(The following presentation was given by Ella Amir on November 26, 2008 as part of a round table discussion including viewpoints of health network partners. It was part of an international conference on the integration of mental health into primary care.)

Today, the relationships between family caregivers and practitioners reflect a departure from earlier patterns that characterized the institutional and post-institutional eras. In the earlier days when people with mental illness were kept in hospitals, often for the better part of their lives (or perhaps the worst!), families were little involved and had distant relationships with professionals. Following deinstitutionalization (which often turned into trans-institutionalization), the contact with professionals increased. Families have often served as the first and last resort for their ill relatives but typically with little guidance or support. The contact with professionals, instead of helping with their caregiving role, often magnified the family problems. With the common perception viewing families as dysfunctional and pathogenic, families have often been held accountable for their relative’s illness and pushed to therapy as a means to correct the problem.

Today’s practitioners are increasingly recognizing the contribution families can make to the recovery process of their ill relatives. They are also gradually recognizing that families have particular needs of their own, which are defined by their caregiving role.

So this is the good news. The gradual change in attitude is long over-due, but it will not be sufficient as long as it does not translate into concrete supports for families.
(Part 2 to be continued next week...)

Ella Amir
Executive Director
AMI-Quebec Action on mental illness