Perceptions of Marriage, Parenting, and Personal Relationships of Individuals with Schizophrenia and Key Family Members

Purpose:Romantic relationship status has been associated with physical and mental health-related outcomes. However, research has demonstrated that romantic and intimate relationships among adults with a serious mental illness (SMI) are not addressed in mental health treatment services. Among Latinos with SMI, factors such as religion, familism, and hope have been found to be associated with a supportive family environment and less burden; however, other cultural factors such as traditional gender roles and stigma may have a counterproductive effect when addressing sensitive topics such as romantic relationships, intimacy, and gender normative behavior. This study explored perceptions of marriage and other romantic and social relationships among Latinos with an SMI diagnosis and their key family members.

 Methods:Data came from an NIMH-funded ethnographic study on family, sociocultural resources, and strengths of Mexican immigrant clients with SMI and their key family members. Twelve in-depth semi structured interviews were conducted and transcribed. The sample consisted of seven clients and five family members. Transcripts were analyzed using template analysis methods. After developing predetermined codes based on intersectionality theory, a code template was developed and updated as more themes emerged from the qualitative data.

 Results:Analysis revealed four thematic domains in which perceptions of relationships were most salient: (1) experiences and perceptions of marriage (e.g., “My husband was bothered that my mother [with SMI] was not doing anything”); (2) experiences and perceptions of other relationships such as parenting (e.g., “Since I had my son I always told myself, how can a mother leave her children?”); (3) a sense of being alone and loneliness (e.g., “I know I have to take care of myself so that I don’t lose my mind again. Because now I am alone”); and (4) perceptions of gender normative roles (e.g., “There’s washing and ironing and making tortillas. … A woman doesn’t rest”).

 Implications:Results indicate that clients and key family members have varying perceptions of marriage and other personal relationships that depend on their role of as a caregiver or client; however, for both types of participants, relational conflicts emerged as a consequence of the client’s illness. Several participants expressed an inability to maintain romantic relationships or avoid relationship conflict due to the responsibility of caring for a family member with SMI and a lack of support or understanding from their spouse or other significant family members. These findings underscore the importance of addressing personal relationships in assessment and treatment services for Latinos with SMI and family members. There is also a need for more purposeful involvement of not only key family members but also other family members such as partners or spouses of those with the illness and family caregivers.