Working in partnership : clinicians and carers in the management of longstanding mental illness / Liz Kuipers and Paul Bebbington.

  • Elizabeth Kuipers
Date:
1990
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Working in partnership : clinicians and carers in the management of longstanding mental illness / Liz Kuipers and Paul Bebbington. Source: Wellcome Collection.

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    MEETING NEEDS • 15 relatives' own mental health. This has been documented par¬ ticularly for those married to depressed or neurotic partners (Kreitman, 1964; Kreitman et al., 1970; Ovenstone, 1973a; Fadden et al., 1987b), but has also been noted for those living with schizophrenic patients (Brown et al., 1966; Hoenig and Hamilton, 1966, 1969; Stevens, 1972; Creer and Wing, 1974). The Burden of Depressive Symptoms The outome of affective illness is less good than commonly be- Heved (Bebbington, 1982; Lee and Murray, 1988; Kiloh et al., 1988). In consequence, a fair proportion of longstay patients have predominantly affective conditions (Mann and Cree, 1975). Moreover, in our experience, many patients with longstanding illnesses that have been given other diagnoses do experience major symptoms of anxiety and depression. There is little information about the specific effects of depres¬ sion on the family of the patient (Kuipers, 1986). The literature deals exclusively with the effects on spouses, although this may not be inappropriate, as depressive patients are much more likely to be married and living with the marital partner than are people with schizophrenia. In these marriages there is frequently con¬ flict (Hinchcliffe et al., 1978), particularly, over role functions (Ovenstone, 1973b) and a high level of dependence (Birtchnell and Kennard, 1983). With increasing pathology on the part of the husband fewer joint decisions are made (Collins et al., 1971), and the wives of depressive patients have significantly less in¬ dependent social activity than controls (Nelson et al., 1970). Fadden and her colleagues (1987b) have recently conducted a pilot study of the spouses of persistently depressed patients of specified types. Their findings show striking parallels with the findings on schizophrenia, and emphasize the severity of the burden borne by spouses and the noticeably adverse effect upon their mental health shown in a high prevalence of depressive and anxiety states. Towards Helping Relatives Although a lot is now known about relatives' difficulties, less has been written about the best strategies for relatives to use in dealing with their probems and of how, even if professionals knew what to advise, they could ensure their advice was adopted.
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