Saturday, July 30, 2011

Planning for the Future With Mental Illness in the Family

Note: This is a guest post from my husband. 

Chaos and unpredictability are not new to the human experience.  In the Old Testament, God's people experienced a series of battles, famines, enslavements and other seemingly insurmountable circumstances.  In each story God came through for his people but only after they had suffered and nearly lost hope.  In the modern world we need look no further than the evening news to see chaos of all forms reported in detail.  Here in modern America we usually have problems of lesser scope than the Old Testament or the Third World. Our typical problems are still substantial enough however to make us lose sleep.  Possibilities of unemployment, under performing 401k retirement plans, health concerns and on and on occupy the minds of a typical family.

Then we take up the case of the family with a mentally ill member or two. Those special family members are more prone than the general population to volatility in their employment, their relationships and their overall health. They often lack motivation or insights sufficient to succeed at the more challenging tasks of adult life.  Mistakes that some others would learn from and move on may be repeated time and time again.  Addiction and substance abuse challenge a high percentage of the mentally ill community.

So how should we as caregivers and stewards of our mentally ill family members manage without either  falling into despair, or, as some have done, over committing ourselves in unhealthy ways? I've found some success with three concepts:  Prayer, Stewardship, and Margin.  You may be thinking Hey wait a minute. This is a Christian blog. I expected to see words like prayer and stewardship but what is this margin business? Sounds like something from an MBA program.

Prayer and faith are staples of the Christian life. God loves you. He loves your mentally ill family member. And as hard as his plan may be to understand some days, we can all count on the fact that he is working things out for our well being in eternity.

Stewardship sounds simple enough.  None of us wants our family member living under a bridge or on the street regardless of what he or she may have done or not done.  Most of us will go to great lengths to see that our mentally ill family member has as good a life as possible.

This is where the margin concept becomes important.  As caregivers, it can be tempting to make bold and generous commitments of our time and resources toset things rightfor our family member.  Where this is likely to fall apart is when all the time and resources have been committed only to have a new problem crop up.  I propose that as responsible caregivers we need to hold in reserve some time and some resources as margin against the next unforeseen event.  Remember I started this article with commentary on chaos and unpredictability and the propensity of our family members to have more than the typical amount of both.

So what does margin look like where the rubber meets the road?  It may be more helpful to pose these ideas as a series of questions to consider since each family is different.

         Have you planned your family budget so you can cover a year or so of doctor and medication costs in the event your loved ones health insurance or government benefits are disrupted?

         For your loved ones transportation needs, would a basic cell phone and a bus or subway pass provide the basics for now?

         Would the use of your spare room or help with basic rent keep them safe without the risk or long-term commitment associated with buying a house or condo?

         Would a group session be sufficient or perhaps even more beneficial than one-on-one counseling?

         Would a couple of semesters at community college make a good low risk way to see how they can perform in a college environment?

         What community or support group resources may be available to my loved one in lieu of fee for service providers.

         Have you talked to an attorney about setting up a trust to ensure the resources you leave behind when you die are managed for your loved one's benefit and according to these same principles?

         What do you need to do to keep yourself well and strong so you are in good shape if your loved one has a crisis?

Remember the idea here is not to be as cheap as possible but rather to provide stewardship of basic needs while retaining some margin in the time and resource budget to account for changing circumstances. If it sounds a little to you like a survival plan that is because it is a lot like a survival plan.  One for you and your loved one.

Prayer, stewardship, and margin. Please let us know if you have ideas or examples of creative ways to cover you loved ones basic needs while still holding a little in reserve for thatrainy day.

Sunday, July 24, 2011

17 Tips for Navigating the Mental Health System

Navigating the mental health system can be very tricky business. Some of the 17 tips below come from a document that Neal Edgar, Franklin County's mental health ombudsman, prepared for the NAMI Family-to-Family class, and others are just hard-won wisdom.

