What if you have an adult son, daughter, parent or sibling who has serious mental illness? How can you help? How can you get them help? What is your role? How do you deal with your own feelings of loss, sadness, anger, frustration, worry or helplessness? How do you set some limits? 

You may notice self-destructive behaviors, racing thoughts, delusions, hallucinations, or other breaks with reality. You might be aware of rapidly cycling moods in your loved one, or angry rants.

If your relative is under 18 years old, parents can intervene, and get a psychological evaluation. Your family member may be helped by medication and counseling. Parents have the legal right to seek mental health assessment for a minor child.

After age 18, the situation becomes much more difficult. The individual themselves has to be willing to get treatment unless they meet the specific criteria for involuntary hospitalization, which are: danger to self, danger to others or gravely disabled.

As a family member, it is essential that you get informed about mental health/chronic mental illness and get support for yourself. One of the best ways to do both is to contact the National Alliance on Mental Illness at www.nami.org.  In many areas of the United States there is a local chapter of NAMI which offers information, support groups, lectures and more. In Orange County, California where I have my counseling practice, the local chapter can be reached at www.namioc.org.  Getting to know other families who are also dealing with a family member with severe mental illness, like schizophrenia, personality disorders and untreated bipolar disorder can be incredibly helpful.

Another valuable resource is your local Mental Health Association, which can help you identify local resources for a family member you are concerned about. In Orange County, our local chapter can be contacted at www.mhaoc.org.  If you live elsewhere in the US, contact the Mental Health America national office at mentalhealthamerica.net and they will put you in touch with your local MHA office.

If your family member has a personality disorder, be aware that many people who have this diagnosis do not see themselves as having a problem and will probably blame others and be reluctant to get help. There are different types of personality disorders, including narcissistic, borderline, paranoid, schizoid, schizotypal, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive. All personality disorders are an enduring pattern of inner experience and behavior that varies far from what we normally expect. Most are difficult to treat, especially if the individual does not acknowledge their situation.

Family members need support in learning the best ways to help the mentally ill member, as well as how to set reasonable boundaries and limits for your own self-protection. For example, if you have an adult son or daughter who refuses to get help, but does not meet the strict criteria for involuntary hospitalization, you will need to sort through what your role will be. Perhaps you can see them and be emotionally supportive, but set limits that you will not accept physical, emotional or verbal abuse. It might be that you can help the grandchildren. You might be willing to help with the cost of some treatment, depending on your circumstances. You might be able to see them in limited amounts and provide emotional support, but not have them live with you.

A family therapist can help you learn not be codependent, and sort out how you can help and how you cantake care of yourself as well. Many people with chronic mental illness won't consistently take their prescribed medication or participate in talk therapy. As a family member who cares you won't be able to fix everything for another adult. Figuring out what you can do to help, and what is beyond your limits is key.