Carer's Handbook
A
Carer’s Perspective
Your
Questions Answered
Services
Available
How
Can I Support Myself As A Carer?
Benefits
Help
What Can
I Do In An Emergency?
Aims and
Objectives
Acknowledgements
Contact
Carers Support Project
A Carer’s Perspective
The initial impact of being told that your relative has mental illness or a serious mental health problem can often be traumatic. Individuals and families can be left in a state of shock, fear, and disbelief. Without help, they can very quickly become exhausted, isolated and less able to cope. It is a sad fact that due to the stigma and ignorance surrounding mental illness / health, many carers struggle alone and feel unable to seek help. At a time in their lives when individuals need the support of their family and friends, permanent damage can result from society, but also from each other.
As a carer, I feel that it is important to state that you are not alone in your situation, feelings or fears. Getting the right information and support can be vital. Talking to other carers or to someone who understands and can empathize with your situation can be essential. All carers deserve the understanding, support, information, education and advice, needed in order to pick up the pieces and to build ways of coping.
It is also important to remember that no one chooses to become a carer. The day to day task of caring often leaves carers feeling anxious and unable to access much needed help, information or support. Very often, carers feel that they cannot cope and blame themselves when mistakes are made. It is crucial to all, including the carer, to acknowledge and recognise the hard earned experience and expertise of carers who neither volunteered nor had any preparation or training for coping with mental illness or a serious mental health problem.
Parents, relatives and families can very often become engulfed in blame, guilt, fear, anger or embarrassment.
Most carers, however, learn to find their way round a maze of services and systems, insisting that the needs of the person they care for are met, very often at the cost of, and with little thought to their own needs or health.
All carers are individuals and all experiences will be different. I personally find it unacceptable that carers still receive little support and very little of the recognition, respect, information and education that they need and so rightly deserve.
Without these tools I would not have survived or have learned to cope. It can be difficult to take the first steps but remember, with help and support you can learn to cope, adjust and manage the future.
Patricia Mullen, Carer
Your Questions Answered
What’s It All About?
This Handbook is designed to help support people who are caring for a friend or relative who has a mental health problem in the Glasgow area.
Caring for someone with a mental health problem can at times lead to a lot of anxiety. This is especially true when a person you care for is admitted to a psychiatric hospital for the first time, or is referred to a local voluntary organization, specialising in the care of people with mental health problems. The carer is often left asking “What is happening?” This Handbook tries to answer some of your questions. It is a useful supplement to the information that will be given to you by the organization providing care for your relative.
Why Was This Handbook Produced?
People who are caring for relatives or friends with mental health problems have highlighted a lack of information, specifically designed to support them. As a result, our project has produced this handbook. Through networking and research, we have involved other organisations and individual carers to produce a readable and easily understood guide to issues facing carers.
The Carers Support Project also recognized the serious impact and sense of loss, grief, isolation, and stigma felt by carers, families and friends. These feelings are very common and it is important to remember that you are not alone. With support and information you can learn about your relative’s / friend’s illness, and therefore, learn to cope, understand and manage better in the future.
What Is Mental Health?
Everyone has mental health, sometimes good, sometimes bad. However, when you have a mental illness, or serious mental health problem, you may experience problems with your feelings, thinking, behaviour and personality. It is much more common than you think.
Some people can develop more serious, longer lasting mental health problems. These include schizophrenia, manic depression, other types of psychosis, obsessions, and very severe anxiety and depression. These serious mental health problems may prevent the person from performing many every day activities, and mixing socially with others. For example, the person may be unable to care for his or her personal appearance, to get up in the morning, to go out to work or maintain close family relationships. The person may need medication, admission to hospital or extra support from family and friends. It has been estimated that approximately one in every four adults has a mental health problem at any one point in time. One in ten people develop a more serious problem and are referred by their family doctors to psychiatrists or other mental health professionals. Not everyone will experience the more serious mental health problems listed:
- Anxiety
- Depression
- Eating Disorders
- Manic Depression / Bi-Polar Illness
- Schizophrenia
- Obsessions
- Phobias
- Psychosis
- Self Injury
Further information in the format of leaflets can be obtained from the Carers Support Project and Advice and Resource Centre (GAMH), Local Health Promotion Centres, Mental Health Resource Centres and local Social Work Area Service Teams.
Some Suggestions from Mental Health Professionals as to the causes of mental illness:
- A genetic risk factor which may be inherited in some way.
- Biochemical factors – it may be that something is wrong in the way the brain works through unusual chemical changes in the brain.
- A person may have been exposed to an early environmental risk factor before or during birth. For example, the baby’s development may have been affected by infection in the womb or through difficulties at birth.
- One or more traumatic life events, such as family deaths, sexual abuse or a horrific accident. Some individuals seem unable to withstand as much stress as others.
