The understanding of illness is in the process of changing. The social aspect of health is being recognized more and more. One’s immediate environment is the family and it is essential that the family must be actively involved in psychiatric care. Psychiatric disorder in one member of the family is usually associated with the emotional disturbance of other members of the family. Therefore, active involvement of members of the family in the treatment programme should be encouraged. Family participation in psychiatric care at the Christian Medical College, Vellore has been practiced since 1957.
In India the traditional structure of the joint family is undergoing a change, still exists especially among the rural population. Department of psychiatry has the facilities to treat 124 inpatients. Average inpatients’ statistics per day is about 80-90%. 30-40 new patients and 400-500 review patients are being registered daily. The most frequent diagnosis is schizophrenia which is followed by neurotic disorders. The average length of stay as inpatient is about 4-6 weeks. It is essential that one or two members of the family should stay with the patient throughout the treatment programme. Patients and family stay in an open environment with very minimal restriction. Occasionally physical restraints are used to control violent behavior for a short time. There are small living units where patients and their family can stay independently.
The relatives are encouraged to take an active part in the treatment programme of the patients. They bring the patients for the Electroconvulsive treatment and supervise them throughout the recovery period. They bring the patients to occupational therapy section and participate in all the activities. When the patients are disturbed, they are of much assistance to the staff and they are often skillful in handling them. The nurse’s psycho educate, supervises the care, observe the patients and assist the relatives.
The relatives have group meetings, supervised by the occupational therapists, social workers and nurses when several aspects of mental diseases are discussed. They thus get an insight into the illness and treatment and also a chance to dispel many wrong beliefs and attitudes about psychiatric disorders which they have been entertaining. At the time of discharge, the relatives are instructed about the details of medication and follow up. The presence of the relatives with the patient is a comforting experience to the patients, especially to those who are leaving their homes for the first time. This minimizes the apprehensions of hospitalization.
Patients participate in the treatment without much reluctance because their people are with them always. During their stay in the hospital, the relatives become aware of the early symptoms of a relapse and they are prompt to bring the patients for treatment at the very early stages of relapse. They get more insight into the rehabilitation of the patients. During their stay in the hospital, the relatives of all the patients get more awareness into the various aspects of psychiatric disorders and they are able to disseminate this knowledge into the society.