Sunday, January 2, 2011

It Takes a Competent Village

The greatest blessing of 2010 was the end of my son's association with the overworked, exasperated (and exasperating) staff at a large community mental health center. He was finally able to transfer to a smaller, more effective center. Instead of a revolving door of case managers with wide variations in competence, he now has a case manager that I trust. That alone is a small miracle these days.

It takes a team to treat mental illness. The Canadian Psychiatic Association has this excellent article on who should do what in your Treatment and Support Team. Different health care system, though, so good luck trying to get all that support in the U.S. 

Our role as caregivers is to find the right people to be part of team (and then to pray that they don't change jobs every six months, which has been about our average.) Family members and good friends are also expected to:
  1. Pay when needed.
  2. Help the loved one keep appointments.
  3. Monitor medication.
  4. Provide information to the health care team that the loved one may not provide. The doctors may not be able to talk to you, unless you get a release, but you can always talk to them. Informing them about changes in behavior and medication compliance is essential for smart medical decisions. 
How you behave is also important. You are likely to get more help if you are pleasant and realistic. So be nice, be honest and be respectful of the team member's time.  Even more important, be informed. If you understand the illness and the system, what is and is not possible for the case manager, etc., to do, you'll be a better advocate.


Finally, family members  and good friends provide love that is unconditional and, if you can manage it, nonpossessive. This is tough for moms, as my repeated failures have proven. The rest of the planet will view your adult child with mental illness as an adult. You, as mom, will see him as your sick child, and it's a struggle to stop the mama bear within. Not only do you want to lash out at anyone standing between your child and proper care, you also want God to abandon the principle of free will just this once so you can manage your child's life yourself.


Nonpossessive love means accepting, respecting and supporting another person in a noncontrolling, nonpatronizing way. It means listening, even when things don't make perfect sense.  It means learning to communicate better. Above all, it means avoiding criticizing, diagnosing, advising and moralizing. It also means that you don't allow anyone to name-call, order, threaten or discount your child's problem.

Being part of the team does give you something to do if you are more of a Human Doing than a Human Being. But it's not easy.

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