Family Guide to Joining the Treatment Process:

How Families Can Be Involved in Residential and Outpatient Care

Author:

Emma Loker

B.S

Editor:

Ashley Pena

LCSW

Active family involvement; it’s a vital tool in anyone’s mental health first aid kit.

Families play a critical role in the care of patients with mental illness by being actively involved. When families are involved in their loved one’s residential or outpatient care, they are more than just passive bystanders – they’re taking part in the recovery process. Extensive research even shows that when families are actively involved in advocating for their loved ones, the length of stay in the hospital is reduced.¹

Good mental health has many layers. It involves emotional, psychological, and social well-being. Families are well placed to give their support across these three areas and may be the first to notice when there are significant changes to their loved ones’ emotional or behavioral “normal.” Thus, they may best understand when it’s time to seek professional help.

If you would like to understand more about how you can help a loved one in their mental health recovery, professional advice and support are available. This article can also help by exploring how you can help your family member in their recovery, whether they’re an outpatient or in a residential mental health care facility. It does so by covering:

The importance of family involvement in mental health treatment
How families can help in mental health recovery
What family involvement in treatment looks like
When to seek help for supporting a loved one’s mental health

The Importance of Family Involvement in Mental Health Treatment

When families are at the heart of the care of someone with a serious mental health condition, the person’s outcomes are greatly improved. For instance, the World Psychiatric Association (WPA) published a study, which recommends that carers and service users collaborate in an inpatient setting as it can improve recovery outcomes.²

There is a range of support that families or caregivers can give, from simple to more involved, which often depends on the severity of someone’s mental health conditions. For instance, families can be involved in:

Psychoeducation:

Families can be involved by learning about a mental health condition. This means that they might join a group to understand a particular mental illness and the management of symptoms. This can go a long way toward helping someone feel supported and understood.³

Designing and Delivering Treatment:

Family support can involve collaborating with mental health professionals to adjust treatment plans for any updates or changes that might be needed. To do this, families might meet with therapists or attend family therapy.⁴

Practical Support:

Family members can help a loved one in practical ways. Living with a mental illness can affect a person’s thinking, including their ability to remember facts and instructions. A family member can help by finding a visual way to remind a loved one about day-to-day tasks, such as attending a doctor’s appointment or creating a shopping list.⁵

How Families Can Help in Mental Health Recovery

Each family is different in terms of their emotional resources to support a loved one with mental illness. Not all families may be able to assist their relatives on the road to recovery, due to reasons such as barriers to accessing mental health services.⁶These can be cultural barriers, issues around stigma, family illness, or financial difficulties.

However, when families are capable of being actively involved, they are key in terms of contributing to the coordination of treatment plans that are residential or community-based. Families are like scaffolding throughout the journey of recovery, forming a “pyramid of care” by being a constant empathic presence, showing respect, and giving emotional support to their loved ones.⁶

We know that, statistically, when families are involved, people are 25% less likely to experience a relapse in their first year of treatment than those who do not have family support. The more supportive a family network is, and the more interventions that can be offered to increase a family’s resilience, the less likely relapses are to take place.⁷

For instance, evidence shows that when treatment involves families and takes into account the patient’s home situation when creating a discharge plan, the smoother the transition into the community. Less positive outcomes to leaving care can occur when staff do not fully take into account the after-care that is required, such as family support with medication and attending therapy.⁸

How to Support a Loved One's Mental Health Care

If you are concerned for a family member’s mental health but don’t know where to start, small, proactive steps can make a big difference in showing that you are there for them.

Don’t underestimate the power of allowing your loved one to share as much or as little as they need to. This can boost trust and encourage open lines of communication – helping your loved one to feel heard and supported.

The following steps can help.

Tip #1: Pay Attention to Changes in Behavior or Emotional Well-Being

Early detection of mental illness is the best approach, so being mindful of any changes in mood or behavior is key.

Below are several examples of emotional and behavioral changes that could be a red flag for mental health problems. However, as mental health conditions are variable, and people are unique, there are many other possible signs.

Persistent low or irritable mood
Problems functioning at work or at home
Difficulties concentrating
Changes in appetite, such as an increase or decrease
Emotional outbursts, such as anger or tearfulness
Changes to sleep patterns
Constant fatigue

Tip # 2: Take Care of Your Own Mental Health

There can be a well-documented burden of care that falls on family members.⁹The intensity of care, from extra physical jobs, to emotionally navigating complex situations, can lead to a risk of burnout.

Who can you turn to to avoid burnout? The primary care provider often has a good rapport with the family and is best placed to screen for any concern around carer burnout. If you’re at risk of emotional burnout, a doctor can work with you to help you feel more supported, problem-solve, and find support from other services, including counseling.⁷

Tip #3: Try Psycho-Education and Support Groups

The more education you can get, the more you can equip yourself to best support your loved one in managing their symptoms – and also to look after your own health.

Support groups can provide you with a larger network of support and resources to help you resolve any issues you might be experiencing. Your doctor or a mental health professional can provide you with group support and psycho-education information about mental illness. These educational interventions can vary in length, from a one-off group session to regular attendance at a support group.¹⁰

According to the National Institute of Mental Health (NIMH), attending support programs can significantly improve a family’s capacity to cope with a loved one’s mental health condition.¹¹Participants who attended groups said that they felt better equipped to manage their family member’s mental illness. This means they took away better problem-solving skills and learned how to “navigate emotional difficulties” around their loved ones’ issues.

