Help for families
Challenges & Choices: Finding mental health services in Ontario
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There are two reasons why you, as a family member, may access mental health services: to find treatment and support for someone in your family who has a mental health problem or to get information and support for yourself.
The effect on family members
When someone has a serious mental health problem, it is natural for the person's family members to feel worried and stressed. You may be mourning a change triggered by a newly diagnosed mental health problem in someone close to you. Or you may be exhausted with trying to help your family member, at the sacrifice of your own needs being met. It is common for family members to feel confused or fearful about what the future holds--or angry or guilty about times they have spent with the family member. Some people lose touch with their own network of friends, which can make them feel isolated and alone.
Often people take a long time to realize how emotionally and physically worn out they have become. The stress can lead to sleeping poorly and feeling exhausted or irritable all the time.
If you are experiencing this stress yourself, don't despair. Seeing the signs is the first step to looking after your own physical and mental health. Finding your own limits and making time for yourself are keys to self-care. Caring for your own needs includes creating a support system of friends and family you can rely on. Think about people you might want to share your thoughts and feelings with. Mental health problems are hard for some people to understand. Open up to people who will support you. And help others by sharing the information and knowledge you have gained. Also, make sure that--along with your own needs--you focus on the needs of other family members who may be in the same situation.
There may be times when people's mental health problems cause them to behave dangerously, but violence is not common among people with mental health problems. In fact, they are far more likely to be the victims of violent or aggressive behaviour than to commit violence. However, when someone who has a mental health problem is aggressive, their actions will often be directed toward the people close to them.
There are many practical ways to take care of your own needs:
- Learn as much as you can about your family member's mental health problem. You can get information on mental health issues and policies through family support programs, hospitals and organizations that focus on specific disorders, such as the Schizophrenia Society of Ontario and the Mood Disorders Association of Ontario. (For contact information, see Appendix B.) You can also find out about individual family support projects or programs by contacting your local Canadian Mental Health Association office.
- Join a support group or support program for family members: you can discuss your feelings, get support and learn from others in a similar situation. Family support groups or programs often focus on a specific problem (e.g., schizophrenia or bipolar disorder). In addition to groups for all family members, there are special groups just for spouses, children or parents of people with mental health problems. Some family support programs also have staff or trained volunteers who can give individual support. You can find support groups and programs through hospitals, community mental health agencies and self-help organizations. Contact specific family support groups through the Schizophrenia Society of Ontario and the Mood Disorders Association of Ontario. Find out how you can get involved. (See Self-help groups, in Section 10.)
- Find out about the many other services available to you: from marriage or family therapy to massage, naturopathy or opportunities for creative expression. (See Section 4: About therapy, and Section 6: Natural healing)
- Look into educational groups that help family members and friends understand what the person with a mental health problem is going through. You can learn about symptoms and treatment (e.g., medication or natural therapies). And you can learn about how to help someone you care about and limits to the help you can give. Educational groups may be offered at the hospital or community agency where your family member is being treated. Some self-help organizations have regular education meetings. Think about finding your own therapist. (See Section 4: About therapy)
Challenge: You do not have anyone to care for your children while you go to an appointment. (This can be a particular worry for single parents.)
Suggestion: Find out if child care is offered through the program or if you can bring your children with you.
Hou you can helpSupport your family member to get help
Someone who is moderately depressed or anxious is more likely to agree to get help without needing to be talked into it. But a person with a severe, ongoing mental health problem may refuse treatment. The person may not believe there is a problem. He or she may want to avoid the mental health system because of a bad experience or may feel that treatment will not make a difference.
You may try over and over again to convince your family member to take his or her medication or talk to a doctor. But trying to coax and persuade sometimes leads to arguments and continuing conflict. Although you may be very close to your family member, your views may not be welcome. The person may shut you out. Sometimes it helps to have someone else you trust talk to your family member.
There are other ways you can help yourself and your family member.
- Familiarize yourself with parts of the Mental Health Act; for instance, the forms that have to be filled out for a mandatory psychiatric assessment and possible hospitalization. Family support programs are also a good place to find this kind of information. (See Appendix C, Forms 1 and 2 and information below about calling the police.)
- Suggest to your family member that he or she consider making a power of attorney for personal care or property in the event that he or she may become incapable of making decisions about personal care (including treatment) or money and other property. (For information on contacting a lawyer, see Legal help, in Section 11. For more information on mental health laws, see Section 13: Understanding your rights)
- Write a journal with details of your family member's problem. This could include the history of the problem (e.g., when the problem started, how it began and progressed, how many times he or she had symptoms and what they were) as well as a record of treatment (e.g. hospitalizations, medications and a list of the health care professionals who treated your family member). It may help to prepare the history with another family member; different people may have had different experiences or may remember things differently.
Confidentiality laws prevent professionals from sharing family information about an adult client without that person's consent, but family members are allowed to provide information. So a journal can be very helpful.
- Prepare a crisis plan if your family member or someone close to you has been in a crisis, in case of another emergency. Keep this plan near the phone or somewhere else where it is easy to find.
A crisis plan contains all the information that would be important to have should there be a crisis. For instance, write down the names and phone numbers of:
- the hospital nearest you
- a mobile crisis unit (see Mobile crisis units and services, in Section 9) and
- a community relations or other contact person at the local police department.
Making contact and informing the local police about your family member's situation will help if a crisis occurs, especially when there is a continuing problem.
- If your family member is in conflict with the law, find out more about court diversion programs and other mental health services in the court system. (See Section 8: More intensive and specialized support)
- If you think your family member might harm him- or herself or others, you might want to consider having your family member put in a hospital. You can contact a doctor, a justice of the peace or the police.
- A doctor can make a house call to assess if your family member can be taken to a psychiatric facility for a period of up to 72 hours (three days) for a more complete assessment under Form 1 of the Ontario Mental Health Act.
- A justice of the peace can issue a Form 2 for a psychiatric assessment authorizing the police to take your family member to the hospital. This is based on a sworn statement from you. Your family member does not have to have seen a doctor. However, the Form 2 only requires that your family member be brought to the psychiatric facility for an assessment. The person only stays in the hospital if a doctor issues a Form 1.
To contact a justice of the peace in Toronto, call (416) 327-5179. To find a justice of the peace outside of Toronto, contact your local courthouse.
- The police are authorized to take someone to the hospital for an assessment if the police or someone else, such as a family member, have seen the person behaving dangerously as a result of a mental health problem or if they have a completed Form 1 or Form 2. (See Appendix C for more details about Form 1 and Form 2.)
- Prepare a list of questions before you meet with the people who are helping your family member. The following will give you an idea of the questions you might ask, depending on whether your family member is already in a hospital or is still being assessed:
- Are there any resources to help me cope?
- Who will assess (or who has assessed) my family member?
- When will we know how long my family member will be kept in hospital?
- What are visiting hours? Can children come?
- Can I bring food or gifts?
- Can I meet the social worker and primary care nurse to discuss plans for leaving the hospital?
- Can I be involved in my family member's care team?
- Will you contact me before my family member is discharged?
Challenges & Choices: Finding Mental Health Services in Ontario