Family Influence in Recovery from Severe Mental Illness

Abstract

The aim of this study was to investigate the perceived influence of family on recovery from severe mental illness. 54 semi-structured interviews were conducted with a diverse sample of people with severe mental illness living in Montreal. Results indicated that family both facilitated and impeded recovery processes. Specifically, family facilitated recovery through providing (a) moral support, (b) practical support and (c) motivation to recover. However family impeded recovery through (a) acting as a stressor, (b) displaying stigma and lack of understanding, and (c) forcing hospitalization. The study indicates the importance of family psychoeducation in promoting recovery.

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References

  1. Adeponle, A. B., Thombs, B. D., Adelekan, M. L., & Kirmayer, L. (2009). Family participation in treatment, post-discharge appointment and medication adherence at a Nigerian psychiatric hospital. British Journal of Psychiatry, 194, 86–87. doi:10.1192/bjp.bp.108.052217.

    Article  PubMed  Google Scholar 

  2. ASMFMH. (2014). About Les Amis de la Santé Mentale. Retrieved from http://www.asmfmh.org/?page_id=506. Accessed on January 28, 2014.

  3. Bateson, G., Jackson, D. D., Haley, J., & Weakland, J. (1956). Toward a theory of schizophrenia. Behavioral Science, 1(4), 251–254.

    Article  Google Scholar 

  4. Becker, D. R., & Drake, R. E. (2003). A working life for people with severe mental illness. Oxford: Oxford University Press.

    Google Scholar 

  5. Bradshaw, W., Armour, M. P., & Roseborough, D. (2007). Finding a place in the world: The experience of recovery from severe mental illness. Qualitative Social Work, 6, 27–47.

    Article  Google Scholar 

  6. Bresnahan, M. (2003). Geographical variation in incidence, course, and outcome of schizophrenia: A comparison of developing and developed countries. In R. Murray, P. Jones, E. Susser, J. Os, M. Cannon, et al. (Eds.), The epidemiology of schizophrenia. Cambridge: Cambridge University Press.

    Google Scholar 

  7. Burland, J. (1998). Family-to-family: A trauma and recovery model of family education. New Directions for Mental Health Services, 77, 33–41.

  8. Callard, F., Rose, D., Hanif, E. L., Quigley, J., Greenwood, K., & Wykes, T. (2012). Holding blame at bay? ′Gene talk′ in family members’ accounts of schizophrenia aetiology. BioSocieties, 7, 273–293.

  9. Cohen, A. N., Drapalski, A. L., Glynn, S. M., Medoff, D., Fang, L. J., & Dixon, L. B. (2013). Preferences for family involvement in care among consumers with serious mental illness. Psychiatric Services, 64(3), 257–263.

    Article  PubMed  Google Scholar 

  10. Docherty, N. M., St-Hilaire, A., Aakre, J. M., Seghers, J. P., McCleery, A., & Divilbiss, M. (2011). Anxiety interacts with expressed emotion criticism in the prediction of psychotic symptom exacerbation. Schizophrenia Bulletin, 37(3), 611–618.

    Article  PubMed Central  PubMed  Google Scholar 

  11. EnglandKennedy, E. S., & Horton, S. (2011). “Everything that I thought that they would be, they weren’t:” Family systems as support and impediment to recovery. Social Science and Medicine, 73, 1222–1229.

    Article  PubMed  Google Scholar 

  12. Gehart, D. R. (2012). The mental health recovery movement and family therapy, part II: A collaborative, appreciative approach for supporting mental health recovery. Journal of Marital & Family Therapy, 38(3), 443–457.

    Article  Google Scholar 

  13. Glynn, S. M., Cohen, A. N., Dixon, L. B., & Niv, N. (2006). The potential impact of the recovery movement on family interventions for schizophrenia: Opportunities and obstacles. Schizophrenia Bulletin, 32(3), 451–463.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Guarnaccia, P. J. (1998). Multicultural experiences of family caregiving: A study of African American, European American, and Hispanic American families. In H. Lefley (Ed.), Families Coping with Mental Illness: The cultural context. San Francisco: Jossey-Bass Publishers.

  15. Guarnaccia, P. J., & Parra, P. (1996). Ethnicity, social status, and families’ experiences of caring for a mentally ill family member. Community Mental Health Journal, 32, 243–260.

    Article  CAS  PubMed  Google Scholar 

  16. Harrington, A. (2012). The art of medicine, the fall of the schizophrenogenic mother. The Lancet, 379, 1292–1293.

    Article  Google Scholar 

  17. Hirsch, R., & Leff, J. P. (1975). Abnormalities in the parents of schizophrenics: A review of the literature and an investigation of communication defects and deviances. New York: Oxford University Press.

