Mental illness, physical abuse and burden of care on relatives: a study of acute psychiatric admission patients

Abstract

As mental health care policies increasingly emphasize treatment and care in community settings, there has been concern over the burden that families of mentally ill people might suffer as a result. We conducted a study of the prevalence of abuse faced by relatives of patients admitted during a 6-month period to the acute psychiatric unit of a busy general hospital, who had previously been living with a relative. Patients and their relatives were assessed using semi-structured interview schedules. The experience of burden and the specific experiences of abuse since the onset of their relative's illness were recorded. In total, 32 (32%) of the 101 relatives had been struck on at least one or two occasions. Verbal abuse, threats and temper outbursts were reported by over 50% of the relatives. Principal correlates of abuse were diagnosis, concurrent drug misuse and a poor pre-morbid relationship between carer and patient.

Attempting to Understand the Increase in the Numbers of Forensic Beds in Europe: A Multi-site Study of Patients in Forensic and General Psychiatric Services

“…Rather, two studies have shown that for patients with severe mental illness living with family increases the risk of engaging in aggressive behavior (Estroff, Zimmer, Lachicotte, & Benoit, 1994;Swanson et al, 2006). Family members are the usual victims of violence by persons with schizophrenia (Arseneault, Moffit, Caspi, & Taylor, 2002;Nordström & Kullgren, 2003;Vaddadi, Soosai, Gilleard, & Adlard, 1997). This often replicated finding suggests that families do provide care to persons with schizophrenia and this increases their risk of becoming victims of violence.…”

Prevalence and correlates of psychiatric morbidity among caregivers of children and adolescents with neuropsychiatric disorders in Nigeria

“…2 There is also an increased incidence of verbal abuse, threats, temper outbursts and physical aggression towards caregivers of mentally unwell patients. 3 Given the magnitude of services provided and the sacrifices made by family caregivers, the adverse consequences of care-giving have emerged as a serious public health concern. 4,5 Among the numerous psychiatric disorders seen among caregivers, depression was reported to be one of the first symptoms experienced and also the most enduring psychological outcome for this group.…”

Conceptualizing Family Members of Violent Mentally Ill Individuals as a Vulnerable Population

“…Among one sample of caregiving family members, all of whom reported threats of or actual physical harm, 79% reported significant emotional symptomology of their own (Vaddadi et al, 1997). In one qualitative study a mother of a son with schizophrenia is quoted, "I don't know what other people live like.…”

“…Current heavy alcohol consumption and current cannabis use have also been associated significantly with higher levels of abuse towards caretakers (Vaddadi, Soosai, Gilleard, & Adlard, 1997).…”

“…Similarly, Nestor et al (1995) found that the delusional beliefs of severely violent forensic psychiatric patients, the majority of whom had murdered a parent, involved significantly more imposter delusions and personal targets when compared to a less violent group of patients at the same facility. In a study with family members living with individuals admitted to a psychiatric hospital, individuals diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder were more abusive towards their familial caretakers than those with other diagnoses (Vaddadi et al, 1997).…”