Mental Illness and Family Caregivers

Purple Yip

May 28th, 2017

Scarborough Chinese Baptist Church

Scenario 1

28 year old woman was diagnosed with

major depressive disorder when she was 19.

She has been taking anti-depressant and is

stable. Lately, she is contemplating getting

married and start a family.

Can she have kids? What are the concerns?

If you are her friend, how would you

respond?

Scenario 2

Your brother and his wife are going through

a separation. As his sister, you know your

brother is suffering from Bipolar Disorder

and the illness has put lots of pressure on

the marriage. He refused medical treatment

and insisted the meds is harming him and

God is talking to him directly.

How would you respond to your brother and

his wife?

Scenario 3

David suffers from depression. Lately, he is

refusing the personal care such as

bathing, grooming or wants to wear the

same clothes everyday.

How would you respond to David as a

family caregiver?

Scenario 4

David is becoming suspicious. Lately, he

mentioned his roommate, Tom went to his

room and stole his belongings. David also

complained Tom has been making a lot of

noises and David cannot sleep because of

that. You know Tom is a gentle and honest

person. You believe David is making things

up.

How would you respond to David ?

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Challenges for families

“Family members who provide care and support to relatives living with mental illness and addiction face a two-fold challenge. First, they must suffer with their loved ones through their daily hardships and use their limited personal resources to try to alleviate them. Second, they must contend with a mental health system that often excludes them from involvement in the information-gathering and decision-making processes while simultaneously leaving them to serve as the fail-safe mechanism to provide unlimited, unpaid care, filling in the cracks that open when any part of the so-called system fails.”

“Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada” 2007

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What are the issues for families?

• Emotional challenges to everyone in the family

• Practical issues – information, treatment, coping with symptoms, navigating the MH

System for services, practical supports such as

housing, finance, future care…• Self-care

• Learn coping skills

• Get support

Caregiving & Self Care

These are signs of burnout:

◦ Fatique◦ Trouble sleeping◦ Easy to become ill◦ Feeling angry and resentful◦ Feeling overwhelmed…….and

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Helpful hints for family members

• Educate yourself about the illness

• Reduce stress & stressful environment

• Pick your battles – be a better communicator• Don’t take things personal• Solve problems one-at-a-time – know which

one

• Be an ally, not adversary - form partnership for Recovery plans

• Get support

Family Caregivers can:

Be knowledgeable & alert to signs

Keep a Journal

Communicate with doctors & professionals

Formulate risk & crisis management plans

Create calm non-stressful environment

Assist in daily living & teach coping skills

Be positive role model & partner

Have realistic goals & expectations

Bring hope

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Helpful Communication

with treatment team or

physicians

Journal-manic symptomsDate Monday

September 16

Tuesday

September 17

Wednesday

Thoughts (思想) -thought she is going to

marry a celebrity

going on diet lost 25 lbs in 3 months (4)

Talked about buying a

one way ticket to the

States to meet a

celebrity (5)

Unusual Behaviors (不尋常的

行為)

(eg. Getting up in the middle of the

night ; pacing ; not showering)

Dress up in evening gown

claiming her “fiancé” is coming to pick her up

soon (5)

Watching a TV show by

the celebrity 5 times a

day ; claiming she can

hear him talking to her

(5)

Hallucination (幻覺)

(audio / visual)

No No

Sleeping pattern (睡眠)

(excessive or not enough sleeping)

Slept only 3 hours (4) Slept only 3 hrs (4)

Appetite (食慾)

(significant increase or decrease)

No appetite (4) No appetite (4)

Feelings (感覺)

(eg. depressed ; guilty ; self

criticizing)

Super-confident

Self centred

Super confident

Other observation (其他)/ coping

skills / meds change

Journal-depressed symptoms

Date Monday

September 16

Tuesday

September 17

Wednesday

Thoughts (思想) Keep thinking why she was

fired (5)

Keep asking why she was

fired (5)

Unusual Behaviors (不尋常的行

為)

(eg. Getting up in the middle of the

night ; pacing ; not showering)

