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Education Is the Key

Network, Fall 2006

On April 8, 1952, the London Mental Health Association got an earful from the superintendent of the local psychiatric hospital, Dr. George H. Stevenson. According to a London Free Press article that appeared the following day, Stevenson asserted that many mental diseases are not inherited, but caused by parental ‘infection’ in early life. The mother infects the child with mental illness, said Stevenson, just as the tubercular mother does.

‘No wonder families felt challenged to declare ‘My child has a mental illness’ if the superintendent of the psychiatric hospital is saying, ‘Well, that’s because you’re a mentally defective parent,” responds Mike Petrenko, executive director of the Canadian Mental Health Association (CMHA), London-Middlesex Branch. During his 22 years with the organization, Petrenko has studied the history extensively. Since the 1950s, he observes, CMHA has made great strides in helping families to deal with the stigma attached to mental illness.

Overcoming stigma begins with education. From the beginning, the London Mental Health Association (which later became CMHA London-Middlesex Branch) has devoted both staff and volunteer resources to public education activities. From 1951 to 1954, public education focused on the mental health of children. In 1953, according to minutes of the executive, this expanded to include ‘the aged, relatives of people with mental illness, and the rehabilitation of patients.’

Many of the founding members were professionals who worked with consumers in the hospitals, along with family members who contributed their time as volunteers. There was very little consumer involvement in the beginning, except for ‘the silent consumer who didn’t want to identify himself, because he didn’t want to be labelled,’ says Petrenko. Even for family members who participated, their involvement was very much behind the scenes. As a result, rather than education or support directed at other family members, CMHA London-Middlesex concentrated on programs for the entire community, using such methods as radio broadcasts and panel discussions.

Miss Edith McDowell, dean of the University of Western Ontario’s School of Nursing, was a board member in the early years. She complained at the May 16, 1951, executive meeting that the education series presented in the winter of 1950/1951 was ‘depressing, in that every program left the listener in doubt as to whether help [could be] obtained in a tragic situation.’ Arguing for ‘a more positive approach,’ McDowell got a motion passed that future programs should be built around ‘how members of a happy family conduct their interpersonal relationships.’

McDowell’s motion was acted upon. Mrs. Jay Peterson, a London artist, produced two posters for the local CMHA Mental Health Week, May 4-10, 1952. One poster presented a dysfunctional family situation and the other a functional one. In the edgy dysfunctional montage, Peterson included many terms that still ring true today, such as ‘escape,’ ‘fearfulness’ and ‘keeping up with the …’Jones’.’ On the functional poster, she cited balanced mental and physical activities, ‘proper food, adequate sleep,’ and the ‘ability to communicate ideas to others.’

The Public Utilities Commission displayed this artwork in a large window during Mental Health Week. The posters were also put on view at the May 26, 1952, executive meeting so members could see their effectiveness. In addition, photographs of the artwork were sent to the ‘Toronto head office’ of CMHA.

Over the next several decades, economic pressures on the health care system and the advent of modern psychopharmacology led to more and more consumers being let out of psychiatric hospitals. The drugs controlled or suppressed symptoms, but while psychiatric hospitals emptied, beds in outpatient facilities filled with consumers who could not find adequate community support or treatment.

Many consumers had trouble finding, and affording, a place to live. As the process of deinstitutionalization accelerated from the 1960s to the 1980s, many consumers sought out family members for support. While many relatives were unprepared to meet the responsibility, others faced the issue straight on.

One of the family members who confronted the crisis was Carolyn Dykeman. A retired doctor’s assistant who has a number of bipolar relatives, Dykeman recalls that she ‘hit every brick wall possible’ trying to get help for them. In the late 1980s and early 1990s, she attended a few meetings of the local CMHA mood disorders group, and she came to the conclusion that family members with mentally ill relatives should have their own support group. So, in June 1990 she formed Families and Caregivers Together (FACT), an independent self-help group that operated out of the CMHA local branch until 2005. The group provided a very important outlet for family members or friends of the mentally ill. These people often felt angry and overwhelmed. FACT gave them an opportunity to let off steam and talk with people who understood what they were going through.

In the fall of 2004, Dykeman developed the Family Psychoeducational Group (FPG) course, along with Patricia (Trix) Van Egmond. Van Egmond is the public education and information and referral team leader for the local branch. Dykeman cofacilitates FPG with Marnie Wedlake, the branch research/information coordinator and mental health public educator. Targeting the same clientele as the FACT group, FPG teaches them about specific mental illnesses, offers anger and stress management techniques, and provides information about local resources. Participants in the course get a binder of reading material they can take home with them to share with the ill family member. After the course, participants who have attended at least seven of the eight sessions are eligible for free counselling for six weeks from the London Interfaith Counselling Centre.

People who have taken the course often cannot say enough about how much it has helped them. ‘Education is key in coping with mental illness in a family,’ commented the mother of an adult son with bipolar disorder. ‘It is a daily struggle, and the information given and personal knowledge of the facilitators is invaluable.’ Another participant added, ‘For the first time in 20 years, I can finally sleep through the night. I now know that it’s not my fault.’

Supported and educated family members can make a critical contribution to their relative’s recovery, and CMHA London-Middlesex has come a long way since the 1950s in recognizing the challenges that family members face. The Family Psycho-Educational Group is a ‘much needed, long overdue program that gives families some tools to help them when mental illness strikes,’ says Dykeman. ‘There is no life manual for it, so some sense has to be made about it. It is very important that families and consumers work together for the best of all involved. Mental illness needs team players. The days of hiding your head in the sand are thankfully long over for most people.’

Petrenko adds: ‘Families and friends of people with mental illness have always had the ‘burden’ or ‘joy’ of supporting their loved ones. This role is much more difficult when the formal mental health system has significant weaknesses. I would observe that when large numbers of consumers lived in psychiatric hospitals, the support role for families was significantly different than today, in that food, clothing, shelter, daily activities, etc. were looked after by others. The struggle today for appropriate housing and supports for independent living preoccupy many families. Through family education and support, CMHA can best help families to be heard. In Ontario, we need to support this voice in each and every Local Health Integration Network, where the significant decisions will be made to improve the lives of consumers and their loved ones.’

Leith Peterson is a freelance writer living in London, Ontario.

» Return to Network, Fall 2006 – Contents