THE FAMILY GUIDE TO MENTAL HEALTH CARE
The Family Guide to Mental Health Care
Interview with Lloyd Sederer, MD — Speaker, Conference ‘13
Psychiatrist Dr. Lloyd Sederer is the Chief Medical Officer for the New York State Office of Mental Health. He was in active psychiatry practice providing direct care for nearly 30 years and continues to help patients with mental illness and their families by consulting on complex cases. He is a prolific writer and the mental health editor for The Huffington Post. Lloyd Sederer’s The Family Guide to Mental Health Care is an excellent resource for families struggling with a loved one’s mental illness. In this book, families can find answers to help them understand a variety of disorders, assess whether doctors are really helping them, identify the right treatments, and learn how to navigate the system and pay for treatment. Dr. Sederer shares insights from his book.
Meena: Why did you write the Family Guide to Mental Health Care?
Lloyd: Whether it’s bipolar disorder, depression, schizophrenia, PTSD, or eating disorder — people must learn that these illnesses last and they need to find good services and stay in treatment. However, for most families that I learned from over the years, the biggest challenge was understanding and managing the mental health system, and the second challenge was helping their loved one get care when their loved one did not want care. That is such a heartbreaking problem — when you care for somebody and you see that help is possible, but they won’t get it.
Meena: What keeps people from getting care?
Lloyd: Sometimes it’s the illness itself. With some of the more serious mental illnesses, including those involving psychosis, people don’t believe that they’re sick. Or they’ve had bad experiences with the mental health system. Or they don’t know enough about the illness to believe that anything can be done. About 80 percent of people with mental illness don’t get the care they need.
Meena: As a family member, how can I get a loved one in denial about his or her mental illness to make a decision for care?
Lloyd: Whether it’s heart disease, diabetes, or depression, people have to come to believe that it’s in their interest to take care of themselves and to manage their illness. It starts with understanding what the person wants.
It starts with a family understanding what a person wants. Families are the biggest support that any of us can have. There’s no resource greater than that for a person who has a persistent illness.
It starts with a doctor understanding what a person wants. Then, helping that person understand that the way they take care of their health and manage their illness will enable them to get what they want. Just exhorting people, telling them what to do, doesn’t work.
Meena: You point out that it can be extremely difficult. You caution families not to get into fights, and to not ever give up.
Lloyd: Sometimes what looks like an impossible situation or one that’s going to go on forever, doesn’t. Sometimes if you wait, if you don’t burn bridges, if you help people continue to rebuild themselves in tiny ways, the moment comes along where things turn. They turn in the right direction and people begin to rebuild their lives.
Meena: In your book, you encourage a family member to talk to the doctor in advance of visit with the patient. Given HIPAA rules, can doctors have this type of conversation with a family member?
Lloyd: There’s a big difference between talking and listening. As a family member, you can say to the doctor, “Look, I know you don’t have consent. I know you can’t tell me anything, but you can listen. There’s no law against your listening and I want to tell you some things that are really important and that you’re not going to hear from the patient.”
In a recent Wall Street Journal article, I talk about the issues of privacy and liberty and how these laws were created a long time ago with good intent, but under different circumstances. Today, lawmakers need to listen more carefully to families and to people who’ve recovered and rebuild the law to make it more effective.
Meena: Your book provides a powerful roadmap for families struggling with mental illness. Do you think families could also benefit from other forms of support and training?
Lloyd: Yes, there is a tremendous amount of illiteracy about mental health in this country. Programs like Mental Health First Aid, which can be taught to so many people, are effective in advancing mental health literacy. They help people understand that these problems are common. They tell people you can have certain basic skills that enable you to reach out to support somebody. You don’t have to have a degree in psychology to do that. But you can make a big difference.
Read the full interview in the special National Council Magazine on Mental Health First Aid. And order The Family Guide to Mental Health Care at Norton or Amazon.