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Families and patients with mental illness: on the recovery road 

Families and patients with mental illness: on the recovery road
Chapter:
Families and patients with mental illness: on the recovery road
Author(s):

Eliahu Shamir

DOI:
10.1093/med/9780199691319.003.0004
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date: 08 December 2019

The onset of severe mental illness typically occurs at a young age, of around 15–30 years. It generates for all of the parties involved—individuals with mental illnesses, their families, and healthcare providers—acute stresses, confrontations, and strong internal and external pressures. This chapter focuses in particular on families. Social stigma, unfounded fears, shame, accusations, and denial all contribute to a dismal situation. Beyond medical treatment, intensive cognitive education and behavioural as well as emotional training are essential for survival, and to avoid crisis and collapse. These approaches facilitate the parties’ psychosocial alliance for effective caregiving, rehabilitation and recovery. The cognitive program described in this chapter consists of “know thy enemy” (the dangers and threats, and learning to use tools and resources to defeat them) and behavioural training (how to handle and negotiate the vastly increased problems and needs among the parties involved, and when and how to control expressed emotion and where to discharge it, using support groups and cognitive behavioral therapy). Education during the early stages of illness is essential in order to avoid serious mistakes and irreversible damage over a period of many years. A list of topics and courses is suggested, tailored for families and also adaptable for professionals and patients. Psychosocial reform of the ways in which societies organize and appropriate mental health services is crucial. An Israeli story and situation is conveyed via the author's 30 years of experience as a father of a mentally ill person, as the chair-person of and public speaker for the NGO of the families of mentally ill people in Israel, as a researcher of health systems, and as a delegate to the 2009 World Association for Psychosocial Rehabilitation Congress in Bangalore, India.

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