The experience of violence and help-seeking among mothers of adult chronically mentally ill individuals

Abstract

<p>Mothers of mentally ill adults are frequently primary caretakers. If mentally ill individuals become violent, mothers are most often victims. In their role as primary caretakers, mothers are knowledgeable regarding their children's illnesses. They are also familiar with the mental health system, including criteria for involuntary hospitalization. Mothers can identify signs of decompensation in their mentally ill children and recognize their need for hospitalization. They cannot, however, always access mental health treatment due to their children's refusal and/or not meeting legal criteria for involuntary hospitalization. This is problematic, particularly for mothers whose mentally ill, adult children have a history of violence. This study used Grounded Theory methods to explore mothers' experiences of violence perpetrated by their mentally ill, adult children and the process used to seek help when violence occurred. Mothers described periods of living on high alert, characterized by waiting in frustration while their children decompensated but did not meet involuntary hold criteria. Mothers used distraction, isolation, and reality orientation to manage their fear and uncertainty. Once their fear and uncertainty outweighed their abilities to manage the chaos their children created, they called the police or psychiatric evaluation (PET) teams, who served as gatekeepers to mental health treatment, for assistance. Mothers then dealt with responses from their children and gatekeepers, and accepted the consequences of being responsible for their children's involuntary hospitalization or of being left home with their children if the gatekeepers did not initiate involuntary hospitalization. Mothers discussed their children's limited housing options. For mothers, stable, long-term housing was a component of mental healthcare for their children. In the absence of conservatorship or a court order, long-term placement was not a possibility. Instead, mothers saw their homes, homelessness, or temporary board and care placement as the limited options available to their children. These three options were temporary and undesirable. Seven factors were identified as important to mothers in deciding which option they preferred for their children: concern for safety, children refusing/walking away from placements, advice from others, maternal obligation, imposing consequences for behavior, quality of available placements, and their inability to provide care.</p>