The 46-year-old man has schizophrenia, but thanks to powerful new anti-psychotic medications, he was able to live independently.
Until recently, that is. Then, his major source of support – his parents – went out of town, and by mistake he took a double dose of medication. “He ended up in a hospital for two weeks,” his sister says. And now, more than two months later, he’s living in a group home, unable to return to independent living because it “takes a long time to get the balance back when his meds get all out of whack.”
The family is upset and saddened at his relapse, and his aging parents feel guilty if they aren’t in touch with him every day.
Like other families who love someone with mental illness, this family is profoundly affected. As taxpayers, each of us is also affected, for we pay for his expensive medications, hospitalizations and group home care through Medicaid.
The man’s story, unfortunately, is not unusual. Treatment of people with serious mental illness such as schizophrenia, major depression and bipolar disorder is complex and too often marked by relapses and expensive hospitalizations. Now, however, Arapahoe/ Douglas Mental Health Network (ADMHN) is implementing a program proven to reduce relapse rates by 50 percent, while also significantly reducing hospitalizations.
The program, called Family Psycho-Education, brings teams of families and their mentally ill family member together over the course of nine to 12 months, according to Laurie Elliott, clinical director for ADMHN. Together, team members learn about mental illness and share effective ways of coping with common problems, such as ensuring that the person who is mentally ill stays on medications, and helping him or her find and keep a job.
Beginning early this year, ADMHN will institute the program at five sites – three in Littleton, and one each in Castle Rock and Parker. Specially trained clinicians will provide extensive education and support to help with recovery from mental illness while also focusing on the well-being of the family. The program provides the support family members need to experience less confusion, stress and isolation, Elliott says.
Family Psycho-Education defines “family” broadly, and may include a spouse, parents or siblings, grandparents, a close friend or other caregiver – anyone who is actively involved in the mentally ill person’s care on a near-daily basis. Teams are taught guidelines for helping their family member, including “keeping cool,” and not being overly emotional when the person with a mental illness is uncooperative. They learn to set limits, ignore what they can’t change, keep communication simple, follow doctors’ orders, solve problems step-by-step and pick up on early signs of a relapse.
Families and their members who are mentally ill must volunteer to be in the program. Families are sometimes initially reluctant to join a new program, according to Elliott, because of the way that mental illness has been stigmatized over the years. Their reluctance may also come from the way that families were once treated by professionals. “In the past, mental illness was often blamed on the mother or father,” she says.
Instead of blaming, today’s mental-health workers use a model of recovery and hope, seeking to partner with families. They look at families as the experts, building on their knowledge and strengths. “Families know their family member best. They also know the best way to get through tough times, to persevere,” Elliott says.
Family Psycho-Education is one of five “evidence-based” practices being implemented at ADMHN. These are practices that have been scientifically studied and proven to be effective. Two of the programs are designed to help people with bipolar disorder and severe depression, while the other three focus on helping people with mental illness find and keep jobs and housing.
Using practices and programs proven to work is an important step for mental health centers. Given the numbers of people with mental illness in this state (ADMHN alone serves nearly 5,000 people a year) and the high cost of hospitalizations, emergency room visits and crisis intervention by police and EMS personnel, the focus on evidence-based practices is a real plus for not only the mentally ill and their families, but also for the community as a whole.
Susan Thornton (smthornton@aol.com) served 16 years on the Littleton City Council, including eight years as mayor. She writes on suburban issues on alternate Thursdays.