- A lack of positive emotional support from others.
- A person may be suffering from an illness resulting from substance abuse – Korsakof’s Disease.
What Services Are Available?
Your relative or friend may be referred, treated and supported by a number of people or services listed in this section. This will depend on his or her diagnosis, types of referral that are considered appropriate, and the outcome of whatever assessments are made. Your family doctor is the person most likely to make the initial referral, although the GP will provide the help that he or she needs if the illness is not too severe. Many voluntary organisations working increasingly within the community operate a self-referral policy. A short list of useful definitions of who’s who is set out below, although it is by no means an exhaustive list:
Psychiatric Hospital
Admissions to hospitals are either informal or formal. Information on compulsory admissions can be obtained from local Psychiatric Hospitals or the Mental Welfare Commission, or Advocacy Matters based within the hospitals.
Community Mental Health Team
A group of mental health professionals, who are responsible for the caring, helping and treating of people, within the community. The team usually includes Psychiatrists, Psychologists, Social Workers, Occupational Therapists, Community Psychiatric Nurses, Support Workers, and Advice Workers.
Out of Hours Service (GEMS)
The Out of Hours Service provides a 24 hour 7 day a week community based crisis response. The aim of the service is to minimize the need for hospital admission and provide an immediate response service in the community where it is safe to do so. Access to the service is via the Glasgow Emergency Medical Service (GEMS) telephone triage system. The team has developed links with other out-of-hours agencies such as police, Social Work standby services and housing agencies.
Care Programme Approach (e.g. Housing, GP, Psychiatrist)
This is a multi-agency initiative, which involves more intensive supervision, monitoring and treatment of people with sever and / or long-lasting mental health problems.
Psychiatrist
A medically trained doctor specifically skilled to diagnose mental and physical illness and to prescribe treatment.
Psychologist
These are professionals who offer particular kinds of counselling and psychotherapy, such as ‘cognitive behaviour therapy’. They are specialists in ‘talking therapies’.
Community Psychiatric Nurse (CPN)
The CPN will assess and offer support to people with mental health problems. Some services include administering medication, providing ‘talking therapies’ and being the role of the key worker.
Occupational Therapists
This person will help people with skills that will restore self-confidence and promote independence, such as anxiety management, relaxation techniques, household skills and work practice.
Social Workers
The Social Worker will provide you with support and assistance in accessing services such as finance and housing. A Social Worker can carry out a comprehensive assessment of your needs if you ask for a Community Care Needs Assessment or a Carers Assessment.
Mental Health Officer
This is a social worker who has specialised training in mental health and who are ‘approved’ to apply sections of the Mental Health Act.
Support Workers
Support Workers will help to provide the emotional, practical and social support that enables individuals to sustain independent living in the community. They also assist with group work, advice and guidance.
Self-Help Groups
These will provide a forum fro people with similar problems to share their experience, information and offer support, encouragement and understanding.
Independent Sector Organisations
Voluntary Sector support services provide a professional service using a variety of skills and life experiences. They deliver a network of support services to the individual, and work collectively with statutory agencies to support long-term, sustainable independence for individuals who have mental health problems.
Glasgow Association for Mental Health has a number of support projects covering the whole of Glasgow . See the GAMH Directory, available at any GAMH Project.
How Can I Support Myself As A Carer?
Caring for a relative or friend with a mental health problem can be a stressful, exhausting and difficult task. The financial cost of caring can add to the stress that many carers go through. Carers need to remember to look after their own physical and mental health and it can be essential to try to receive advice and support. Talking to other carers who have experiences similar situations can often help. Emotional and educational support can help the carer, who may feel that they have no one to turn to. The points listed below are some helpful tips and coping skills that have been put together by carers, who, through their own experience, have found useful:
- Learning and getting the right information is essential.
- Make time for yourself and others – time out.
- It is okay to be upset or emotional.
- Someone to talk to who can understand and empathise with your situation – use support groups – how do others cope?
- Learn new strategies and share information and ideas.
- Focus on the positive things.
- Be involved, recognised and informed.
- You can request a Community Care Assessment for yourself and the person you care for via the local Social Work Area Service Team.
What Benefits Or Help Is Available?
Welfare Rights Advice
You can be provided with Welfare Rights Advice to promote full uptake of benefit. To do this, contact your local Social Work Area Service. You may also contact Glasgow Association for Mental Health on 0141 550 8822, who will advise and signpost you to your local advice service. The person you care for may have a worker with GAMH who can also direct you to local advice services.
What can I do if I need someone to talk to urgently? It would be helpful to keep a list of useful telephone numbers together so that you always have it handy. Telephone helplines are available if you want someone to provide emotional support in a crisis.
