Family Support

BY CHRISTINE HANLON

Supporting an adult family member who is struggling with mental illness and/or substance use disorder (SUD) is challenging and stressful. Feelings of concern, compassion and love are more often than not accompanied by fear, frustration, guilt, anger, anxiety, grief, despair, and a sense of helplessness. The first casualty when individuals are struggling with mental illness or addiction is the relationship with those around them, including their family. At the same time, research indicates that loved ones can play a significant role in an individual’s recovery and ability to stay well. The question is how to best support the one we love while addressing the need for our own self-care.

As with all issues related to mental health and addictions, there are no easy answers and no quick fixes. As frustrating as it can be at times to see them and those around them suffer, support does not mean making our loved ones take the steps towards recovery. Only they can decide and act on their recovery. But we can support them.

An important starting point is education. Becoming informed about the individual’s mental illness/addiction is essential to supporting a loved one as effectively as possible despite all the challenges involved. Education helps us separate the person from the disorder. Seeing a loved one struggle with mental illness or SUD is overwhelming. Finding out as much as possible about what they are experiencing can help break things down into more manageable pieces.

Community organizations such as the Mood Disorder of Manitoba (www. mooddisordersmanitoba.ca) and the

Anxiety Disorders Association of Manitoba (adam.mb.ca) have excellent resources related to depression, bipolar disorder and personality disorders, including coping methods for families. To access an even broader range of educational resources, The Canadian Mental Health Association (CMHA) Manitoba and Winnipeg (mbwpg.cmha.ca) is always a good starting point.

The Addictions Foundation of Manitoba (afm.mb.ca) has a long history of offering support and education to family members of those with addictions. A quick look under Courses & Workshops reveals several useful offerings, including Fundamentals of Addiction, Family Dynamics: Substance Use and Gambling, and Family Violence and Addiction.

As these courses suggest, family support is a multifaceted issue. It encompasses everything from supporting our loved ones in seeking, obtaining, and sustaining treatment while helping them with the challenges of everyday living. At the same time, it’s about supporting family members affected by the loved one’s disorder.

One significant challenge for family members is when a loved one experiencing a substance use or mental health disorder is unwilling to seek treatment. Nagging, pleading, or threatening rarely work and often result in a breakdown of communication. However, doing nothing is not an option when a loved one’s health and life are at stake – along with the health and wellbeing of the family members affected.

CMHA Manitoba and Winnipeg and the Bruce Oake Recovery Centre have developed a skills-based Community

Reinforcement and Family Training (CRAFT) program that teaches family members practical strategies to motivate change both in themselves and their loved ones grappling with substance use or mental illness. The goal is to provide education, empowerment, and hope by developing positive ways of interacting with loved ones who are struggling. Courses are offered free-of-charge through the CMHA.

This organization is also a good resource for tackling some of the practical issues related to mental health and addiction problems. The very nature of their illness makes it difficult for those with a mental health or substance use problem to find and access options once they’ve decided to seek treatment. Testimony in A Pathway to Mental Health and Community Wellness: A Roadmap for Manitoba (Government of Manitoba, February 2022) highlights some of the challenges: “Despite having worked in the mental health system for 30 years, when I went through issues with family, I found them very difficult to navigate. I can’t imagine the average person with no professional mental health experience having to go through that.” As such, families and friends can be important advocates in helping a loved one access care for a mental illness or addiction.

At the same time, individuals struggling with either or both of these challenges often face significant financial challenges. Organizations such as CMHA can help families connect to programs related to income and housing. Navigating the bureaucratic system of signing up for something like Employment and Income Assistance can be daunting even for someone who isn’t struggling with a mental health problem or addiction! As those supporting a loved one in this situation know, even the basic demands of everyday life can be very difficult for those experiencing poor mental health, including sleep, hygiene and nutrition.

Fortunately, there are also resources for how to effectively support loved ones with the challenges of daily living, such as the Supporting a family member with schizophrenia manual, one of many resources available at www.porticonetwork.ca. At the same time, families can be instrumental in providing important practical support such as managing doctors’ appointments. This can range from helping make an initial appointment, giving respectful reminders, and helping draft advance lists of issues to be discussed, to providing transportation or even accompanying a loved one to the appointment. It is important to remember that an adult’s health care team can only disclose medical information with a patient’s consent. This can make it very challenging for concerned family members. Nurturing a positive relationship with a loved one – whenever possible – can be the key to family members remaining informed.

But if anything is certain when it comes to mental health and substance use disorders – and few things are – it is that there will be crises. Talking with a loved one during times of noncrisis about how they would like to be supported when a crisis arises can go a long way to being a more effective support.

At the same time, crises and ongoing challenging behaviours can take a toll on family members and their own mental health. Physical, emotional, or verbal abuse by a loved one struggling with addiction/mental illness is never acceptable. Setting boundaries and learning the difference between supporting and enabling are critical tools. Walking away can be a necessary and responsible action. mandyvanleeuwen.com

“Set your boundaries,” emphasizes the organization Families for Addiction Recovery. “If you are angry or feel like a doormat, you may need to adjust your boundaries.” The site goes on to acknowledge how difficult that can be, especially in a parentchild relationship. As well as an excellent online resource, FAR (www. farcanada.org) offers a free and confidential two-month Parent-to-Parent program (P2P) for parents whose children (regardless of age) are struggling with substance use. Participants are matched with trained supporters who also have children living with addiction. The organization also has online support groups and a phone support line.

Canada’s Minister of Mental Health and Addictions, Carolyn Bennett recently noted the importance of having peer support at the forefront of care and support services. The lived experience these support workers bring to the table endows them with invaluable insight. Peer Connections Manitoba or PCM (peerconnectionsmb.ca) offers family members who support individuals with mental health/substance abuse issues regular unlimited phone calls with a trained worker who has lived experience with these issues. PCM also runs a 10-week peer-led online support group.

Other online support groups include Family Connections, a 12-week program through The Sashbear Foundation (sashbear.org) that focuses on providing skills, support, and hope for family members or friends of someone with emotion dysregulation, resulting from such conditions as borderline personality disorder.

There are also ongoing and in-person support groups for family members and other ‘supporters.’ All IN Family (www.allinfamily.ca) holds two weekly support groups. Al-Anon, which supports family members of alcoholics, offers both online groups and in-person meetings at a variety of locations throughout Manitoba.

Family support cuts both ways. When supporting a family member experiencing mental illness or addiction, it is important to seek support for yourself as well.

Being there for a loved one who is struggling with these life-altering challenges is hard. There are many moments of exhaustion and even despair. But families are not powerless. Doing what we can to most effectively help our loved one and ourselves is worth the effort.

No one resource is going to provide everything we need to meet the challenges that arise. At the same time, our fractured mental health care and social assistance systems often present hurdles that hinder and frustrate our efforts. Supporting our loved one is a long-term commitment that requires persistence and stamina.

A sentence highlighted in one of the resources I was consulting when researching this column jumped out at me: "No one is to blame, and you cannot cure a mental disorder for a family member." True enough. But we can be there to support them as best we can.

*In the three-year priority initiatives outlined in A Pathway to Mental Health and Community Wellness: A Roadmap for Manitoba, the Government of Manitoba indicates that it plans to pursue “Review and enhance family supports” and “Increase supports for clients and their family members/ caregivers.” To date, family support is delivered mainly through community and not-for-profit organizations.