Family Conundrums with Psychiatric Medication: An Inquiry into Experiences, Beliefs, and Desires

Background and Purpose: Research with families of people with serious mental illness consistently shows that conundrums about their loved one’s medication are among those most centrally voiced. Yet, we could find only a handful of studies that focuses specifically on their complex concerns related to psychiatric medication. The hope is that an expanded, up-to-date knowledge base in this area will serve to inform family member’s caregiving role, normalize their experiences, ease the emotional burden they experience, and empower them to understand, empathize with, and support the care and treatment of their loved one.

Method: To more fully understand these conundrums, the inquiry relied on an anonymous cross-sectional Likert-type online survey of attitudes, beliefs and experiences of family members (N=339) specifically related to psychiatric medication. Because one question of interest was related to whether family members with stronger affinity to a medical model of mental illness (that is, they believe more forcefully in biological causes and brain-related explanations of mental illness) would hold different views on medication, a latent profile analysis (LPA) was conducted. Verbatim narrative responses to five open-ended questions were also analyzed.

Results. The frequency data revealed that these families know what medications their loved ones are taking and believe they are at least somewhat effective in helping their loved ones to feel or act more normal, even though two-thirds acknowledge their loved ones face significant side effects. In addition, this group of family members were, in general, not overly concerned about “dependence” on medications, nor is their home life riddled by shame or conflicts related to medication. The latent profile analysis did yield two categories of interest among respondents: those “skeptical of the medical model” (43%), and those “supportive of the medical model” (57%). Several meaningful differences between the two groups emerged related to perceived effectiveness of medication and its impact of their own safety. Narrative data echoed other studies of families in that most respondents did not feel adequately prepared for medication-related challenges of their loved ones and very few received a sufficient amount of information from providers or felt included in decision-making.

Conclusions and Implications: The findings clearly suggest family members desire greater inclusion in medication-related decision-making and wish providers more radically embraced collaboration with them and other providers, as well as more balance in their approach to care. This is important because we know that family support and involvement in care can be a positive force in the recovery of people with mental illness, specifically improving outcomes and adherence, helping to reducing stress, motivating their family members to get better, and offering them hope. Results also suggest that psychoeducation programs for families should include more individualized information on which families can base their expectations for their loved one (e.g. rationale underlying drug choices, timelines for short-term and long-term effects, broader view of treatment options). This expanded knowledge may help both families and providers be more responsive and compassionate in their care of those with serious mental illness, especially as it relates to psychiatric medication.