Toward a family-oriented treatment approach for consumers and carers of mental illness

摘要

In 2010–2011, a qualitative focus group study was commissioned by Australia’s beyondblue to explore the needs and experiences of consumers and carers of mental illness. Overall, it was found that their ‘stories’ are substantially different from one another, leading to high stigma within families. The aim of this article is to discuss these phenomena more deeply. In summary, the pervasive stigma associated with mental illness in society affects: people from gaining in-depth knowledge about it and therefore capacity to recognize symptoms early and provide the necessary empathy required; the capacity of health professionals to provide holistic treatment and not simply rely on a ‘medical model’; and the provision of adequate funding to ensure the formal mental health system has appropriate infrastructure to meet consumers’ needs. Stigma essentially hides mental illness from the community, placing pressure on families to provide support instead who may lack the expert knowledge that clinical consumers require. The ongoing and stressful nature of caring can cause carers to develop stigmatic attitudes and behaviors. These are intensified with misperceptions about consumers’ control over their mental illness, unequal distributions of attention within the household, and low consumer insight into the carer experience. It can also lead to the development of their own trauma that requires formal help. To address these complex issues, stigma is the foremost issue in need of redress. It can help reduce barriers to help-seeking in both consumers and carers, and ensure the provision of an informed and well-resourced ‘mental health response’ for families.