Tip #4: Know When to Seek Professional Help

Guidelines suggest that if you notice your loved one experiencing severe symptoms that are affecting their emotions or behavior, which last for 2 weeks or longer, then it may be time to seek support.¹²

Don’t wait for your family member to reach out to you. If you are in doubt, it’s safer to check in with them and let them know you’ve noticed they seem to be having a hard time. You can also offer to help them do some research into finding the right support.

What Does Family Involvement in Residential and Outpatient Care Look Like?

Family involvement in residential and outpatient care can vary according to the patient’s needs. It can include helping with personal care, visiting, and acting as emotional support, such as sitting with them and listening in a non-judgmental way. Family involvement could also involve advocacy, which is the work involved in ensuring a loved one is getting the right mental health support.

While there are many different types of family involvement in residential care, family engagement is more active. Family engagement means collaborating with healthcare professionals and participating in the treatment plan, which might be adjusted as needs change. When families are part of the decision-making processes in such ways, the recovery outcomes tend to be better.

Family involvement or engagement can include the following approaches:

1. Mental Health Family Education Programs

There are many educational resources about mental health available to families. These education programs could be online, to suit your schedule, or you could choose to attend an in-person group. Peer-to-peer support can help you learn more about how to advocate for a family member, ensuring they get the best out of their treatment. Additionally, this support can alleviate some of the emotional pressure that families experience when supporting a family member in mental health treatment.

2. Supporting a Family Member in Counseling

There is no “magic wand,” or quick fix when it comes to recovery from a mental health condition. Everyone is unique, so they recover at various speeds. Recovery requires patience and understanding from family members, and there will inevitably be bumps along the road. However, you can support your loved one by giving them sufficient space, respect, and love while they attend counseling or therapy. You could also participate in counseling, such as by going to family therapy sessions.

3. Family-Based Mental Health Interventions

Families are complex. People take on certain roles, often without knowing that they do. They may also find that they’re taking on too much, avoiding certain actions, or unable to recognize their communication patterns. This is where family therapy as an intervention can be helpful. Family therapy is an evidence-based intervention that provides a confidential space to unpack some of the dynamics within a family. Through shared problem-solving and working through conflicts, family therapy can help strengthen relationships and lead to positive mental health outcomes.

When to Seek Help for Supporting a Loved One’s Mental Health

Families are integral to the outcomes of a loved one with mental illness. You can support a loved one in their mental health recovery at any stage of the process, but the earlier you do, the better the outcomes tend to be.

At Mission Connection, we place families at the heart of our mental health programs. Recovering from a mental illness is multi-faceted and we work within a holistic framework that recognizes the critically important role that families play in this journey.

If you are concerned about a loved one’s mental health, contact us today for a consultation.

References

Honig, A., Hofman, A., Rozendaal, N., & Dingemans, P. (1997). Psycho-education in bipolar disorder: Effect on expressed emotion. Psychiatry Research, 72(1), 17–22. https://doi.org/10.1016/s0165-1781(97)00072-3
Wallcraft, J., Amering, M., Freidin, J., et al. (2011). Partnerships for better mental health worldwide: WPA recommendations on best practices in working with service users and family carers. World Psychiatry, 10(3), 229–236. https://doi.org/10.1002/j.2051-5545.2011.tb00062
Czepielewski, L. S., Massuda, R., Goi, P., Sulzbach-Vianna, M., Reckziegel, R., Costanzi, M., & Gama, C. S. (2015). Verbal episodic memory along the course of schizophrenia and bipolar disorder: A new perspective. European Neuropsychopharmacology, 25(2), 169–175. https://doi.org/10.1016/j.euroneuro.2014.09.006
Mottaghipour, Y., & Bickerton, A. (2005). The pyramid of family care: A framework for family involvement with adult mental health services. Advances in Mental Health, 4(3), 210–217.
Cuesta-Lozano, D., Lopez-Alcalde, J., Castro Molina, F. J., García Sastre, M., Maravilla Herrera, P., Muriel, A., Asenjo-Esteve, Á. L., Alvarez-Diaz, N., Monge Martín, D., & Carralero-Montero, A. (2022). Psychoeducation for the parents of people with severe mental illness. Cochrane Database of Systematic Reviews, 2022(6), CD014532. https://doi.org/10.1002/14651858.CD014532
Dehbozorgi, R., Fereidooni-Moghadam, M., Shahriari, M., & Moghimi-Sarani, E. (2022). Barriers to family involvement in the care of patients with chronic mental illnesses: A qualitative study. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.995863
Ong, H., Fernandez, P., & Lim, H. (2021). Family engagement as part of managing patients with mental illness in primary care. Singapore Medical Journal, 62(5), 213–219. https://doi.org/10.11622/smedj.2021057
National Collaborating Centre for Mental Health (UK). (2012). Service User Experience in Adult Mental Health: Improving the Experience of Care for People Using Adult NHS Mental Health Services. British Psychological Society (UK).
Mottaghipour, Y., & Bickerton, A. (2005). The pyramid of family care: A framework for family involvement with adult mental health services. Advances in Mental Health, 4(3), 210–217.
Cuesta-Lozano, D., Lopez-Alcalde, J., Molina, F. J. C., Sastre, M. G., Herrera, P. M., Muriel, A., Asenjo-Esteve, Á. L., Alvarez-Diaz, N., Martín, D. M., & Carralero-Montero, A. (2022). Psychoeducation for the parents of people with severe mental illness. Cochrane Library, 2022(6). https://doi.org/10.1002/14651858.cd014532
NIH. (2011, July 27). Support Program Can Help Caregivers Cope with Relative’s Mental Illness. https://www.nimh.nih.gov/news/science-updates/2011/support-program-can-help-caregivers-cope-with-relatives-mental-illness
NIH. (n.d.). Caring for Your Mental Health. https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health