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The Family Crisis Moment The Impact of Mental Illness on Families

PSRT 4271: The Family Role in Rehabilitation Week Four . The Family Crisis Moment The Impact of Mental Illness on Families. The Family Crisis Moment. What is a crisis? (Roberts, 2005). “…disruption of psychological homeostatis …” “…usual coping mechanisms fail…”

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The Family Crisis Moment The Impact of Mental Illness on Families

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  1. PSRT 4271: The Family Role in Rehabilitation Week Four The Family Crisis Moment The Impact of Mental Illness on Families

  2. The Family Crisis Moment

  3. What is a crisis? (Roberts, 2005) • “…disruption of psychological homeostatis…” • “…usual coping mechanisms fail…” • “…distress and functional impairment…”

  4. A perception… (Bard and Ellison, 1974) • “…subjective reaction…” • “…to stressful life experience…” • Functioning “…seriously compromised...”

  5. Characteristics of those in crisis • Threat • Incapacity • Fear • Discomfort • Disequilibrium

  6. Crisis Theory There is such a thing…

  7. Roberts’ Crisis Intervention Model(Roberts, 2000) 7. Follow up. 6. Make an action plan. 5. Explore alternatives. 4. Deal with feelings. 3. Identify major problems. 2. Establish rapport. 1. Assess lethality.

  8. How people react to disability (Powers & Dell Orto, 2004) 5 determinants: • Triggering events • Severity of disability • Personal influences • Contextual influences • Stigma; societal reactions

  9. Effects: 8 “themes”(Power & Dell Orto, 2004) • Denial • Grief • Guilt • Isolation • Anger • Depression • Coping • Acceptance

  10. Needs (Power & Dell Orto, 2004) • Meaning • Support • Validation • Information • Balance

  11. Ways of Coping

  12. Providers: How to help? (Clarke & Windsor, 2010) • Acknowledge; connect; engage • Offer coping mechanisms • Comprehensive involvement at discharge • Instill hope

  13. Impact on Families (The Raft of Medusa, by Theodore Gericault, 1791–1824)

  14. Mental Illess: Decision Elements • Medical • Cultural?... • Political?...

  15. Stages of “Emotion Management” (Karp & Tanarugsachock, 2000)

  16. Overall (Milliken & Northcott, 2003) • Disenfranchisement “When parents try to assume responsibility for an ill adult-child with schizophrenia, the law, mental health prac-titioners, and often the ill person reject their right to do so.”

  17. Mothers (Copeland & Heileman, 2011) • Feelings • Powerless, voiceless, anxious, frustrated, isolated, tired, desperate, trapped, guilty, worried, scared, sad, grief, confused • “Internal factors” • Sense of safety • Perception of care ability • Contingencies and consequences • Maternal love and obligations

  18. Fathers (Wiens & Daniluk, 2009) • Reflection on roles • Devastation and vulnerability • Sadness and loss • Frustration with the system • Admiration for the child • Personal growth and learning

  19. Siblings (Lukens, Thorning & Lorher, 2002) One step removed… • Reactions to illness • Strategies for coping • Whether, how to intervene? • Setting limits? • Resentment, anger, hopeless? • Efforts to obtain services • Wish for validation • Efforts to help themselves

  20. Grandparents (Seeman, 2009) What happens when ill child has children? • Custodial, co-resident, nonresident… • Child’s exposure to mother’s illness • Financial impact • Isolation • Role conflicts • Divided loyalties

  21. Redefining parental identity (Milliken & Northcott, 2003) “Anticipating” Parent Marginalization Disenfranchised parent “Embracing the collective” Re-enfranchised parent Evaluating my life Emancipated parent

  22. Our Presentation Topic… Bellevue Inside Out Trailer http://www.youtube.com/watch?v=Ojd_fsHbGl8

  23. Our guest presenter… Jim Romer, Monmouth County Crisis Screening Center > 30 years of experience. County Services Director for Monmouth Medical Center (Long Branch, NJ) Former Director of Screening Services for Ocean County at Kimball Medical Center in Lakewood, NJ President of the Mental Health Emergency Screening Association NJ Certified Screener No. 1 Monmouth Youth Council. Special interests: kids in crisis. youth suicide issues. Bachelors of Arts from Seton Hall University.

  24. Jim Romer • James Romer, Monmouth County Services Director, Monmouth Medical Center (Howell, Monmouth), Member, NJ SAFE Task Force • James Romer is a mental health professional with more than 30 years of experience. He currently serves as the Monmouth County Services Director for Monmouth Medical Center in Long Branch, New Jersey. He previously served for nearly 20 years as Director of Screening Services for Ocean County at Kimball Medical Center in Lakewood, between 1991 and 2009. Romer is President of the Mental Health Emergency Screening Association, was the first certified screener in New Jersey and serves on the Monmouth Youth Council. Romer has been proactive reaching out to law enforcement regarding issues of kids in crisis. His current work includes health screening for individuals, providing evaluations for the danger they pose to themselves or others, kids and adults alike. Romer has also experience working with school populations on youth suicide issues. He obtained his Bachelors of Arts from Seton Hall University.

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