It would be useful to keep some telephone numbers handy:
- The Samaritans: open 24 hours a day. Telephone: Glasgow Branch - 0141 248 4488
- NHS Carers Helpline: open 9am to 8pm every day. Telephone: 0800 224488
- Phone the emergency social worker, your family doctor or other member of staff who is working with you. Talk to a friend or relative.
- CARERS SUPPORT LINE - 0141 353 6504
What Do I Do If My Relative Is Suicidal?
Firstly, take them seriously and listen to their reasons for wanting to kill themselves. Try to reassure them that these sad and desperate feelings will only be short lived and that there are many reasons to be hopeful about the future. If you continue to be worried about you or your relatives SAFETY, contact your family doctor, Community Mental Health team or local ‘on call’ service. Most surgeries and health centres have 24 hour cover, so someone should be available at night.
What Can I Do If My Relative Or Friend Becomes Violent?
If you feel in danger, dial 999 and ask for the police. Emphasise that your relative or friend has a mental health problem and requires help.
What Can I Do If My Relative Needs Somewhere To Stay In An Emergency?
Phone your local Social Work Area Service Team and ask for the Duty Worker. Outside office hours, and on public holidays, contact the Standby Service on 0800 811505.
Make a note of the numbers that you may need in an emergency.
Ambulance or Police - 999
Samaritans - 0141 248 4488
Social Work - 0141 287 2000
(Glasgow City Council Switchboard who will direct you to your local Social work Area Team)
Standby Social Work - 0800 811 505
GP -
Local Accident and Emergency Department -
Hospital -
Resource Centre -
Community Mental Health Team -
Psychiatrist -
Out of Hours (GEMS) - 0141 616 6200
Other -
Aims and Objectives
GAMH Core Purpose
The Association pursues aims which are primarily concerned with the health, social welfare and the attainment of social justice, for people with mental health problems and their carers, who live in the Glasgow area.
Carers Project Aims and Objectives
The project is a new development in Glasgow Association for Mental Health. The project support individuals who care for an adult, sibling, friend or any other relative, who through mental health difficulties require support to live in the community.
Our Aims and Objectives are:
- To support carers in their tasks as carers.
- To advance the education of carers and those they care for in social welfare.
- To promote the awareness of the needs of carers amongst professionals.
- To enhance, encourage and enable greater self-confidence by promoting self-help groups as defined by the carers.
- To provide advice, support and training to assist carers in the development of their own organisation / groups.
- To maximise the opportunities for carers to participate in recreational and educational opportunities.
- To encourage carers to make the best use of local services and make those needs known to service providers.
- To promote the principle and practice of equal opportunities for carers.
- To promote and raise awareness of mental health issues and the needs of carers.
The project aims to consult with carers and develop services that are needs led, with regular review and evaluation processes in place. Currently, several carers support groups have been developed. We aim to provide individual support to carers through a pool of trained volunteers, and hopefully a Drop-In in the near future.
The Carers Support project welcomes referrals from Carers and Professionals. Initially, carers receive an individual assessment. Types of support currently provided by our project are befriending, emotional support, advice, information, friendship, benefits advice and social support.
Acknowledgements
This Handbook attempts to take out the confusion of working your way through mental health services, especially when you are new to being a carer. I hope it will help to inform you, and make your role as a carer less stressful.
There have been many drafts, re-drafts, and hours of time put into compiling the Handbook, and I have been fortunate to have been supported by many enthusiastic, like minded people. I would like to thank the Overnewton Carers Group, and all the carers who filled out questionnaires. Matt Dunsmuir for designing an eye-catching front cover (this has not been included within the website).
All the staff, volunteers, students – especially Patricia Mullen, whose honesty and expertise was invaluable. Debbie, Geri and Brigitte in Admin Support for typing and re-typing again and again.
Finally, special thanks to Ronnie Sharp, Patient Services manager and the Greater Glasgow Primary Care NHS Trust for funding this publication.
Thanks again, everyone.
Shelley Paterson
Project Manager
Carers Support Project
This Handbook will also be available in alternative formats on request in Urdu, Punjabi, Chinese, in Braille and Large Print. It is also available at Mental Health Resource Centres and Psychiatric Hospitals, and Glasgow Association fro Mental Health Carers Support Project. It is also available within the Publications page of this website in Adobe portable document format (PDF).
Contact Carers Support
Carers Support Project
Glasgow Association for Mental Health
The Big
Issue Building, Room 3&4
71 Oxford Street
Glasgow
G5 9EP
Tel:
0141 429 7593
Fax: 0141 429 4731
Carers Support Email: carers@gamh.org.uk
GAMH Information
Email: webmaster@gamh.org.uk
Web Address: http://www.gamh.org.uk/
Related Link
Carers Support and Young Carers
To find out how to get to the Carers Support project or Young Carers project please click on the relevant external link below.
Location Maps: Carers Support Project | Young Carers Project