Special Concerns for Families



Families often feel guilty and frustrated when a family member is ill and are concerned that the illness may be the result of something they said or did. Parents may feel that they passed on a defective gene to their child. Although there is a general consensus that serious mental illness has a chemical or hereditary component, the truth is that not all individuals exposed to the same circumstances become ill. While identical twins have the same genetic makeup, there is only one in four chances that both twins will become ill. Genetic inheritance is not the only cause of mental illness. Mental illness significantly alters a family’s relationship with each other and with the ill relative. It is important to remember that the best families can do is to be supportive and encourage their relatives to remain in treatment.


The very best way to keep your ill relative well is to see that he/she receives proper care and treatment. If on medication, it should be taken faithfully as prescribed. Your relative should visit his or her therapist or doctor as often as necessary and participate in activities during the day. It may be beneficial for individuals with mental illnesses to have a case manager who will advocate for them and help them with housing, finances, recreation, and other supports. Families should make themselves available to doctors, case managers, and therapists. Ask to be included in the development of treatment or discharge plans. Families may become involved in family therapy or join a support group. Here in Rochester, we have a local National Alliance on Mental Illness (NAMI) chapter.


Deciding whom to tell about a mental illness is a very sensitive and personal issue. Many ill people will not admit to being ill, therefore reinforcing the stigma attached to mental illness. Throughout our lives, one in five people is affected by mental illness in one form or another. It is unfortunate that people find it difficult to discuss mental illness the same way they do other illnesses.

Mental Health Professionals

More and more mental health professionals are recognizing the value of communicating with the family during the course of therapy. Of course, mental health professionals are bound by confidentiality laws regulating the disclosure of information about specific therapy sessions. Families are encouraged, however, to keep the lines of communication open and to ask about the general progress of therapy and the prognosis for the ill relative. Families can also offer therapists a unique perspective on the illness because of their close and ongoing relationship with the consumers. Consumers may sign a release form at any time during therapy, which will allow the therapist more freedom to discuss the therapy process with family members. Particularly when therapy is on an outpatient basis, and treatment teams cannot observe the client on a daily basis, the information provided by the family can significantly aid the progress of therapy. Most professionals welcome the opportunity to have input from the family.

Where to Live

Once the relative is recovered, the question of an appropriate residential setting may be raised. The answer depends on the needs of the relative as well as the needs of the family. Many consumers and families agree that living away from home is best. The consumer can live at a comfortable pace, and the family can resume their own way of life. Options include licensed community residences, single-room occupancy programs, supported and supportive housing, and apartments. In making the decision, both the family’s and consumers’ needs should be respected.


Family members and consumers share many of the same goals for access to treatment, appropriate residential settings, and a reduction in the guilt and stigma often associated with mental illness. Working together with mental health professionals, families, and consumers can advocate for more research dollars, improved access to treatment, and appropriate, available living arrangements. As each of these goals is accomplished, individuals with mental illness will truly represent a meaningful, important, and productive segment of our population.