My family member has a mental disorder, what should I do?

The family, as the core of our personal relationships, is an essential space for personal development. When someone in our family has a mental health problem, those closest to them are also indispensable in their care, support, and recovery process.

In accompanying our loved one with a disorder, there are especially difficult moments to manage, such as the moment of diagnosis, possible crises or relapses, the transition from the specialized child and adolescent care network to that of adults, as well as the implications of the ongoing tasks of care and support.

And at 18, what then?

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What might I need as a family member?

Needs can vary from time to time, and it's important to identify them in order to find the best resource. The most common needs are:

• Having information about what is happening to our family member, to our own family, and also about the network of services and where to go in case of doubts, discomfort or crisis situations.
• Having professional support to manage different situations is essential. It's important to know where to turn, who the relevant professional teams are for our family member, and to be able to ask for help whenever needed.
• Knowing what to do. When faced with a mental health disorder, we need to learn what to do in each situation and acquire personal tools that allow us to cope with difficult situations.
• To be taken into account and participate in decision-making and therapeutic processes . Many families report that, despite being the primary caregivers of their relative, living with this person, or even sometimes being their economic, social, and emotional support, they are not always included in the therapeutic process. This is often more pronounced when the person with a mental disorder is an adult, whose right to privacy and confidentiality, autonomy, and preferences regarding how and with whom to share their personal information must be respected.
• Feeling supported and accompanied. Closely related to this, some families may feel displaced, abandoned, or that they are not heard or valued as part of their family member's recovery by some professional teams.
• Being able to share what we are going through . The EUFAMI Caring for Carers survey indicates that nearly 9 out of 10 caregivers would like to have more opportunities to meet and share knowledge and experiences with professionals (93%) as well as with other families and caregivers (90%).
• Space and time to take care of ourselves . Caring for a person with a mental disorder often has an impact on the family member's own health (physical and mental): excessive worry, exhaustion, stress, depression, etc.
• To receive financial support , for the family or for the family member with the mental health problem, in order to continue to meet the needs of care and support and to develop an independent life.

Where can I find help?

Generally, once a mental health problem has been diagnosed, the first place to go is the primary healthcare service . From Primary Care Centers, patients are referred to specialized care at Child and Adolescent Mental Health Centers (CSMIJ) or Adult Mental Health Centers (CSMA). These centers offer professional support and care, information and advice, as well as information on social and community resources, support networks for family members and people with lived experience of mental health issues, and available aid and benefits.

If we accompany our family member during a visit, it's important to keep in mind that they will be the one explaining their needs to the professional team so that the appropriate decisions can be made. Therefore, it's important to let them speak first and wait for the family to add anything if necessary (such as explaining any warning signs that may have been noticed, if the person being visited hasn't mentioned them). During the visit, you can also take notes or ask them to provide relevant information in writing.

These joint visits will only be possible if the person is a minor or, if they are an adult and not under guardianship, authorizes the family to be present. In any case, if necessary, a space can be requested for family support: confidential information about the person with the disorder will not be shared, but support and guidance can be offered.

Another important source of support is the network of associations for family members and people with lived experience of mental health issues. They play a vital role not only in providing information, accompaniment, listening, and support (many of these organizations offer support groups and mutual aid groups), but also in advocacy and advocacy. Some organizations also offer their own services that can address some of the needs of both the person with a mental health problem and their family, as well as legal advice. You can find family associations in your area by contacting your health or social services, or here:

• Europe: EUFAMI - European Federation of Associations of Relatives of People with Mental Illness
• Spain: Spanish Confederation for Mental Health
• Catalonia: Mental Health Catalonia

Sometimes, family situations are especially complex, either for clinical reasons (severity of the disorder, lack of clinical stability, long evolution, difficulties in managing symptoms and health care) and also for added factors that increase the needs of the person's care and support for the environment (substance abuse, relationship difficulties or disruptive behaviors, situations of exclusion or risk of social exclusion, isolation, or insufficient social or family support, among others).

To address these more complex situations, it is common for different professional teams from various fields (health, social services, education, and sometimes even the justice system) to be involved. That is why it is so important to contact the professional teams that support the person with the mental health disorder and request a space to explain what the family is perceiving, how they are experiencing it, and to ask for guidance on how to manage it.

Sometimes, the person affected doesn't want to receive help , either for a reasoned reason or because they don't feel the need for help or treatment. If the person isn't endangering their own life or the life of another person by threatening self-harm or suicide, it's important for the family to be patient, try to avoid judging or blaming them, show empathy, and express support and affection to accompany them in whatever they need. It's also important to continue encouraging them to talk about what's happening to them or how they're feeling with someone they trust (an adult in their environment, a member of the school team, a professional, or friends).

Sometimes this won't be enough, and the family may feel the need to speak with a professional for support and guidance in managing the situation. This also allows them to inform the professional teams if they detect risky behaviors that require further action by the services and professionals (in exceptional cases, they may request judicial authorization for involuntary admission).

In emergency situations, such as a crisis, threat, or suicide attempt, the family can activate emergency medical services (in Spain, by calling 061). It is very important that families know and feel at all times that they are not alone in supporting the person with a mental disorder, whatever their situation may be; that they are informed, listened to, and valued, so that everyone can work together to support their loved one's recovery.