Seventeen well siblings of chronically mentally ill (CMI) individuals were studied to examine effects associated with having a CMI sibling and factors associated with variations in effects. The respondents were largely better-educated, white, middle class, and age 21 years or older, recruited through a local family support group, and an acute care mental health facility. A self-report questionnaire was developed for use in this study utilizing a Likert scale for standardization. Areas of focus were self-esteem, relationships, and emotional and financial burden. All areas except self-esteem showed some negative effects. The main concerns identified were a "Don't Talk" attitude about mental illness, active mourning, fear of having a CMI offspring, and future financial responsibility. Differences in effects were observed between groups by gender, birth-order, likeness (same sex/opposite sex), and proximity. Diagnosis and level of functioning also appeared to be associated with variations in effects.

This study examined the problem of the lack of understanding of the family's reaction to the psychiatric hospitalization of a family member. A review of the literature indicated that little has been done to increase our knowledge of the family's perception of this event in their lives. It further indicated that these families have needs and concerns resulting from the experience of the psychiatric illness and hospitalization. These needs and concerns were not being addressed by health care workers. This qualitative study utilized the phenomenological approach. Data were obtained from seven families of patients admitted to a psychiatric hospital for the first time. Two unstructured interviews were conducted with each family during the course of the patient's hospitalization. The content of the interviews included discussion of all aspects of the hospitalization with the families directing the emphasis toward the aspects that were important to them. The data were analysed using the method of constant comparative analysis. Major categories were developed which reflected the meaning of the hospitalization experience for the families. The categories included acknowledging the hospital as a solution to the problem, reframing past events to make sense of the present, assimilating the experience into their every-day lives, and questioning the future in relation to the present experience of the illness and the hospitalization. The themes were not found to be discrete, sequential activities but were described as inter-dependent and circular in nature. The data were discussed in relation to the literature reviewed, with comparisons being drawn between those previous studies and the current one. The implications for nursing practice, education, and research were discussed. / Applied Science, Faculty of / Nursing, School of / Graduate

published_or_final_version / Social Work / Master / Master of Social Sciences

published_or_final_version / Social Work / Master / Master of Social Work

Families are now often the primary caretakers of severely psychiatrically disabled relatives, also referred to as the chronically mentally ill (CMI). As a result, families report experiencing stressors such as a lack of psychosocial resources, disturbance in family routine, and increased financial problems--in addition to feelings of guilt and embarrassment. Research has indicated that the families need education, support, and training in coping skills. La Frontera Center, Inc. (LFC), a comprehensive community mental health agency in Tucson, Arizona, provided both education and support to families of the severely psychiatrically disabled. The education essentially involved providing families with knowledge regarding schizophrenia; support was available through a task-oriented self-help group. The purpose of the present research was to develop a complementary coping skills training program, and investigate its effectiveness. The research was conducted through two separate studies. The first study compared subjects who received the skills training, and education, with subjects who received education only. The second study utilized members from the LFC support/advocacy group who had previously attended the education class. One-half of these subjects received the skills training, while continuing involvement with the support group, and were compared to subjects who were involved with support only. In each study, subjects were randomly assigned to either the treatment or comparison group. Both designs involved repeated measures, with data analyzed according to an analysis of covariance statistical procedure. Though the hypotheses were not supported statistically in the first study, a number of results were statistically significant in the second study, and did support the hypotheses, including treatment subjects experiencing decreased anxiety, decreased depression, decreased conflict within the family, and increased social functioning and use of community resources.

The purpose of this study was to assess the special needs of the families of hospitalized mental patients. The study focused upon the time prior to and including the decision to hospitalize a mentally ill family member. Particularly, the researchers wished to examine the stresses that the family encountered in attempting to deal with a disturbed member as well as their concerns regarding psychiatric hospitalization and the effect which it had upon the family.

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There is growing evidence of the important role that family members play in the support and recovery of individuals diagnosed with a serious mental illness. The National Alliance for the Mentally Ill (NAMI) Provider Education Program (PEP) trains providers of mental health services to work collaboratively with families in the treatment of individuals with a mental illness. This study examines the effect of the NAMI-PEP on Assertive Community Treatment (ACT) provider representations of and services provided to families at Frontenac Community Mental Health Services. Qualitative and quantitative methods of research are combined to explore ACT provider beliefs about, feelings toward and services provided to families before and after participating the NAMI-PEP. Findings suggest that the NAMI-PEP is effective in initiating changes in provider representations of family at a cognitive level. Changes in provider views are detected indicating movement toward a strengths-based orientation and an improved understanding of the components of collaborative practice with families. Analysis of changes to ACT practice patterns illuminates the challenges of implementing cultural change at an organizational level and identifies a fertile area for further research.

Disruptive behaviour disorders (DBDs) in children are among the most common referrals to mental health services and can lead to adverse psychosocial outcomes. There is consistent evidence that dysfunctional parenting, which has been associated with parental psychopathology, is a risk factor for the onset of these disorders. Yet, few studies have explored a wide range of parental pathology and parenting behaviours as well as perceptions of mental health and parenting of the parents of children with DBDs. This study, which took the form of a multiple case study, aimed to explore and describe the mental health and parenting of parents of pre-adolescent and adolescent children with DBDs. It also aimed to explore and describe parental perceptions of their own mental health and parenting and how (or if) they perceive their mental health as influencing their parenting. Purposive sampling was used to select participants and the sample size was determined through data saturation. Data was collected via the Millon Clinical Multiaxial Inventory and a semi-structured interview. Thematic content analysis and cross-case synthesis were used to analyse the data. The participants’ personality profiles indicated the presence of moderate to severe pathology including personality disorders and clinical disorders. Parenting themes that emerged included a number of dysfunctional parenting behaviours. The parents showed an awareness of their mental health and perceived it as influencing their parenting. This study emphasised the importance of exploring mental health and parenting interventions for parents of children with DBDs. The biggest limitations of this study was the small sample size.