, while another may be more worried about how relationships will change. If you ask questions and listen to the answers, you can learn about your family member’s unique concerns.
You can also acquire better skills for offering support, as you learn what works well in your family and what doesn’t. If you come from a family that’s uncomfortable talking about mental illness or emotions, remember you have the ability to improve your communication. Similarly, even if you feel like you don’t know how to offer encouragement right now, you can develop and improve through practice.
Remember support is not control
We can support and encourage our family members. We can’t, however, make their treatment decisions for them. We should offer suggestions and input, but be ready to accept and support their decisions.
They may not choose the treatment options that we would prefer, but by acknowledging their right to decide, we create a respectful, healing environment within the family. We improve their immediate quality of life by treating them with dignity. We’re also encouraging them to commit to their chosen course of action.
The reality is that we can only control our own actions. We have to learn to give the people around us responsibility for decisions that only they can make. It’s ultimately up to them to decide on their goals and strategies. You can encourage your family members, but you must let go of the feeling that you have to solve their problems for them.
Remember, an illness is influencing your family member’s behaviour
Even when we know someone has a mental health condition, it can be hard to recognise his or her efforts to be well. Sometimes we wonder if a family member is ‘trying to be difficult’. We may find ourselves looking for something to blame: should we blame our family member or the mental health condition itself. In general, we should try to give family the benefit of the doubt. Remember that no-one chooses to experience these symptoms.
Things you can do to be supportive
One of the most important ways to support a family member is to maintain our own mental health. The healthier we are, the more energy we have for problem solving and offering encouragement. We can then offer practical support, such as the following:
Learn as much as possible about mental health and your family member’s condition. Knowledge gives you practical insight and understanding. Learn about available treatments. What therapies and medications can help? Do people with this condition typically spend time in residential treatment? What options are available for supportive housing or employment?
Show interest in your family member’s treatment plan. Doctors and other medical providers cannot talk to family members without a patient’s permission, so ask your family member to arrange this permission. Talk to the medical team about what to expect from the treatment plan. In particular, ask about possible side effects of medication. Find out how to call the provider if you notice behavioural or emotional changes you’re concerned about.
Encourage your family member to follow the treatment plan. This might mean offering transportation to therapy sessions or reminders to take medications as prescribed. Because daily prodding about medication can easily insult or anger an adult, handle this carefully. Talk to your family member about his or her preferences. Try to set up a simple system to reassure you that treatment is continuing as planned.
Strive for an atmosphere of cooperation within the family. Cooperation means not just offering support. It also means communicating with everyone in the family and distributing responsibility equally. Don’t try to ‘spare’ family members from stress by leaving the caretaking to one individual. Assign everyone in the household roles to play according to their abilities. Include your family member with the illness as well, making his or her responsibilities to the family clear.
Listen carefully. Simply listening is one of the best ways to show your support. If your family member says hurtful things, it helps to listen for the emotion behind the words rather than focusing on the words themselves. Try to recognise and acknowledge the pain, anxiety or confusion rather than getting into unnecessary arguments.
Resume ‘normal’ activities and routines. Don’t let life revolve around your family member’s mental health condition. Return to a regular routine within the family. Spend time together on activities unconnected to illness, such as watching a movie, eating dinner out or visiting a favorite park. Practice living life with a mental health condition, rather than struggling against mental illness.
Don’t push too hard. At the same time, remember that it takes time to heal from an acute episode. Allow your family member to rest. Offer him or her opportunities to ease back into routine activities rather than requiring participation. A gentle approach encourages recuperation.
Find support. Outside support and encouragement is critical for everyone in the family, not only the person with the mental health condition. Whatever your role in the family, stress is easier to handle when you regularly talk to people who understand your experience. Peer-led support groups are available for people living with mental illnesses and also for their family members.
Express your support out loud. Spoken encouragement can reduce stress levels. You don’t need to say anything fancy. Practice a few simple, gentle statements: ‘I’m sorry you feel bad and I want to help’; ‘It isn’t your fault. It’s an illness that can happen to anyone’; “Hang in there because you’ll feel better down the road”.
Keep yourself and your family member safe. If there’s a risk of violence, make safety a priority. Regarding physical or verbal abuse, set limits that you can keep. For instance, state that you will leave and call the police if your family member becomes physically violent. Discussing your plans for these situations ahead of time can make them more manageable.
Prepare a crisis plan that includes important phone numbers such as the local crisis intervention team. Include your family member in the planning of this document. Make everyone in the family aware of what they should do in case of an emergency.
Don’t give up. A person with a mental health condition benefits enormously from having social support. Remind your family member that you’re there to help and you’re not giving up. When setbacks occur with one treatment strategy, look for alternative strategies. Try something new, and encourage your family member not to give up.
A good life is possible.
See more resources at the National Alliance on Mental Illness