  1. Know the system as best you can.
    1. Get a resource directory.
    2. Go to meetings and get involved. 
    3. Get to know a social worker in the system.
  1. Get support from others in the same situation.
  1. Lower your expectations, and kick up your prayer life.
  1. Get the facts right and learn the language so people will listen to you.
  1. Know who to contact: case manager, team leader, Client Rights Officer, clinical director.
  1. Make friends with advocacy people.
  1. Be assertive, but polite and positive/empathetic/appreciative. Try not to be negative, threatening or critical.
  1. Get an agreement on a timeline.
  1. Document your contacts and your conversations.
  1. Make copies of everything you mail.
  1. Try to get a Release of Information signed.
  1. In a private hospital, the primary therapist (usually a psychiatric nurse) knows the most. In a public hospital, talk to the social worker assigned to the ward. Get an appointment at his or her convenience. The earlier, the better. Make it short.
  1. Ask for practical information about what to do when the patient is at home.
  1. Write letters of appreciation.
  1. Call and provide information, even if the worker can’t tell you about your loved one.
  1. Keep your loved one involved and informed as much as possible.
  1. Prioritize your relationship with God, your own health and the overall family’s welfare.

Friday, July 15, 2011

Shame on US: Veterans and Mental Health

Item: More than 202,000 veterans returning from Iraq and Afghanistan were seen for potential Post-Traumatic Stress Disorder at Veterans Administration facilities between January and March 2011, an increase of 10,000 over those seen in the last quarter of 2010.

Item: Veterans diagnosed with PTSD and other mental health issues face long waits for treatment that leave them at risk for suicide, according to testimony at a Senate hearing Thursday and new reports from the Department of Veterans Affairs Inspector General.

Item: PTSD and traumatic brain injury are the signature wounds among soldiers returning from combat in Iraq and Afghanistan. An estimated 1 out of 5 veterans who have served in those wars have one or the other.

Item: Suicide has claimed as about many lives of active-duty service members as the enemy has in recent years.

Item: President Obama has decided to send condolence letters to the families of active-duty service members who commit suicide in combat zones, reversing a long-standing practice of ignoring military suicide survivors.

All this was in today's Virginian-Pilot, the fine newspaper that chronicles life around the naval base in Norfolk. It also reported that two Navy ships that cost $300 million and were never used will be going to a scrap heap.  Maybe we should have spent that money on mental health care for our soldiers who were used.  Used in more ways than one.

Sunday, July 3, 2011

Loving Someone With Mental Illness

My son's case manager calls them "your Earth friends."  They are the people you know and love who do not have a mentally ill family member. They can sympathize. They can listen. But they really can't understand, no matter how hard they try.

Here are some things you have to live to understand:

1. Removing your child from yet another activity because other parents are complaining.

2. The sound of the psych ward door locking behind you during visiting hours.

3. Getting a slip of paper without comment that contains a diagnosis that changes your life forever.

4. Waiting with dread to hear from MIA adult children with mental illness .. and the instant relief when you discover that they are cursing out someone online. So they are alive!

5. What a really bad day is ... and what it is not.

That's why it's so important to find companions who have been there. I have had the good fortune of meeting many fine people at Families in Touch, the Mental Health America group, as well as our Support and Recovery Group, Loving Someone With Mental Illness, at Vineyard Columbus.  Laughing together at jokes that everyone else would find in poor taste is such a great stress reliever.

I co-founded Loving Someone With Mental Illness because I wanted the opportunity to pray with others about our mentally ill loved ones. For me, the best way to live faithfully in a secular work as a radical Christian is to belong to a small group of spiritual companions. Our group is there to allow us to share each other's burdens and point each other to Jesus in good times and bad. Loving Someone With Mental Illness meets on the first and third Thursdays at 7 p.m. at Vineyard Columbus' main campus on Cooper Road, Westerville.

Don't go through the pain of caregiving for a mentally ill person alone. Having someone other than your "Earth friends" to help you is truly a godsend.