"Families are the single largest group of caregivers, often providing financial, emotional and social support, although their role generally goes unrecognised."
(Trainor, J, Pomeroy, E & Pape, B. (2004),
A framework for support: Third Edition. Canadian Mental Health Association)
Mental ill health has a profound impact not only on the individual but on families and care givers as well. The stigma, social exclusion and emotional burden are not confined to only the person with mental health ill health but are also experienced by family members and care givers.
In most instances, it is families which provide financial, emotional and psychosocial support with little or no recognition or assistance.
In Fiji, where there are limited or no community mental health services and supports the families are an even more important component of the recovery process.
Research supports the notion that family involvement in a patient's mental health care can improve outcomes, including reducing readmission rates, increasing compliance with treatment regimens, strengthening reintegration into communities and improving mental health awareness, promotion and advocacy.
As such it is obvious that families also save mental health care systems money by undertaking tasks that would normally be done by service providers to aid in consumer recovery and rehabilitation.
Mental health service providers should ensure that families are well-equipped to deal with their role as partners in mental health care by providing them with adequate support, education and care.
All too often the role of families and caregivers is taken for granted without any care to providing basic information or understanding of the mental health issues at hand, leaving families to orientate and navigate the mental health system on their own. Little or no psychosocial support is offered to families to assist them in caring for their loved ones.
As such, Fiji is fortunate to have seen the formation of the Family Support Network (FSNet), which is long overdue and an important milestone in Fiji mental health. It is an organisation of family members supporting one another with technical support from mental health care professionals with the focus on providing the best possible care for their loved ones through better understanding, skills and knowledge of relevant mental health issues which is a vital necessity. Through their efforts they have published a Carers' Manual and DVD, which are available through St Giles Hospital.
Mental health care systems, mental health care professionals and communities need to recognise the value of families as partners in mental health care and nurture this essential collaboration to ensure the best possible outcomes for those living with mental ill health.
FSNet is just the first step to be taken to acknowledge the vital role families play and the need to assist them in their efforts. The concept of engaging families in the care of those with mental ill health is also supported by Fiji's 2010 Mental Health Decree.
The decree emphasises the early engagement and active involvement of families in the treatment process; the rights of the consumers and carers of mental health services are paramount and include access to adequate information and treatment in the least restrictive environment.
This means that consumers and carers are no longer passive recipients of mental health care but are actively involved in the treatment and recovery process. Communities are also important partners in these processes.
They can be strong proponents for consumers and carers and provide the necessary support and environment in which consumers can recover and promote their social re-integration. In addition, communities can provide much needed assistance to families and carers that can help ease their emotional, financial and psychological burden as well as minimise the social isolation that results from the stigmatisation of mental disorders.
It is evident that working and caring together, communities, families and mental health care systems can make significant contributions to the recovery of persons with mental ill health. With the support of local faith-based groups, CSOs, NGOs, youth and women's groups people, as well as other governmental departments, consumers living with mental illness can be more easily integrated into their communities, have improved access to opportunities and quality of living.
Ultimately, the burden and disability associated with mental illness can be minimised which benefits not only consumers and their families but also our society and communities.
* Dr Odille Chang is a senior lecturer in psychiatry and is a consultant psychiatrist at the Fiji National University. She is also the president of the Fiji Alliance for Mental Health. This article is a contribution of the College of Medicine, Nursing and Health Sciences towards Mental Health Month Activities this year.