NAMI CA Policy Position on Family Involvement in Treatment
NAMI California believes that treatment should be collaborative. Family members are a central resource in the treatment of children and adults living with serious mental illnesses and should be an integral part of the treatment team and empowered to facilitate mutually agreed upon treatment team goals. Research overwhelmingly shows that when families
take an active part in treatment decisions, consumer outcomes are better. While families do not cause or maintain serious mental illnesses, their knowledge of and relationship with the consumer is unique and can be a significant help in determining the best course of treatment.
In no case should the presence of a loving, caring family be used as a substitute for a delivery system that provides for all of the person’s treatment and rehabilitative needs.
Treatment should be client- and family-centered. The consumer should be encouraged to participate fully in planning, monitoring, and evaluating treatment. Other treatment team members should assure that their focus is on meeting the consumer’s needs, not the desires of the system or service providers.
Common courtesy dictates that consumers and family members be treated with compassion, dignity and respect. They must also be provided with extensive education to understand all aspects of the illness in order to be more effective in its treatment.
Family and consumer advocacy should always be encouraged. In circumstances where the mental health system is understaffed, under-financed, and services are uncoordinated, or other problems impede proper service delivery, family and consumer advocacy is effective and powerful.
Sometimes, because of stigma and lack of information regarding serious mental illnesses, the family is not involved. Their absence does not usually indicate that they don’t care or are not concerned. Mental health workers
must understand this and work to strengthen family relationships. When
family members become educated and are respectfully involved in a way
they experience as empowering, their approach to the patient and the
treatment system changes.
In such cases where consumers do not want their family members involved, their wishes must be respected. At the same time, extensive
educational efforts should be made to help these consumers understand
that their families are not to blame for the illness and that recovery is more likely if all interested parties work together. A one-time rejection of
family involvement should not prevent ongoing requests for authorization
of family participation.
All treatment and services provided to children living with serious mental illnesses and their families should be child-centered and family-driven,
with the needs of the child and family dictating the types and mix of
services provided. The families, surrogate families, and legal guardians of
children with serious mental illnesses should drive the treatment planning
and delivery process, in close consultation with the treating providers.
Children living with serious mental illnesses should be included in all
aspects of treatment planning whenever possible.
Family-driven means that the treatment provider gives the family the information, skills, and support to make informed decisions as equal partners in the treatment planning and delivery processes. Children living with mental illnesses should be included in all aspects of treatment planning whenever possible.
Families must have a primary decision-making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory, and nation. This includes:
Choosing supports, services, and providers;
Setting goals;
Designing and implementing programs;
Monitoring outcomes;
Partnering in funding decisions;
Child-serving systems and their funding mechanisms should be designed to allow families with children living with serious mental illnesses to easily access appropriate mental health and related services. Child-serving systems should be designed with cross-system and interagency collaboration to ensure an appropriate coordination of services for children and families. Families should not be required to navigate multiple, complex and overly bureaucratic systems to access appropriate services for their child.