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Managing Mental Health Successfully Means CHANGE. I'm Looking At You, Family Members. (Pt. 1)

You're shuffled into a room in a hospital. A doctor spends all of a few minutes talking with you before telling you that you're sick, and he wants you to take a pill. Or, let's take it a bit further--he wants you to be injected with what he calls a medicine that will "make you feel better."

"But I'm not sick, I feel fine," you think, alarmed at the idea of having a substance injected into your veins of which you know little-to-nothing and about which said doctor is not eager to share much. You're told if you take the injection, it means you can leave the hospital faster. If you refuse, it may mean that you stay longer. And you don't get to leave whenever you want; this doctor decides whether you leave at all. During this entire exchange you think, why is he telling me I'm sick and why do I need this mystery drug? What is it supposed to do?

You relent in the face of essentially having your liberty restrained and agree to the injection. Within a day you feel groggy, cloudy, incredibly sleepy, as though there is a blanket on your brain. You do not feel "better," though it appears you are able to communicate more effectively with a social worker who comes by to see you two days later. You are still not free to leave this hospital, and you've seen a doctor all of three times for about three minutes a piece. In a hallway.

Scary, huh? The emotions that come to my mind are alarm, fear, confusion, even terror at the idea of not being able to leave a place I was supposedly taken to for help I didn't ask for. Yet, this is a story I have heard hundreds of times over from clients and others who have been admitted to psychiatric hospitals, both State-run and, even more commonly, privately-run behavioral health facilities. These crisis-stabilization units, or CSUs as they are known in Georgia, function in this way almost every time. And after the course of a week, these individuals are almost always discharged regardless of any potential insight they may, or may not, have gained. It is a classic proverbial revolving door. (And, it's incidentally massively profitable to the private "healthcare" companies who run them, but that's a soap-box for another day.)

I speak often about the need of family support for those wrestling with mental health challenges to be able to empathize with their loved one if they ever expect change. Inherent to this idea is the fact that we, as support, must CHANGE OUR OWN PARADIGMS when it comes to these challenges, or what mainstream psychiatry would label "mental illness." For me, it is the critical linchpin to success; without it, you are simply spinning your wheels.

Why? For one, your loved one with mental health challenges is most certainly, in my experience, far more intelligent than you. Specifically, far more intuitive. This is a commonality that I have simply accepted as fact, though I recognize it is disputed in the psychiatric community. But, over the course of almost 20 years and somewhere in the realm of 1500 clients with mental illness, I can say I hardly ever speak to family who don't, within five minutes of starting the conversation, tell me how amazingly smart their kid/sibling/parent is. It's just truth, and it means that they will likely know where you're going with your conversation before you even get it off the ground. If they can't see that you can relate, in any way, with what it's like to be hospitalized against your will, or to take psychotropic medications, then THEY WILL TUNE YOU OUT. Period.

Yet, we as support are the front lines for encouraging our loved ones to engage in a treatment protocol with professionals. So, why don't we take our roles more seriously and recognize that we, in many cases, don't know what we're doing and don't have a plan to implement? Worse, most of our "plan" is to be reactive, and panicky reactive at that.

This series of blog posts will focus on what I see as the greatest obstacle to success in mental health management: the inability to, refusal to, and/or the outright, indignant hostility towards change by family support for those with mental health challenges. Far more exhausting than working with my clients is the process of planting and cultivating this seed in the minds of those families who hire me to represent their loved ones. But, where I see the most growth is where family embraces their need to change their views on mental illness, change their lexicon, and educate themselves as to what their loved ones are experiencing. And I hope this series will help you understand why it is so critical.

Part 2 will focus on the ever-ubiquitous question on the lips of every family member who has ever entered my office: "Why won't he just take his medicines?"

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