Mental Health First Aid Australia Caregiverswww.mhfa.com.au of people with mental illness A GUIDE FOR Caregivers of people with mental illness Mental illness can affect not only the life of the person with the illness, but also their close family, partners and friends. Significant people in a person’s life are often a source of support with the illness. However, family, partners and friends may be faced with a loved one’s mental illness without much information on ways to deal with it and its impact on their life. If you are a family member, partner or The information and suggestions in disorder, the more specific guidelines friend who is 18 years or over and a this guide resulted from a study that may be more appropriate for you. primary source of support for a person combined the latest research with the www.bipolarcaregivers.org with mental illness, this guide was opinions and consensus of international Not all of the information or suggestions designed for you. It involves information panels of caregivers, people with bipolar may be relevant to you. Mental illness and suggestions about how you can disorder, clinicians and researchers, all comes in many different forms. Caregiving help a person with mental illness who with experience and expertise in dealing experiences differ as well. Finding what is 18 years or over (there are additional with bipolar disorder. (Berk L, et al. works for you to deal with your situation considerations when caring for children Development of guidelines for caregivers can be a trial and error process. and adolescents) and ways to cope with of people with bipolar disorder: a the personal impact of the illness and to Delphi expert consensus study. Bipolar take care of yourself. The information in Disorders 2011; 13: 556 - 70). The this guide is most suitable for people who guidelines resulting from this study were are caring for someone who has a mental analysed and the most general advice illness which is severe, chronic, treatment was used to create this general guide. If resistant or very recurrent. you are supporting a person with bipolar This guide is NOT a replacement for medical advice and we strongly recommend that you or the person you care for discuss issues related to treatment with a clinician. Although this guide is copyright, you can freely reproduce it for non-profit purposes provided the text remains intact and the source is acknowledged. Enquiries should be sent to Claire Kelly at [email protected] 1407_KJ Caregivers of people with mental illness Mental Health First Aid Australia www.mhfa.com.au 1: Know the illness 2: Treatment and 2.3. Complementary and alternative therapies and self- In order to be an effective caregiver for management help strategies a person with a mental illness it helps to 2.1. Medication be properly informed about the person’s There are a small number of mental illness. This includes knowledge Not everyone with a mental illness complementary, alternative and self-help about the symptoms, prevalence, risk requires medication, but for some, it will strategies which have demonstrated factors and treatment options. become an important part of keeping effectiveness in treating mental illnesses. well. Taking ongoing medication (even Different therapies have been shown to Sources of information can include when the person is well) can help to be effective for different illnesses. Consult talking to the clinician, reading good- prevent relapse, reduce hospitalisations reputable sources for information, such quality, reputable websites and books. and suicide risk if the illness is episodic as the beyondblue “What Works” books You can also learn a lot from memoirs and severe. Specific psychological (see link in chapter 1). written by people with mental illness treatments, illness self-management and their caregivers, but it’s important strategies and good support from Most therapies, such as self-help books to remember that those stories are very caregivers and clinicians can also help based on cognitive behaviour therapy, personal and individual, and may not people to keep well and enjoy life. have been shown to be most effective reflect your experience with caregiving. when guided by a clinician. Others, It is useful to learn what you can about such as exercise and massage therapy, These guidelines can’t give you all the medications. For example, while some may enhance a person’s response to information you need about mental medications begin to work quickly, treatment and improve mood symptoms. illnesses, but we recommend the others take days or weeks to be effective. following websites. Medications can have side effects. Some Many herbal supplements, naturopathic and homeopathic therapies exist which Depression: of these go away when the person gets used to taking the medication, or have never been evaluated for safety www.beyondblue.com.au or effectiveness. These should not be www.bluepages.anu.edu.au/ respond to a change in dose, but others are more serious and the person may used without consulting with a clinician Anxiety disorders: need to change medications with the and should never be used to replace www.crufad.com advice of their clinician if this happens. effective medications. If you are not sure www.ecentreclinic.org whether a complementary or alternative For more information about medications, treatment is safe or effective, seek and Schizophrenia: and what may happen if the person follow the advice of your clinician. www.sane.org tries to stop taking medication without 2.4. Reducing triggers of illness Bipolar disorder: advice, see section 4.1. and making lifestyle adjustments www.blackdoginstitute.org.au 2.2. Psychological treatment ‘Triggers’ are ‘stressors’ that increase Eating disorders: Psychological treatments can be effective the risk that the person will develop www.thebutterflyfoundation.org.au alone in managing mild to moderate symptoms. Recognising a trigger Substance use disorders: mental illnesses, but are generally not provides the opportunity for the person www.adf.org.au sufficient to treat a severe or complex to put supports in place to avoid illness. condition. This is particularly true in the case of psychotic disorders, where Common triggers include stressful life events, both positive (e.g. the birth of a For additional information about these medication is required to treat the positive symptoms. baby or a work promotion) and negative mental disorders, and many other, see ones (such as ending a relationship or the National Institutes on Mental Health The main psychological treatments losing a job), conflicts and interpersonal website: www.nimh.nih.gov that have shown benefit are cognitive stress, and the use of alcohol and other behaviour therapy, interpersonal therapy drugs. and family therapies. Many other psychological treatments are available To keep well the person may need to and may be of benefit depending on the make some adjustments to their lifestyle individual concerned and the needs of and goals. The extent of this adjustment the family and other caregivers. can differ from person to person. It usually takes time for the person to make these changes and work out how to live well with the illness. 2 Caregivers of people with mental illness Mental Health First Aid Australia www.mhfa.com.au 2.5. Developing a good support 3: Supporting the person person is severely ill or there is a risk system when they are ill to their wellbeing or that of others, they need emergency assistance (see ‘Dealing Many people with mental illness Caregivers differ in how much and what with a crisis’ section 3.2). Encourage the recommend developing good support type of support they provide (e.g. some person to focus on getting well as their networks. These networks usually help only when there is an emergency, primary goal. include family members and friends for while others also assist the person to companionship and to help with the try to prevent relapse). The type and Helping to monitor the illness illness when necessary. A clinician with severity of the illness will influence what Keep in contact with the person and whom the person has a good relationship support the person needs. There are observe, listen and tactfully enquire is essential. The support system may also lots of things you can do to help, but about how they are. In this way you can include more distant acquaintances you need to work out what suits you, assist with monitoring the symptoms to such as a neighbour (for example to pick the person and your caregiving situation see if they are becoming worse. children up from school or collect mail (see ‘Considering how involved to be Helping if the person needs to go to when the person is in hospital) or work in helping the person with their illness’ hospital colleagues who are supportive. Peer section 7.1). Below are suggestions for support or mutual support groups can supporting the person in the different Some episodes are more severe than provide opportunities to communicate phases and severities of illness. The next others. While many people can be with like-minded people. chapter focuses on ways to help the treated at home, sometimes people with person prevent relapse and enjoy life. severe mental illness need to be treated in hospital for a short time. 3.1. Helping when an episode Hospitalisation may be recommended if: occurs • There is a crisis, such as the person There are helpful ways to communicate is severely ill and their functioning is with the person and support them when very impaired or they are in danger an episode occurs. of doing something with damaging or Communicating calmly life threatening consequences (see Recognising a When the person is ill, it is best not to ‘Dealing with a crisis’ section 3.3).