Not showering

Not grooming

Not brushing her teeth (4)

Not showering

Not grooming

Not brushing her teeth

(5)

Hallucination (幻覺)

(audio / visual)

No No

Sleeping pattern (睡眠)

(excessive or not enough sleeping)

Lie in bed most of the time

except when mom called

her for supper (4)

Same as yesterday (4)

Appetite (食慾)

(significant increase or decrease)

No appetite (4)

Suspect losing 10 lbs in last

month

No appetite (4)

Feelings (感覺)

(eg. depressed ; guilty ; self

criticizing)

Self critical

Critical at others

Argumentative (3)

Self critical

Critical at others

Very angry (4)

Other observation (其他)/ coping

skills / meds change

Received a letter from

previous employer

Helpful Communication

with the sick family member

Learn to LEAP

L = Listen

E = Empathy

A = Agree

P = Partner

LEAP Model

LEAP 由Dr. Xavier Amador 開發

Dr. Xavier Amador 寫“我沒有病 ; 我不需要幫忙”一書 “I am not sick, I don’t need help”

L = Listen (Reflective Listening)

E = Empathy

A = Agree

P = Partner

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Caregivers and Caregiving

Recovery starts from

Family Caregivers

Recovery starts from caregivers

Practising self care in these aspects :

• Physical• Emotional• Spiritual• Social well-being

Recovery starts from caregivers

Accepting and Managing your own

emotions

Work through your own emotions

including anxiety, fear, anger and guilt

Be aware of co-dependence

Encourage the person to own the illness

and recovery

Nurture independence in early stage of

recovery

Community Resources for Caregivers

Family Organizations

FAME (Family Association for Mental

Health Everywhere)

http://www.fameforfamilies.com/

MDAO (Mood Disorders Association of

Ontario)

https://www.mooddisorders.ca/

SSO (Schizophrenia Society of Ontario)

http://www.schizophrenia.on.ca/

http://www.fameforfamilies.com/https://www.mooddisorders.ca/http://www.schizophrenia.on.ca/

Community Resources for Caregivers

CMHA-Family Outreach & Responsehttp://toronto.cmha.ca/news/family-outreach-and-response-

program/#.WRnv4mgrLtQ

Family Navigation Project (age 13-26)http://sunnybrook.ca/content/?page=family-navigation-project

Hong Fook Mental Health Association

http://hongfook.ca/

Camhhttp://www.camh.ca/en/hospital/care_program_and_services/support_for_f

amilies_and_friends/Pages/support_groups_families_friends.aspx

(For services at camh, inquire through Access camh at (416) 535-8501 and

select option 2)

http://toronto.cmha.ca/news/family-outreach-and-response-program/#.WRnv4mgrLtQhttp://sunnybrook.ca/content/?page=family-navigation-projecthttp://hongfook.ca/http://www.camh.ca/en/hospital/care_program_and_services/support_for_families_and_friends/Pages/support_groups_families_friends.aspx

Community Resources for Caregivers

Al-Anon and Alateen

Friends and families of problem drinkers

find understanding and support

http://www.al-anon.alateen.org/

Nar-Anon Family Groups of Ontario

http://www.naranonontario.com/about-2/

Gam-Anon and Gam-Ateen

www.gam-anon.org

http://www.al-anon.alateen.org/http://www.naranonontario.com/about-2/http://www.gam-anon.org/

Community Resources – Early Intervention of Psychosis

Referral to and EPI program in your area, if

your loved one experience: a significant change in normal personality, which lasts weeks or

months

faster, slower, or disorganized speech that is difficult to follow

suspicious, guarded, or fearful behaviour

a severe change in sleep pattern

an inability to function at their normal level (e.g. can’t perform at school or work, neglects hygiene or personal affairs)

a preoccupation with unusual ideas (e.g. thinks they hear God’s voice, believes coded messages are being left for them in the

media)

http://help4psychosis.ca

http://help4psychosis.ca/

Access Point (Toronto)

Access Point is a central referral service for:

Intensive Case Management

ACT Team

Supportive Housing

Eligibility: are 14 years of age or older

have mental health and /or addictions problems

that are seriously affecting their lives

live in, or plan to live in, The Access Point boundaries, which are

Port Union Road to Highway 427 and Steeles Ave. to the lake.

