4.4 Increased responsibility

A Family Guide to Concurrent Disorders - Part II: The impact on families

Caring for basic needs

Family members may begin to take on much more responsibility for their relative. In more severe cases, the relative may be unable to care for basic needs such as keeping up with personal hygiene, eating meals or even getting out of bed. If the caregiver is also the family's only source of income, being unable to leave the family member alone can lead to huge financial consequences for the family and more emotional strain for the caregiver.

Our son not only has schizophrenia, but he uses drugs, he's been involved with gangs—and with the police. Half the time we're not sure if he's taking his medication—he gets mad if we keep after him to do simple things, like have a shower . . . we're so stressed as it is. We're trying to find out things, how we can resolve some of these problems. Sometimes I think I can't deal with it all.

People with concurrent disorders often have trouble maintaining stable and decent housing. They may:

• spend their money on substances rather than rent, which can lead to eviction
• become involved in criminal activity such as robbing, property theft, prostitution or the sale of drugs to raise the large amounts of cash needed to buy the substances they use, which can result in loss of supportive housing and sometimes homelessness
• open their home to others involved in problem substance use, then be unable to maintain that home, forget to feed and bathe themselves, pay heat and light bills, and face eviction.

These consequences create even more challenges for the families.

Co-ordinating treatment

Some mental health programs refuse to treat people with concurrent disorders, or only treat the mental health problem. Similarly, some addiction treatment programs and facilities may not address the mental health problem. Families may have to take responsibility for co-ordinating treatment between two or more service providers, as well as caring for their relative.

Having a loved one who is suffering from both a mental illness and a substance use disorder can represent a significant disruption in the lives of families and can have an enormous impact on overall family functioning and sense of well-being.

People need to be able to call somebody when their loved one is in the hospital because of a mental illness or a drug problem. They need to be able to touch base and get information from someone. It's hard for people who don't know the system—like, what channels have to be maneuvered—or who to call when you have specific questions. There are so many roadblocks.

Some suggestions for navigating the substance use and mental health system are discussed in Chapter 7 .

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