    Google Scholar 

  18. Jenkins, J. H. (1991). Anthropology, expressed emotion, and schizophrenia. Ethos, 19, 387–431.

  19. Laing, R. D. (1967). The Politics of Experience. Harmondsworth: Penguin.

  20. Leff, J. (2013). Expressed emotion in 100 words. The British Journal of Psychiatry, 202, 335.

    Article  Google Scholar 

  21. Lefley, H. P. (1997). The consumer recovery vision: Will it alleviate family burden? American Journal of Orthopsychiatry, 67(2), 210–219.

    Article  CAS  PubMed  Google Scholar 

  22. Lincoln, T. M., Wilhelm, K., & Nestoriuc, Y. (2007). Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence, and functioning in psychotic disorders: A meta-analysis. Schizophrenia Research, 96, 232–245.

    Article  CAS  PubMed  Google Scholar 

  23. Lucksted, A., Mcfarlane, W., Downing, D., Dixon, L., & Adams, C. (2012). Recent developments in family psychoeducation as an evidence-based practice. Journal of Marital and Family Therapy, 38(1), 101–121.

    Article  PubMed  Google Scholar 

  24. Luhrmann, T. M. (2007). Social defeat and the culture of chronicity: Or, why schizophrenia does so well over there and so badly here. Culture, Medicine and Psychiatry, 31, 135–172.

    Article  CAS  PubMed  Google Scholar 

  25. Maxwell, J. A. (2005). Qualitative research design: An interactive approach. New York: Sage.

    Google Scholar 

  26. McFarlane, W. R., Dixon, L., Lukens, E., & Lucksted, A. (2003). Family psychoeducation and schizophrenia: A review of the literature. Journal of Marital and Family Therapy, 29(2), 223–245.

    Article  PubMed  Google Scholar 

  27. Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada. Calgary, AB: National Library of Canada. Retrieved December 4, 2014 from http://strategy.mentalhealthcommission.ca/pdf/strategy-text-en.pdf.

  28. Neill, J. (1990). Whatever became of the schizophrenogenic mother? American Journal of Psychotherapy, 44(4), 499–505.

    CAS  PubMed  Google Scholar 

  29. Padgett, D. K. (2007). There’s no place like (a) home: Ontological security among persons with serious mental illness in the United States. Social Science and Medicine, 64(9), 1925–1936.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Padgett, D. K., Henwood, B., Abrams, C., & Drake, R. E. (2008). Social relationships among persons who have experienced serious mental illness, substance abuse, and homelessness: Implications for recovery. American Journal of Orthopsychiatry, 78(3), 333–339.

    Article  PubMed  Google Scholar 

  31. Pernice-Duca, F. (2010). Family network support and mental health recovery. Journal of Marital and Family Therapy, 36(1), 13–257.

    Article  PubMed  Google Scholar 

  32. Pharoah, F., Mari, J. J., Rathbone, J., Wong, W. (2010). Family intervention for schizophrenia. Cochrane Database of Systematic Reviews, 12, CD000088. doi:10.1002/14651858.CD000088.pub3.

  33. Schon, U., Denhov, A., & Topor, A. (2009). Social relationships as a decisive factor in recovering from severe mental illness. International Journal of Social Psychiatry, 55(4), 336–347.

    Article  PubMed  Google Scholar 

  34. Topor, A., Borg, M., Di Girolamo, S., & Davidson, L. (2011). Not just an individual journey: Social aspects of recovery. International Journal of Social Psychiatry, 57(1), 90–99.

    Article  CAS  PubMed  Google Scholar 

  35. Ware, N. C., Hopper, K., Tugenberg, T., Dickey, B., & Fisher, D. (2007). Connectedness and citizenship: Redefining social integration. Psychiatric Services, 58(4), 469–474.

    Article  PubMed  Google Scholar 

  36. Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20, 633–666.

    Article  CAS  PubMed  Google Scholar 

  37. Whitley, R., & Drake, R. (2010). Recovery: A dimensional approach. Psychiatric Services, 61, 1248–1250.

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Acknowledgments

We would like to express appreciation to the clinicians and consumers whose participation made this study possible. We also gratefully acknowledge Marie-Eve Boucher, Anna Miller, and Aldric Reid for their work as research assistants on this project. We would like to thank the Canadian Institutes of Health Research who funded this research through an Open Operating Grant (231520).

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Correspondence to Heather Michelle Aldersey.

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Aldersey, H.M., Whitley, R. Family Influence in Recovery from Severe Mental Illness. Community Ment Health J 51, 467–476 (2015). https://doi.org/10.1007/s10597-014-9783-y

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Keywords

  • Recovery
  • Family
  • Severe mental illness
  • Canada
  • Quebec