When it comes to managing mental health, having the support of loved ones is crucial.

But the impact of being the support person for someone with mental ill-health is not often discussed, and family members are frequently left to suffer in silence.

“Family members are the forgotten,” says Psychotherapist, Dr Karen Phillip.

“While some are told of basic symptoms and ramification, most have little idea on the how to help their family member

“They’re often left confused about the issue their family member is facing, the actions they need to take, the support they are required to offer, the likely behaviour of the affected family member, and the expectation of recovery, if any.

In most cases, the burden of care falls to spouses and parents (particularly in the case of childhood or adolescent mental ill-health), but siblings, friends, and even children may be left to provide the bulk of care. 

“Spouses are extremely challenged when their partner is suffering a mental illness,” says Dr Phillip.

“Sometimes their partner changes into someone they no longer recognise, at times they withdraw, become aggressive, depressed, disengaged from the relationship and family.”

These changes can make it difficult for relationships to remain strong, and resentment can also creep in.

For parents, the more common experience is self-blame.

“Parents often blame themself for everything their child experiences,” says Dr Phillip. 

“The challenges for parents are understanding the condition, how it may have eventuated and any responsibility they have played, as this is what parents normally seek to discover.

“They want to engage and understand their child but often they are unable to as the child withdraws as they often don’t understand what they’re going through themselves.”

With at least one in five Australians experiencing mental illness each year, the butterfly effect on families is significant.

According to the Black Dog Institute, of the 20 per cent of Australians with a mental illness in any one year, 11.5 per cent have one disorder, and 8.5 per cent have two or more disorders.

Almost half  of the Australian population will experience a mental illness in their lifetime.

Dr Phillip says there are three possible outcomes for families dealing with mental health challenges.

“Families can either band together, break apart, or suffer silently,” she says.

And sadly, the pressure of caring for someone with mental ill-health, can lead to the carer suffering their own mental health challenges down the track.

In fact, research in some countries shows mental illness in married couples co-occurs at a level far greater than expected by chance.

According to the Australian Institute of Family Studies, a large study in Edmonton, Canada used standardised interviews to assess lifetime psychiatric history in 519 pairs of spouses.

The results showed significant associations between diagnosed disorder in one spouse and diagnoses in the other.

For example, major depression was about twice as common in spouses whose partner had major depression compared with those whose partner did not have this diagnosis; and alcohol abuse or dependence was about three times as likely when a spouse had this problem.

“It can be confronting for every family member, not trained in dealing with the issue and while limited information may be provided, this is rarely enough for families to really know how to manage the issue.”

To avoid a decline in mental health, Dr Phillip says family members must step back when possible to spend time on things they enjoy, with others who are either unaffected or uninvolved with the situation.

“Too many times we see families isolating themselves as they struggle to deal with the mental illness, and this detrimentally affects them all.

“For children, they may be embarrassed or unable to understand what is happening to their family member or parent.”

If you are caring for someone with a mental illness, Dr Phillip says to be aware of your own (or other carers’) feelings of overwhelm, withdrawing from friends and external events, failure to find enjoyment in life day to day, or an inability to plan for their future.”

“It is incredibly tough for families.

“They should be proactively taking part in the treatment and recovery process where possible, as it affects them all.”