Parents of mental patients

When discussing mental (not retarded) patients, many people are not aware of what the parents are like.  I had a some contact with them when running a home for male patients in their 20s and 30s.

Usually one parent called about visiting the home.  (Why didn’t the son call?)  The parents and son would arrive  (once this was a father in a Rolls Royce with black eyes the son had given him).  They would tour the house, sit down, whip out a cigarette, and discuss arrangements.

Usually the mother did the talking.  When the conversation was directed to the son, he sometimes bungled it.  The parents would fill in; the son would interrupt and bungle it again.  There would be smiles and laughs, but underneath smoldered resentment.

One mother said she would be taking her son home on weekends – just like that – his opinion meant nothing.

When some parents read the rules, I saw them smirk.  Here was what they had been trying to get their son to do for years.  I thought they would support me.  How naïve.

After one patient had been in the house a while, I complained to his mother about his not cleaning his room.  She said, ‘Oh, Tom never cleans his roooooooooooooom!’  as if someone had forgotten to tell me.

During the week I would get the patients out of bed, have them take care of their cooking, laundry, chores, and get them off to catch the bus for their therapy.  On weekends some parents let them come home, sleep the whole weekend, and did everything for them.

One couple said they would be ‘ever so grateful’ if I could get their son on his feet.  But they wouldn’t go to family therapy, they had him home weekends, and eventually let him move home. Nothing was worse.  He spent most of the next three years in bed.  He wasn’t ‘sick;’ he did it to escape.

 While it was easy to fault the mental health system, patients and their parents seemed out to prove the system bankrupt so the son could move home:   ‘We’ve had him in hospitals, care homes, and all sorts of programs; no one cares nor can help him’.   (No one could help the patient if he didn’t want help, and if they kept making it too easy for him.)

‘It’s been terrible, but he’s home now’.  (what they had wanted all along).  Then too, once home they got part of the son’s check.

The parents love had smothered their sons over the years, giving and giving, never confronting, nor taking a stand.  Once the sons were seen as ‘sick,’ parents felt they had to give even more.  The sons could make their parents jump through hoops for cigarettes, spending money, long distance calls, attention, favors – whatever.  They weren’t devious, just immature.  A lot of their behavior was testing.  They wanted someone to set limits, but their parents wouldn’t, nor would the mental health system.

The parents ignored the fact their sons wouldn’t take care of their hygiene, clothing, chores, manners, work habits, etc.  If they couldn’t handle these small responsibilities, they couldn’t handle the big ones involved in getting well.  That must be why patients went in and out of hospitals, homes, and programs over the years, costing some parents all their insurance and savings.

When parents found a hospital or doctor they liked, some went overboard describing it or him as ‘so wonderful, caring, warm, dedicated, fantastic’.  They were looking for magic.  One couple talked about their son ‘snapping out of it’.  Nothing was further from the truth; progress is slow and painful.   One mother held hands with her son during therapy.  Another in a documentary brought her son candy and fawned over him,

‘Oh, he’s so wonderful; just look at him.  Oh, I love him so much ..’.   The son got the candy, turned his back on her, and went to his ward.   He cared less.    Parents and sons were mutually dependent and resentful – sometimes to the point of great anger.  Little wonder there was the conspicuous absence of one parent who had washed his hands of the problem.  Others had too.  Hence the comments of the one parent remaining:

‘He doesn’t have anyone but me.  He has no friends; no one cares’.  (There was no point in caring; the parent had made the son a baby, and the system had reinforced it.)

Parents and sons couldn’t be separated with a crowbar.  One operator of one of these homes put it in an interesting way.  ‘If some patients got well, the parents would divorce, as their son’s problems were the only thing keeping them together’.

Much later I joined a parents group.  It seemed to hold promise, but their main interest was more and more ‘care, treatment, services, therapy and programs’ (each word meaning the next). When I said their sons weren’t going to get well without learning responsibility, they didn’t want to hear it.  When a former patient said she began to get well only after realizing it was her respon­sibility as her folks had moved out of the country, they missed the point.  They would work for improvement at the higher levels of the system, but wouldn’t look at the nuts and bolts.

Parent duties

  1. Prohibition of adult patients from living with or close to their parents.
  2. Lengthy outlines on matters which might have contributed to the patient’s condition.
  3. Parents to do nothing for their son he can do for himself.
  4. Only one call per week and one day visit per month.
  5. Withdraw from major respon­sibilities in his life.
  6. Mandatory family therapy.

Parent rights

  1. To be dealt with in plain language
  2. To periodically rate all agencies, programs, and staffs.
  3. To assure records are completed, used, and transferred on time.
  4. Some way of assuring that those involved with their son collaborate regularly
  5. Access to the family therapy part of the record.
  6. Access to a descriptions and ratings of all agencies, medications, programs, relevant literature, and key staff.