Important information for relatives

Early recognition for family members – what has to be done?

bildAs a person closely related to someone suffering from such an illness you can play a very important role in the course of the early recognition and intervention in cases of psychoses since, as a rule, you will be able to perceive early symptoms first of all. As a mother or father, you will already be able to notice changes very early which you have completely and correctly rated as passing and age-appropriate crises. Usually, these changes in your son or your daughter are also really temporary and no ground for worry.

However, if you observe such changes over a longer period of time, which cause you concern, particularly involving increased social retreat, a depressive mood, increased mistrust, increased stress and irritability, as well as disturbances in concentration, learning and memory capabilities of your child, it may be recommendable to consult a specialist in private practice or to visit an early recognition centre. You then have the sometimes difficult, but also very important task of motivating your relative to undertake the necessary steps of clearing up a diagnosis. It also proves to be helpful if you offer all conceivable assistance for your relative like arranging an appointment or offering to accompany him/her to an appointment, etc.
The first contact points are frequently school counsellors and information centres or also family doctors, psychotherapists and specialists in psychiatry. Specialists for childhood and juvenile psychiatry and psychotherapy are unfortunately only rare and frequently overloaded. If the parents' concern is the main problem, special family information centres can sometimes provide help in clarifying the problematic situation. In the field of drug addiction, there are also special contact sites.

The outpatient departments of the psychiatric hospitals and clinics demonstrate different specialities. Some have particular offers for those who are diagnosed for the first time, like the early recognition centres, for example, which frequently also cover the fields of addiction and psychoses quite well.

The admission to a psychiatric clinic is still always associated with a great deal of fear. Even though much has changed positively here, there are meanwhile a number of investigations which have shown an outpatient therapy to be more advantageous in the event of severe crises. The first admission increases the probability of undergoing a second one. The manner of the first contact with the psychiatry moulds the treatment not only in the quantitative but also in the qualitative sense. Discussions and relationships are decisive for the "patient career". Continuity reduces the rate for a compulsory hospitalisation and the site of the first therapy also influences the probability for later admissions. Before all else, the Scandinavians have shown the long-term positive effects of so-called "home treatment" attained in this connection.

At this site, it is not possible to provide a complete review concerning where it is best to treat which student of which age and with which problems. Depending on whether eating disorders or problems with addiction, depressive or psychotic symptoms are in the foreground, the first step to take can be very different. However, important is to look for help once too often rather than once too little!

If you want precise information for the early diagnosis of psychoses, visit our Website "Early recognition of psychoses"

The situation of relatives

Information on guardianship law

Closely related individuals must be prepared that third parties, frequently also the clinics, might file for the compulsory admission of your family member for care. Often, the family members are not even involved or informed. Family members are generally are not aware of their own rights nor do they know which far-reaching consequences the arrangement of such care can have.

The ideas of "care" and "care providers" are used in different connections. This can lead to some confusion.

Legal care provider: He/She is appointed by the court and has the task of taking care of all affairs and regulating all business activities which the patient cannot take care of alone. The appointment of the legal care provider is regulated through the law. There are voluntary care providers, like for example family or professional care providers.

Social care providers: These are members of the staff of psychosocial facilities or outpatient services, e.g. in residential homes or assisted living facilities. The social care provider has absolutely no legal authority. He/She merely provides support in the practical handling of the patient's day-to-day life.

Social care providers: These are members of the staff of psychosocial facilities or outpatient services, e.g. in residential homes or assisted living facilities. The social care provider has absolutely no legal authority. He/She merely provides support in the practical handling of the patient's day-to-day life.

A universally valid answer to the question of whether or not relatives should strive to have the care of a psychologically ill member of the family entrusted to them probably cannot be given. The individual family situation must be considered carefully. If the wishes of the family members to be appointed as care providers are not to be fulfilled, the reasons are to be presented concretely and in reference to the existing case. The court can in special cases demand an opinion from the treating doctor. If the treating doctor expresses him/herself against the order of relatives to act as care providers, the relatives should not accept such lump sum formulations as "lacking distance", "to close a nearness".

Special problems

Personal privacy as a pretence?

Not rarely family members who are in a similar situation themselves are rejected, explaining as a ground for this decision that one must be loyal to one side as a physician or therapist and can only provide services for this one side. This is understandable to the extent that no discussions are to take place behind the patients back and no insider information is to be passed on to others. But here, this is of no concern to the family members.

As a rule, a conversation carried out in time and in the form of a dialogue serves to provide relief to all participating parties - including the therapist. In this manner, it represents the easiest possible way to eliminate unnecessary complications and to form more realistic goals to be carried out jointly.

To prevent confusion from "rearing its ugly head" as well as, at the same time, to stabilise the individual and familiar resources, is the goal of all involved. Once again, communicating with one another in a more or less relaxed manner can be difficult after an acute psychosis. To learn how to do so once again helps a great deal on the way to stabilisation. There is no question that both parties involved require aid. For a well-versed therapist, it is therefore imperative to examine whether all parties involved will benefit more from the common or from individual collaboration. 

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