National Alliance on Mental Illness
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Helping Families Navigate Mental Health Care
By Bob Carolla, NAMI Director of Media Relations
The Family Guide to Mental Health Care
By Llyod I. Sederer, M.D.
If you have a family member with mental illness, then The Family Guide to Mental Health Care by Lloyd I. Sederer, M.D., is the book for you.
Usually, when symptoms begin, no one knows what to do or where to even begin to look for help. People enter an alien world, desperate for guidance and reassurance.
Dr. Sederer provides it. He is also no mere psychiatrist moonlighting as a tourist guide. He is the medical director of the New York State Office of Mental Health—i.e., “chief psychiatrist” for the nation’s largest state mental health organization and former medical director and executive vice president of Harvard-affiliated McLean Hospital in Massachusetts.
He is also the mental health editor and columnist for The Huffington Post. Even more impressive than his credentials is his straightforward, warm, compassionate tone. In a foreword to the book, actress Glenn Close writes that Dr. Sederer “makes me feel like he is sitting at this very kitchen table, gently explaining to me, with great knowledge, insight and patience, what is happening to my loved one and what my family and I can do about it.”
He doesn’t pull punches. Families who navigate the world of mental illness will need to “set aside their confusion, sadness and anger—suspending any feeling of despair—about what’s happening in order to get on with what needs to be done.” He shares eight principles, or “guideposts”: Analyze behavior; Remember, it’s not your fault; Trust yourself; Don’t go it alone; Seek help as soon as possible; Don’t get into fights; Learn to bend the mental health system to your needs; Settle in for a siege and never give up.
These steps may be easier said than done, but the book provides important information to help put these principles into action—such as how to recognize symptoms of mental illness, get a diagnosis, choose among treatment options and choose the right therapist. Lists of “questions to ask” about medications and other topics also are provided.
Occasionally, Dr. Sederer will explain scientific or medical concepts in ways that are not only friendly for a lay reader, but also entertaining. In “Getting the Right Diagnosis,” he explains that the psychiatric profession knows that some treatments work, but not why—because we still do not know exactly what causes mental illness. But that’s also not unusual, he notes. In the 19th Century, germs weren’t “discovered” until after doctors realized that fewer babies (and their mothers) died if doctors washed their hands before delivering them.
In “Treatment Decisions,” Dr. Sederer provides just enough information to allow readers to understand the concepts of “evidence-based practices,” “measurement-based care” and “stepped care” without overwhelming them. Those concepts can be important in choosing between options, managing expectations and evaluating progress toward recovery. Similarly, in “The Places You May Go,” he describes the alien terrain that many families may have never expected to visit: e.g., outpatient clinics and psychiatric inpatient units, followed later by mentions of transitional housing, group homes, supportive housing and other programs.
Dr. Sederer’s last two principles are paramount: Prepare to take on the mental health system and never, ever give up. His book prepares the reader for that challenge. He sees families as partners in both trying to make the mental health system work—and to reform it. He also sees them as a source of knowledge and inspiration in their own right. In the book’s acknowledgements, Sederer gives “special thanks” to NAMI members “who welcomed me into their meetings and lives and deepened my understanding of what needs to be done… I hope this book honors their efforts.”