The experiences of partners whose wives have a serious mental health disorder
Many studies have addressed the impact of a mother’s mental illness on her children from a child protection perspective. However, mental illness is not the only problem. Often, these mothers also experience marital and financial difficulties or single parenthood. Family and friends of people with a mental illness are already aware of this. What they need is more information about the partner’s experience in order to provide support for them and the family.
A recent study conducted in Quebec City by a team of researchers from Université Laval(1) and GRIOSE-SM (Groupe de recherche sur l’inclusion sociale, l’organisation des services et l’évaluation en santé mentale) interviewed fourteen mothers with a mental health problem, fourteen partners and eight young people, allowing them the opportunity to study the experiences of thirty-five different families. Approximately 100 caregivers and program managers were interviewed over the course of the same study. The results highlight four categories of difficulties or hardships experienced by partners and emphasize the critical role they play in this situation. These challenges are interrelated and the order in which they are presented does not reflect their level of importance.
Partners experience a sense of loss over their relationship when their spouse experiences a mental health problem. Depending on the symptoms, they may feel that their wife is no longer the same or that she is no longer present. They talk about their wives’ mood swings and impulsivity and the conflicts this creates. They also say the medication taken by their wives has affected their sex life. In this context, many admit to feeling alone. Not all partners react in the same way and different factors influence their attitude and behaviour. These include the severity of the crisis, the partner’s characteristics, their level of fatigue, health and distress as well as the information, assistance and support received. It should be noted that a partner’s actions will also have an impact on the person with the mental illness. While in some cases, the difficulties are accompanied by violence and lead to separation, in other cases, partners will experience a new sense of closeness and even attribute positive effects to their wife’s illness. A partner’s positive, calm and understanding attitude helps to maintain a good relationship. Many try to support and protect their wives. They take more responsibility in an effort to prevent any relapses. They also try to maintain a normal life by keeping in touch with the outside world, i.e., friends and leisure activities, which is confirmed and appreciated by their wives.
Partners feel overloaded when their partner can no longer function, i.e., taking care of the children and the house. They find it difficult to cope with the dual task of working outside the home and taking care of domestic and family tasks when they return home. They feel overwhelmed and at the same time criticized for doing things differently. The solutions are never simple. On the one hand, partners are not always able to take time off work or make temporary adjustments. On the other hand, it is not easy to find domestic help and all of these measures can have financial and relational impacts which can add to the stress already present.
Given the mother’s difficulties in functioning, it is often her parents or the partner’s parents (mainly women) who help with the children’s care and transportation, meal preparation and housework. However, this is not always easy, because misunderstanding and prejudices about mental illness also exist in the families affected by it. In addition, the ability to receive assistance depends on the health, availability and proximity of family members. So, it is not easy to ask for or obtain adequate and satisfactory help. Despite some family members’ essential and well-appreciated contribution, partners admit to feeling somewhat invaded in their daily lives by all the third parties called in as reinforcement. It can feel as if the solution to one problem has created another.
Finally, partners feel left out by the care team. They often know little to no information about their wife’s condition, so they search for the causes of the illness and come up with explanations of a physical (overworked, difficulty breastfeeding, post-traumatic stress), relational (difficult family relationships, adjustment disorder, feelings of guilt) or other nature. When they receive information from health care providers, they have difficulty absorbing all the information given to them. It is often their wives who tell them what is going on. They also feel that providers do not pay attention to them and their experiences, worries, concerns and suffering, nor do they take into consideration their knowledge of their wife’s situation or their views on her treatment and recovery. Partners frequently emphasized the importance of being informed, supported and consulted by their wife’s care team so that they can gain a better understanding of the situation and collaborate with one another.
The process that families of mothers with mental health disorders go through is marked by different stages, from the onset of symptoms or issues to their resolution and the mother’s recovery. However, between these stages, there may be other situations to manage, such as denial of the illness, the search for treatment, hospitalization, taking care of children and the reorganization of daily life. For some, hospitalization is not the worst time, because the tension decreases as caregivers take care of the mother and there is hope for improvement. On the other hand, we hope that family contact will not be severed during this period and that the mother is able to easily see her children. We want the health care system to understand the reality families face and support them.
Among the behaviours most valued by family members are courtesy, respect, attentive listening, accessibility of services and availability in emergency situations. They also want concrete help, including respite care services as well as reassurance, support and self-help options. They want flexible services that meet the needs of the mother and her family members, timely interventions for specific needs and effective treatments with minimal side effects. Partners want those involved in providing care to help them understand the illness, teach them to recognize the symptoms, reassure them, help them improve their relationship with their partner and distance themselves from family problems. This requires a better understanding of themselves and their own needs, the development of parenting skills and child-friendly support services.
Monique Carrière Ph.D.
Full Professor
Department of Rehabilitation – Faculty of Medicine
Pavillon Vandry – Université Laval
Québec G1K 7P4
_______________
1. Monique Carrière, Michèle Clément, Sylvie Tétreault and Geneviève Pépin assisted by Mireille Fortier and Steve Paquet.
