Addressing Mental Health Needs in Families with Children

1
Addressing Mental Health Needs in Families with
Children

• National Conference on Ending Family Homelessness
• Helene M. Rimberg, PsyD

2
Key Points

• In order to be most effective, service providers
  need to understand the complexities of their
  clients
• Families are systems
• Families are part of multiple systems
• Mental Health issues impact the individual, the
  family, how it interacts with other systems, and
  how other systems respond
• Housing case managers can play a vital role in
  assessment, resource development and follow
  through

3
Fragmented Approach

• Feel misunderstood
• Feel disrespected
• Feel like a problem not a person
• Less likely to follow through
• Service delivery is less effective

4
Integrated approach

• Person feels understood
• Problems are viewed in context
• Person feels respected
• Views provider as ally
• Services are appropriate and likely to succeed
• More likely to engage and follow through

5
Families as systems

• A family is greater than the sum of its parts
  creates a unique whole
• Family members impact, and are impacted by, each
  other ripple effect or interdependence
• Have a defined set of rules
• Have a defined structure
• Have patterns of behavior that are resistant to
  change
• Seek to maintain status quo

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Families are part of multiple systems
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Add mental health issues

• Mental health issues impacts
• How members respond to each other
• Familys level of engagement
• Familys quality of engagement
• Response from others

8
Depression

• Low energy
• Hopelessness
• Fragility
• Suicidal
• Sleep problems
• Sadness

• Family members caretake, protect neglect own
  needs
• Limited engagement with others
• Engagement marked by low motivation
• Others feel frustrated, tend to take over

9
Bipolar Disorder

• Depression
• Mood swings
• Instability
• Impulsive
• Excessive involvement in pleasurable activities
  drugs, gambling, sex, spending
• Grandiose
• Agitated
• Resistance to medications

• Family members response varies with phase
  creates instability
• Engagement varies with phase in manic state
  will avoid purposeful contact
• Others response will also vary based on phase
  caretaking during depression, punitive during
  manic phase

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Schizophrenia

• Starts in late adolescence or early adulthood
• Thought disorder
• Delusional
• Hallucinations
• Paranoid
• Nonsensical communications
• Poor self care
• Flat affect
• Disconnectedness
• Cognitive problems memory, attention, organize
• Substance use

• Family members feel burdened, helpless, scared,
  embarrassed by bizarre behaviors
• Engagement with others is difficult marked by
  communication difficulties
• Others are at a loss on how to engage turf to
  more restrictive environment

11
Borderline Personality Disorder

• Pervasive instability in relationships, moods,
  behavior, self-image
• Highly sensitive to rejection
• Good/bad thinking
• Self-harming
• Impulsive
• Substance use

• Family members are overwhelmed, angry, fear
  upsetting the other, feel manipulated
• Engagement with others is unstable good
  provider vs. bad provider
• Tend to disrupt systems, burn bridges
• Others feel manipulated, fear becoming the bad
  provider, not sure what to believe

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Role of Housing Case Manager

• Thorough assessment of family to determine mental
  health issues, impacts and needed resources
• Create system of support utilize community
  resources to serve family within community
• Resist what mental health issues pulls from you
  respect the family, your boundaries
• Be genuine you are your best tool