Study identifies resiliency strategies for family members of violent patients

Family members of people with severe mental illness and violent tendencies often feel confused and isolated. Mental health professionals can help them by increasing their knowledge of mental illness and introducing them to strategies to ease the burden.

That conclusion came from research led by Karyn Sporer, Ph.D., assistant professor of sociology at the University of Maine. She and her team used in-depth, ethnographic interviews with 42 parents and siblings of violent children with severe mental illness to generate data and identify coping methods.

Her results, published in the Journal of Family Issues, highlighted ways that families said they are able to cope better in the midst of trying circumstances. The data showed three themes representing helpful strategies: gaining insight and knowledge; joining peer support programs; and identifying a silver lining.

Sporer began collecting data five years ago while working at a non-profit in Norwood, Mass., and witnessing the negative consequences of living with a violent child and the toll of caregiving, in general.

She said she was struck by the perseverance of some people who still looked at the world “pretty optimistically” despite all the turmoil.

She was also first daunted by the need to take families into consideration after working with the family of an adult male who nearly killed his mother during a psychotic episode.

Over a two-year period, she interviewed people in New England, Omaha, Nebraska, where she pursued a doctoral degree, and across the country in person and by phone.

“It was like life history interviewing where they talked about when they first realized their child or sibling had a problem,” Sporer said.

“These are people living in tough conditions—being pushed, screamed at, shoved down the stairs, killing pets, all the way to homicide…whether it is the person with mental illness killed in self-defense or that person actually killing a parent.”

Sporer added, “We’re talking acute and extreme domestic violence.”

In these situations, family members are always “walking on eggshells,” afraid of causing the child to have increased symptoms that manifest with aggression or violence. They struggle and experience the same barriers as victims of partner/spousal abuse.

“There is a lot of denial, not only by moms, but also by treatment providers, people in the community, friends…” Sporer discovered.

“Mothers had MDs or psychologists telling them it was their parenting, a phase or boys being boys or `they’ll grow out of it.’ That denial really delayed treatment.”

Lack of insurance coverage and full ERs were other barriers.

The children or adults with mental illness ranged from age eight to 48 and had diagnoses including mood disorders, schizophrenia, and personality, bipolar, reactive attachment, and psychotic disorders.

Issues surrounding resilience are the study’s main takeaways.

· Learning as much as they can about the reality of the mental health care system and taking care of themselves is key for family members.

· Speaking to others who have comparable scenarios can help ease isolation. Support can be found in community settings or online.

· Identifying the silver linings, the little things, can make ordinary moments become extraordinary.

An example one father talked about was an evening where he, his wife and daughter and his son with mental illness were able to sit together and laugh over the ridiculousness of a Sharkado movie.

Sporer noted, “He said, `this is what life is all about.’”

Situations where families can have a meal together without having to hide knives or without screaming and throwing plates can be `extraordinary’ times.

Psychologists can help by learning more about how families perceive the experiences and not just focusing on the person with the diagnoses, she added. They can also educate caregivers on how to navigate the system.

Co- authors of the study are Lisa Speropolous, Ph.D, assistant professor of justice studies, University of Southern New Hampshire and Katarina Monahan, who earned a bachelor’s degree in psychology from UMaine in 2018 and is a mental health rehabilitation technician at Dirigo Counseling Clinic in Bangor.