You can call (416) 640-1934 or visit their website

http://theaccesspoint.ca/

(they have an extensive resources online)

http://theaccesspoint.ca/

Streamline Access (York Region)

Streamline Access is a central referral

service for:

Intensive Case Management

ACT Team

Supportive Housing

Eligibility: trying to deal with a serious mental illness, and/or addiction,

and/or dual diagnosis

16 years of age or older

living in York Region or South Simcoe

You can call us at 289-340-0348 or toll free 1-844-660-6602, or visit

their website http://www.yssn.ca/streamlined-access

http://www.yssn.ca/streamlined-access

References Canadian Mental Health Association. (2014). Myths about mental illness. Retrieved

from http://www.cmha.ca/mental_health/myths-about-mental-illness/#.VKIE4UAAIY

Canadian Mental Health Association. (2014). Fast facts about mental illness. Retrieved

from http://www.cmha.ca/media/fast-facts-about-mental-illness/#.VLBvHyeWfKB

Centre for Addiction and Mental Health – Education Services. (n.d.). Introduction to mental health. Retrieved

fromhttp://www.camhx.ca/education/online_courses_webinars/mha101/introtomentalhealth/Introduction_to_Mental_Health_.htm

Health Canada. (2002). A report on mental illnesses in Canada. Retrieved from

http://www.phac-aspc.gc.ca/publicat/miic-mmac/pdf/men_ill_e.pdf

Mental and substance use disorders in Canada, Pearson, Janz and Ali, Health Statistics Division, Statistics Canada, September 2013

Mental Health First Aid Handbook

Mental Health Commission of Canada. (2012). The facts. Retrieved from

http://strategy.mentalhealthcommission.ca/the-facts/

http://www.cmha.ca/mental_health/myths-about-mental-illness/#.VKIE4UAAIYhttp://www.cmha.ca/media/fast-facts-about-mental-illness/#.VLBvHyeWfKBhttp://www.camhx.ca/education/online_courses_webinars/mha101/introtomentalhealth/Introduction_to_Mental_Health_.htmhttp://www.phac-aspc.gc.ca/publicat/miic-mmac/pdf/men_ill_e.pdfhttp://strategy.mentalhealthcommission.ca/the-facts/

References My Mental Health. (2015). Causes of mental illness. Retrieved from

http://www.mymentalhealth.ca/learn/causes/tabid/839/default.aspx

National Guidelines for a Comprehensive Service System to Support Family Caregivers of Adults with Mental Health Problems and Illnesses, Mental Health Commission of Canada, May 2013

Out of the shadows at last-transforming Mental Health, Mental Illness and Addiction Services in Canada, The Standing Senate Committee on Social Affairs, Science and Technology, May 2006

Public Health Agency of Canada. (2013). Mental illness. Retrieved from

http://www.phac-aspc.gc.ca/cd-mc/mi-mm/index-eng.php

Rays of Hope, 4th edition, Schizophrenia Society of Canada

SAMHSA Issues Consensus Statement on Mental Health Recovery

Slade, M. (2009). 100 ways to support recovery: A guide for mental health professionals. Retrieved from http://www.mentalhealthrecovery.com/recovery-resources/documents/100_ways_to_support_recovery1.pdf

Strengthening Families Together, Schizophrenia Society of Ontario

http://www.mymentalhealth.ca/learn/causes/tabid/839/default.aspxhttp://www.phac-aspc.gc.ca/cd-mc/mi-mm/index-eng.phphttp://www.mentalhealthrecovery.com/recovery-resources/documents/100_ways_to_support_recovery1.pdf

Contact Information

Purple: purple_yip@hotmail.com

THANK YOU!!!

Questions, comments?

mailto:purple_yip@hotmail.com