Research: Siblings need help too

A youth mental health worker now lecturing in occupational therapy at La Trobe University says the impact on siblings of young people experiencing mental illness has gone under the radar.

Siann Bowman says it’s crucial that families of people with mental illness are supported. ‘With an increasing number of adolescents and young adults still living at home, support for the family – including siblings – is vital. Sibling relationships tend to have longer durations than most other relationships. However little research attention has been given to the sibling experience of early psychosis,’ says Ms Bowman.

In this study, Ms Bowman surveyed 157 siblings during the first 18 months of their brother or sister’s treatment, looking at their knowledge of psychosis, their sibling relationship, burden being experienced, quality of life and the impact of traumatic events due to their brother or sisters illness.

Ms Bowman found that hospital admission, substance abuse, physical violence and suicide attempts greatly impacted on the sibling relationship and sibling quality of life, particularly social life. Younger sisters were most affected.

‘Siblings need to be included in early interventions of those adolescents or young adults with early psychosis, particularly individualised education to reduce burden, enhance coping and to identify those at risk. Parents also need education about the common experiences of siblings,’ says Ms Bowman.

As an example of the issues facing siblings, Ms Bowman cited a journal entry she made during data collection for her research:

Elizabeth is the younger sister of a 21 year old boy experiencing an early psychosis. He lives in the caravan out the back of the house, smoking cannabis, not taking his tablets and consequently extremely paranoid and persistently unwell. She spoke of her respect for him in his struggle as well as her despair and helplessness at his inability to manage life and do the things he needs to do to get well. She believes it has something to do with the death of their mother and her father not knowing how to help. Today she told me that her younger brother has just been referred to the early psychosis program (EPPIC) as well, as he too has started to experience symptoms of psychosis. She cried as she told me this. It was not a cry of panic but rather an expression of her grief. She reported feeling stuck in the middle, not knowing whether to move out of home and away from this situation or to stay and support them as best she could. She said she was doing well in year 12 and her friends were extremely supportive. I was struck by her courage and compassion for her brothers. She seems to have an intimate understanding of where they are in life and I do believe she would do anything to help them. I can’t believe she is only 18.

In Australia, official data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare demonstrate that one in four young people experience a mental disorder in any 12 month period (most commonly substance abuse, depression, anxiety, or a combination of these) and that mental disorders are the key health issues facing young Australians today, accounting for over 60% of the health burden in the 15–24 year age group.

Ms Bowman says the prevalence of mental health problems in adolescents aged 13 –17 years is 19%, rising to 27% in young adults aged 18–24 years. Depression and anxiety are the most prevalent mental health issues experienced by young people, with around 30% of adolescents experiencing a diagnosable depressive episode by the age of 18 years. Mental illnesses such as the psychotic disorders, personality disorders and bipolar disorder are less prevalent but have the potential to create severe long-term disability unless treated early and adequately with a focus on recovery.

‘It has been estimated that the financial cost to Australia of mental illness in young people aged 12–25 was $10.6 billion in 2009, approximately 70% of which is productivity lost due to lower employment, absenteeism and premature death of young people with mental illness,’ says Ms Bowman.

Youth is the peak period for the emergence of mental ill-health, with the onset of most mental disorders falling within a relatively discrete time band from the early teens to the mid-20s, reaching a peak in the early 20s.

‘We believe that over the next decade there is enormous potential to make significant progress in reducing the impact of mental illness on young people, their families and the community, says Ms Bowman.

‘There are three principal areas in which progress can be made: extending access to current best-practice supports to more young people experiencing mental ill-health; making new discoveries relating to the prevention, identification and support of mental ill-health in young people; and providing a stable and skilled workforce.’

(Source: La Trobe University)