The Partnership Between the Psychiatrist, Psychologist and Caregiver

The important relationship between the psychiatrist and/or therapist and the caregiver of a child or adult with a mental illness.

This is for the carers of people with severe mental illness who provide continuing help and support, without pay, to a relative, partner or friend;

It suggests ways of improving communication and liaison that allow mutual respect and real working partnerships to develop from the point of diagnosis.

As the carer, you may feel:

• guilty
• worried that you are losing the person you knew
• wonder if anyone else in the family will be affected
• exhausted by caring and ensuring that the person is safe
• scared about admitting there is a problem
• worried about the long-term outcome for the person
• worried about coping and getting help
• worried about the long-term financial responsibilities of caring
• worried about people's negative attitudes towards mental illness and the stigma associated with it.

Tips for carers

In partnership with your doctor and members of the mental health team

Good communication between a doctor, members of the mental health team, a child or adult with a psychiatric condition and their carer is important but takes time and effort. Forming a positive, long-term relationship with all the staff and doctors involved in the care of the patient is especially important if the condition is long-term.

If the person has the symptoms for the first time, it is important to see the doctor or therapist as soon as possible. If you go to your family doctor, the physician will make the initial assessment before referring the person to a specialist. If the person refuses to see a doctor, the carer or another trusted person should try to persuade them to accept professional help.

Some of the specialists you are likely to come across are psychiatrists, psychologists, counselors, occupational therapists, social workers, community psychiatric nurses, and support workers.

Questions to ask the psychiatrist, psychologist or mental health professional

• What does the diagnosis mean?
• Can you explain it in a way that I will understand?
• Are there any treatments?
• Where can I get information about medication and possible side-effects?
• How long will it take for the medication to work?
• Are there other things we can do to help ourselves?
• What can we expect in the near future and over time?
• Will the person be able to continue in work or in education? Is it safe for the person to drive?
• Will the person I care for get better:
• How often should I come and see you?
• Can you give me an after-hours emergency telephone number:
• Do you have any written material on this disorder, if not who does?
• Is there anything that we can change at home to make things easier, or safer?
• Are there any organizations or community services that can help?
• Where else can I get guidance and advice?

Remember to arrange your next appointment before you leave.

Regular well-prepared visits to the doctor, or other members of the mental health team, will help get the best care for both of you.

Advice which will help you prepare for follow-up visits

• Keep track of changes in behavior and reactions to medication in a notebook, along with any concerns or questions since you last saw the doctor.
• Look at the information you have collected since your last visit and write down your top three concerns. This will make sure that you remember to talk about the things that matter. Your concerns may include questions about:
  • changes in symptoms and behavior
  • side-effects of medication
  • general health of the patient
  • your own health
  • additional help needed.

During your visit

• If you do not understand something, ask questions. Do not be afraid to speak up.
• Take notes during the visit. At the end, look over your notes and tell your doctor what you understood. This gives your doctor a chance to correct any information or repeat something that has been missed.

Further tips for caregivers when dealing with doctors and other members of the mental health team

Doctors and healthcare professionals can be reluctant to discuss a person's diagnosis or treatment with the caregiver. There is a real duty of confidentiality between doctor and patient. Of course, if your child is under 18, then the doctor or therapist can share any information with you. If the person is too ill to understand what is going on, doctors will usually involve the carer in discussions and decisions.

If your child or loved one is over 18 and the doctor is unwilling to involve you as the carer, there are a number of things you can do:

• ask the person you care for if you can be with them at some of their appointments, or for a part of their appointment
• talk with other carers as they may have some helpful suggestions
• try to talk to other members of the mental health team
• contact mental health support groups such as NAMI or the Depression Bipolar Support Alliance