THE CARING FAMILY: Living with Chronic Mental Illness

Helpful guidance in structuring the home environment to make it therapeutic for a mentally-ill family member--with some gaps in related areas. The authors, two psychologists and a social worker, well describe the behaviors that families can expect to encounter (high vulnerability to stress, difficulty in managing daily life, extreme dependency, problems with relationships) and how to cope with manifestations of them--from social withdrawal and thought disorder to violence and suicide. Their sympathy is squarely with the hard-pressed family--whose friends may see the ill member as a source of shame, who may themselves be blamed by health professionals for the illness. The guilt, fear, or despair they may feel are carefully and sensitively covered (though there might have been more detailed attention to such special problems as changes in relationships with a spouse). Causes and treatment are largely outside the book's purview; it can be faulted, however, for not providing more information and expertise in the sections on patients' and family rights and commitment laws. Except in the case of a child under legal age, families ""essentially have no legal rights with respect to records, discharge, or knowledge of the ill person's whereabouts,"" the authors note; and the tangle of conflicting and obscure regulations further complicates their situation. It takes more know-how than the book provides to get around and use the system. For an understanding of causes and treatments, and a grasp of the mental-health network, readers will still need to consult--as the authors too suggest--Clara Claiborne Park and Leon N. Shapiro's You Are Not Alone. With that background, the pointers here can be distinctly useful.