Assistance Provided By Persons with Serious Mental Illness to Their Relatives

Background and Purpose:  Due to insufficient community supports, persons with serious mental illness (SMI) often receive much caregiving from their relatives.  However, persons with SMI also make valuable contributions to their families.  Despite reciprocity in the relationships of persons with SMI being known to be associated with favorable outcomes for both persons with SMI and their family members, research has largely failed to examine this topic.  The objectives of the present analysis are to 1) describe levels of assistance provided by persons with SMI to their relatives and 2) examine the relationships of proposed factors (related to persons with SMI, their relatives, and their interactions with each other) with contributions made by persons with SMI to relatives. 

Methods: A cross-sectional survey design was employed. 573 U.S. residing adults with a family member with SMI completed a survey between 2014 and 2015, with most participants being caregivers.  Participants provided information regarding themselves, their relatives with SMI, and their interactions with one another, including how often their relatives with SMI had provided them with assistance with activities of daily living (ADL) and financial assistance, in the past 6 months.  Multivariate logistic regression was employed. 

Results: 61% (n = 349) of relatives reported that their family member with SMI had provided them with some level of assistance with ADL in the past 6 months, with 37% (n = 211) reporting that they had done so at least once a week.  37% (n = 213) of relatives reported that persons with SMI had given them some level of financial assistance in the past 6 months.  After controlling for covariates, assistance with ADL by persons with SMI to relatives was significantly associated with disability status, regular alcohol use, and arrest history of persons with SMI; relatives and persons with SMI being romantic partners; and caregiving provided by relatives to persons with SMI.  Financial assistance provided by persons with SMI was associated with income of persons with SMI, age of relatives, relatives and persons with SMI being romantic partners, and caregiving provided by relatives.   

Conclusions and Implications:  Although it was found that persons with SMI received more assistance from their family members than vice versa, it is clear that many persons with SMI provide financial assistance and assistance with ADL to their relatives.  It is critical that social workers acknowledge the contributions made by persons with SMI to their families.  Results indicate that providing such assistance is more likely when persons with SMI are not disabled, do not regularly use alcohol, and have higher incomes, likely indicating that persons with SMI with a greater ability to help family members are, indeed, more likely to do so.  This finding underscores the importance of social workers providing appropriate recovery and rehabilitative services.  It is notable that attendance of mental health treatment was not associated with assistance provided by persons with SMI. It may be advisable for providers to encourage and support persons with SMI in providing aid to their family members.